Can someone help me to see if I need to adjust my pressure settings

[kalannar]

I have been seeing huge ramp ups in pressure on my machine.  Want to make sure everything is ok, and if there are any adjustments I should make to the settings.  Any help would be appreciated.  Thank you.

[staceyburke]

Welcome to the board.  

You have pressure increases because of the flow limits, Resmed raises pressure when it finds flow limits to stop them from becoming larger O or H events.  Flow Limits are apnea just like O or H events but they are smaller and not as long (an O or H has to be 10 seconds or longer to be classified as O or H).  I have how they are classified in the signature at the bottom of this post.

You can stop most flow limits by using EPR (exhale pressure Relief).  Your setting are not using EPR at all.  I would suggest making these changes.

Change EPR to FULL TIME
EPR 3

That will help with the pressure swings.

[kalannar]

I set the settings you suggested. So I set my pressure to 7-20, saw my MED was 9.98 and upped my min pressure to 8 using the article that said to set your min pressure to -2 of Med.  I have attached the two nights, should I up the pressure some more?  Or do my numbers look good?  Thanks for the help.

[SarcasticDave94]

It's getting better with this latest setting. I think I'm seeing a small amount of Positional Apnea clusters. Check your pillow and see if it's thin or too thick. Thick or several pillows may cause your chin to tuck towards your chest, causing external force to restrict the airway. If this applies, you'll either need that thinner pillow or maybe a soft cervical collar to block the chin tuck.

[kalannar]

I have a hiatal hernia, and my doctor suggested I try sleeping on a wedge pillow, which I have, to keep the acid from going to my throat and lungs.  So I use the following https://www.amazon.com/dp/B08DHKD7CN?psc=1 pillow with another soft pillow on top.  Should I try removing the pillow and seeing if that helps?

[SarcasticDave94]

That might help. You'll possibly need to adjust things with various wedge sizes, configurations to get the balance between acid reflux and Apnea events control.

[Sleeprider]

Please read the Positional Apnea article here https://www.apneaboard.com/wiki/index.ph...onal_Apnea Wedge pillows or sleeping on an incline are common reasons we see clusters of obstructive apnea. It is the physical blocking of your airway caused by your chin dropping toward your chest that causes the obstruction that cannot be opened by normal CPAP pressure. We can show you the source of the problem, but you're going to have to consider the best way to deal with the positional apnea caused by inclined sleeping, while not making your hernia worse. Are you also on antacid therapy?

[kalannar]

I was taking Nexium but my lung doctor suggested I try sleeping with two pillows or wedge pillow with Tums if needed, so I didn't have to use Nexium everyday.  Would the collar with the wedge work?

[SarcasticDave94]

Yes you can try that combo. I myself have a hiatal hernia with bad acid reflux. I'm taking Rabeprazole, a PPI, and have an electric tilt home hospital bed to facilitate my tilt needs.

My hernia won't be surgical repaired as it was once already during bariatric sleeve surgery. Surgeon said to repair the hernia now will require bariatric revision to the old bypass style, Dave says no-go.

[kalannar]

Ok will try. Are my min-max pressure find then?