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[Treatment] New CPAP user with OSCAR data---High AHI
#21
RE: New CPAP user with OSCAR data---High AHI
Ramp is needed only when you need a brief transition to your therapeutic pressures. Most, not all, of the senior people do not use a ramp at all.

ResMed uses Flow limits as a signal to increase pressure to prevent obstructive events. Pressure difference, EPR for ResMed CPAPs, between EPAP/exhale and IPAP/inhale pressures is what best treats Flow Limits, Hypopneas, RERAs, UARS, a ND even snores. Most of the medical community assumes that EPR is only a 'Comfort' feature, it is not.

How to know? Look at the charts. Pressure will increase after flow limits, and after Obstructive events, to prevent future events.

If EPR does not lower your high pressures I would lower your max pressure to increase your comfort. Using EPR will also increase your 'comfort', after all it is a 'comfort' feature.
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#22
RE: New CPAP user with OSCAR data---High AHI
(06-02-2020, 08:25 AM)format Wrote:
(05-30-2020, 09:00 PM)Crimson Nape Wrote: Two things that are probably happening.  You are sleeping on your back and your Flow Limit is what is driving your pressure so high.  I would recommend setting your EPR to 3 and "Full Time".  Try sleeping on your side.

The recommendation above is based on the report listing an AirSense 10 for Her.  Your profile lists an AirCurve 10 VAuto.  Why are you using the AS 10?


How about his idea?  Ramp only is really better? thaks
https://myapnea.org/forum/not-understand-epr-setting

This Sleeptech doesn't understand that Flex is a proportional response to your breathing and EPR is a fixed response.  EPR, with the limited values it has of 0,1,2,3, behaves identically to pressure support on the next machine up, the BiLevel, not so with flex.  He is correct in that the reduction of pressure from EPR must be accounted for., You are on a 'self adjusting' auto machine and at far higher pressures than where this will be applied and we will evaluate the effects of the change 

This Sleeptech seems to be very Old-school

Look at the breath waveform from both a CPAP with EPR and a ResMed BiLevel with PS and see for yourself.
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#23
RE: New CPAP user with OSCAR data---High AHI
Using an EPR of 3 will make your CPAP act as a Bi-level machine. This will provide higher pressure during inhale helping overcome the flow limitations. If you can overcome the flow limitations, the CPAP's pressure will not increase to its limits. Ramp only EPR is for comfort only and not for apnea therapy.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
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Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
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Apnea Helpful Tips

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#24
RE: New CPAP user with OSCAR data---High AHI
Crimson Wrote:Using an EPR of 3 will make your CPAP act as a Bi-level machine.  This will provide higher pressure during inhale helping overcome the flow limitations.  If you can overcome the flow limitations, the CPAP's pressure will not increase to its limits.  Ramp only EPR is for comfort only and not for apnea therapy.

bonjour Wrote:This Sleeptech doesn't understand that Flex is a proportional response to your breathing and EPR is a fixed response.  EPR, with the limited values it has of 0,1,2,3, behaves identically to pressure support on the next machine up, the BiLevel, not so with flex.  He is correct in that the reduction of pressure from EPR must be accounted for., You are on a 'self adjusting' auto machine and at far higher pressures than where this will be applied and we will evaluate the effects of the change 

This Sleeptech seems to be very Old-school

Look at the breath waveform from both a CPAP with EPR and a ResMed BiLevel with PS and see for yourself.

ok, I enable EPR and Using an EPR of 3 to overcome the flow limitations, also I put on cervical collar's cover already, still high AHI.

How to improve it? What happened to me? please advise, thanx

   
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#25
RE: New CPAP user with OSCAR data---High AHI
Set your min pressure to 10 based on your previous charts, you have since set EPR=3 fulltime which is treating your flow limits much better.
What are you doing to treat the clusters?
If you are using a soft cervical collar it is not fully working. Is your chin tucking behind / under the collar? Is the Collar tall enough?
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#26
RE: New CPAP user with OSCAR data---High AHI
(06-12-2020, 06:39 PM)bonjour Wrote: Set your min pressure to 10 based on your previous charts, you have since set EPR=3 fulltime which is treating your flow limits much better.
What are you doing to treat the clusters?
If you are using a soft cervical collar it is not fully working.  Is your chin tucking behind / under the collar?  Is the Collar tall enough?

I use both, not working

https://images-na.ssl-images-amazon.com/...L1500_.jpg

https://img.alicdn.com/imgextra/i3/22006...459174.jpg
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#27
RE: New CPAP user with OSCAR data---High AHI
Try wrapping a towel around the chin area to get a higher height at the chin, or buy a taller collar. I'm not fussy on how but something needs to be done to improve the collar use. You could try and limit yourself to only side sleeping in addition to the collar.
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