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Trying to Understand EPap, IPap & RS
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #21
RE: Trying to Understand EPap, IPap & RS
(05-21-2014 07:04 AM)BiBob Wrote:  So, if my sleep test indicated that a pressure of 18 cmH2O was required to eliminate most OAs, I should set my min EPap close to that. If that's true Instead of 14 I should set min EPap at 15 or 16 with max IPap at 22 and RS at 2. That way when events are sensed, the difference in pressure required to minimize OAs is less than when I've set min EPap at 14 and therefore quicker.

Is this correct?

Hi BiBob,

Yes. Considering your 95% pressure has been a lot higher than 14, therefore a Min EPAP of 15 or 16 would likely be better.

But at the same time, your titrated pressure was likely high enough to prevent most obstructive apneas/hypopneas (on that one night, at least) when you were sleeping on your back, in the "supine" position. Your current 95% pressures may be similarly high because you may be continuing to spend some time sleeping on your back.

Obstructive Sleep Apnea is usually very positional, with the worst position usually being sleeping on our back. That is why sleep techs try to get us to spend at least some time on our back, so they won't miss the usual worst case sleeping position.

My point is that if we can ensure we will never sleep on our back our pressure needs will likely be much lower. Less presure means fewer side effects from high pressure, perhaps less air swallowing, perhaps fewer Centrals. On some people high pressures can cause dizziness or ringing (tinnitus) or hearing loss, or air and nasal mucus to come out the tear ducts after being pushed into the eye socket.

So doing what we can to lower our needed treatment pressure is usually a good idea.

I sleep in a snug teeshirt with a tennis ball in a pocket sewn right between the shoulder blades, to ensure that when I roll onto my back while asleep I wake up just enough to keep rolling, onto my other side.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 05-21-2014 09:50 AM by vsheline.)
05-21-2014 09:37 AM
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