12-07-2017, 04:33 PM
RE: help!! Bad machine??
From what I can tell, you did great, and the machine increased pressure to prevent most events. Your median pressure was over 13, so my suggestions of 10 or 11 were actually pretty conservative, and nothing you have not already experienced. Let me explain why higher pressure might be good for you.
With your EPR at 3, a minimum pressure of 7.0 is needed to take full advantage of EPR, because the minimum pressure the machine will output is 4 cm, so at a minimum CPAP pressure of 4, you actually have IPAP/EPAP pressures of 4/4, 5/4, 6/4, 7/4, 8/5, 9/6, etc. As you can see, with low pressure, the EPAP is stuck at an ineffective pressure, which can allow the airway to collapse, and in your case, the EPAP did not rise above 4-cm for nearly 30 minutes after starting therapy. In addition, starting at a higher pressure can often prevent the machine from going quite as high because your airway is more stable. Finally, less pressure change is less disruptive to your sleep. So there are good reasons to optimize the minimum pressure. You should do what makes you most comfortable, and it's fine to ease into it.
Keep an eye out for clustering obstructive events. That could be a sign that your sleep position is contributing to airway obstruction, and is an easy problem to fix.
![[Image: attachment.php?aid=4039]](http://www.apneaboard.com/forums/attachment.php?aid=4039)
With your EPR at 3, a minimum pressure of 7.0 is needed to take full advantage of EPR, because the minimum pressure the machine will output is 4 cm, so at a minimum CPAP pressure of 4, you actually have IPAP/EPAP pressures of 4/4, 5/4, 6/4, 7/4, 8/5, 9/6, etc. As you can see, with low pressure, the EPAP is stuck at an ineffective pressure, which can allow the airway to collapse, and in your case, the EPAP did not rise above 4-cm for nearly 30 minutes after starting therapy. In addition, starting at a higher pressure can often prevent the machine from going quite as high because your airway is more stable. Finally, less pressure change is less disruptive to your sleep. So there are good reasons to optimize the minimum pressure. You should do what makes you most comfortable, and it's fine to ease into it.
Keep an eye out for clustering obstructive events. That could be a sign that your sleep position is contributing to airway obstruction, and is an easy problem to fix.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com
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Apnea Board Moderator
www.ApneaBoard.com
____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
