[CPAP] New CPAP user, what are some settings/tips/optimisations I can use to better it?

[Determinism]

Thank you Ron Aka for your help! I will get the chin strap and see if it helps. With the taping so far I feel great with no discomfort. I'm assuming that I turn a lot in the night and its during these turns that the seals are getting stressed and leaking some air. Maybe I should just train myself to sleep on my back all night. I've been a side sleeper mostly all my life. You mentioned that it appears EPR ramp is not turned on. How do I check this?  I have the ramp time set to auto and EPR Type to Ramp Only. Start Pressure(under ramp time) is at 4.0.

If you set the Ramp Start to 4 cm it will not do anything as that is the minimum pressure the way you have your machine set up. If you change your minimum pressure to 9 cm, and keep the Ramp time on Auto, I would suggest setting your Ramp Start to 6 or 7 cm, or what feels comfortable to you when you are awake. It will hold the pressure at that say 7 cm and apply the EPR during the ramp time, but when you go to sleep it will ramp to 9 cm at 1 cm per minute.

Ron, thank you for the explanation. Just to make sure I am understanding it right...if I want a min pressure of 12 cm(the goal is 9 cm but since epr is 3 I'm setting it to 12), would a ramp start pressure of 9 cm be good for starters? My EPR type is currently set to full time. I'm a bit confused.

[Determinism]

Don't ignore the humidity settings.  I find a major difference in congestion and airflow at different humidity levels.  It took me weeks to dial in the right humidity setting.  Once I found that, the pressures that I needed to maintain an open airway dropped as well.  Also, dropping the pressure eliminated my need for a chin strap since it became easier to breath through my nose.

If you do need a chin strap, pay attention to when you are breathing through your mouth.  If you're breathing OUT through your mouth, EPR or Bi-Level might help, since that will lower the pressure on expiration.  If you're breathing IN through your mouth, then your pressure might be too low, or you might be suffering from nasal congestion, which can be caused by the wrong humidity levels....

Thanks for your response. I will get fine tune the humidity settings over the next few weeks.

Your results are excellent, and the advise above is pretty good. I am going to add a suggestion to try EPR (exhale pressure relief) to increase comfort. Your only events are hypopnea, and EPR can actually work to minimize that, but in your case the event rate is already low. EPR for you will be a comfort setting. Along with your new minimum pressure of 9.0, try EPR Full Time at 2. You can increase or decrease it according to your comfort. I see no drawback to using EPR and I think you will like the results.

Thank you Sleeprider. One question, if I'm aiming for an min pressure of 9.0 with EPR full time at 2 cm shouldn't my min pressure should be set to 11 cm?.

[Determinism]

[attachment=5457]

Wow! AHI is almost down by half with the new settings you guys recommended. Thank you so much. I'm still losing my mind about how I haven't removed in the mask even once in the whole night! That's almost a first.

[Walla Walla]

Determinism, If your EPR is 3cm than you want to set the ramp pressure to 7cm to get the full effect of EPR. Any pressure below that will reduce the EPR because pressures won't go below 4cm. The ramp is just for comfort so it doesn't really matter where you set it. It just delays treatment while you try to fall asleep. So set it to whatever is comfortable or you can turn it off like a lot of people do.

[Sleeprider]

Wow! AHI is almost down by half with the new settings you guys recommended. Thank you so much. I'm still losing my mind about how I haven't removed in the mask even once in the whole night! That's almost a first.

That result is as close to perfect as it gets.  Congrats. I'll just add that the use of EPR can be an effective treatment for hypopnea. There is no need to over-think this on your machine. You benefit from the IPAP/EPAP pressure difference and your machine self-adjusts to give you the minimum pressure you need. Just enjoy.

[Ron AKA]

Ron, thank you for the explanation. Just to make sure I am understanding it right...if I want a min pressure of 12 cm(the goal is 9 cm but since epr is 3 I'm setting it to 12), would a ramp start pressure of 9 cm be good for starters? My EPR type is currently set to full time. I'm a bit confused.

If you set minimum to 12 cm and EPR at 3 cm full time, then I would suggest trying a Ramp Start pressure of 7 cm. And set Ramp Time to Auto. I think 9 cm might be a bit high, and you may feel like you are getting too much air. But it really is what you feel comfortable with when you are awake and trying to go to sleep.

A 7 cm Ramp Start will start you out each night with a constant 7 cm on inhale and 4 cm on exhale. That should be quite comfortable for going to sleep. When the AirSense decides you are asleep it will ramp you up from 7 cm to 12 cm over 5 minutes.

Based on your latest chart it looks like a max of 14 is still OK with EPR at 3 cm. Just watch to be sure you are not hitting the max more often and having events. At this point it looks good though.

[trish6hundred]

Hi Determinism,
sounds like you are off to a great start with CPAP therapy.
Good luckk/