Abnormal I:E ratio?

[Kobayashim4ru]

Hello everybody,
 
While my AHI is generally good (2 or below, I don’t wake up too often and I am not tired during the day), I noticed that my I:E ratio is always a little bit abnormal from what I read on this forum.
 
Could you take a look at my charts please? 
 
Thank you again for everything, I learn a lot from all of you.
 
Frank

[Sleeprider]

I:E ratio here is nearly equal and not a major concern, however I think there may be an opportunity to further leverage EPR to minimize flow limits. While there are some CA events, this is not central apnea. Increased ventilation may increase those, but it should relieve the flow limitation, RERA and hypopnea. Only one way to know for sure.

[Kobayashim4ru]

Hello Sleeprider,

Thank you for your time.

As suggested, please find my chart with EPR 2.

I noticed that some of my ''CA's'' tonight were longer than usual (up to 26 seconds).

Thanks again!

[Sleeprider]

Still not too bad. The OA is clustered in 3 places like a positional issue, so watch extra pillows or sleep positions that encourage chin-tucking. There is a reduction in flow limits, No RERA, and no real changes in respiration. I'm not too concerned with the CA at this point and think it may be more related to adapting to the better ventilation or pressure. I think, try this another night and if the trend for higher CA continues we can move back to less EPR or try a fixed pressure, probably somewhere near your current median pressure of 10.4. While I can see CA is worse in these charts, I'm more concerned with how you qualitatively perceive comfort and sleep disruption.

[Kobayashim4ru]

Hello Sleeprider,
 
Thank you, I will try again with higher EPR tonight.
 
Just to have a better understanding of how good or bad my situation really is, am I more into the « optimizing / comfort zone » of my treatment or are there changes that need to be done because my therapy is not effective/safe the way it is now?
 
Once again, I cannot express how grateful I am, thank you so much Sleeprider.
 

[Sleeprider]

I'm not going to pretend you should be satisfied with current results, however progress needs to measured in more than AHI. The reason I emphasize comfort and your quality of sleep feedback, is that is the more important metric at this point to see if we are moving the right direction. There is no reason to think the CA events won't improve, and while we are optimizing settings, I have also pointed out that part of the problem is likely positional. That needs to be an area of greater focus. Check out our positional and soft cervical collar wikis.
https://www.apneaboard.com/wiki/index.ph...onal_Apnea
https://www.apneaboard.com/wiki/index.ph...cal_Collar

[Kobayashim4ru]

Hello again,

As suggested, here is a second night with higher EPR.

I noticed that my FL numbers are going the right way! I woke up 3 or 4 times, but the night was not that bad and I was not tired today.

I also purchased a cervical collar recently and I will try it again to avoid chin tucking.

Thanks a bunch!

[Sleeprider]

You have pretty much killed the positional stuff...congrats. I think the CA events may be sleep stage disruption and other things, but you might want to try EPR 2 to see if that cuts it back a bit.