EPR 1, hight flow limit, but lots of CA

[throwaway1242]

Hello!
 
After a couple of months of not trying CPAP I'm starting again! I recently got a new mask micro Nova nasal pillow and I found it much more comfortable.
I noticed my flow limit was high for 95% (0.09), and I seem to have a lot of CAs.  I know people want me to try EPR 3 to combat high flow limit, but EPR 3 has always been hard for me to breathe in.
Should I also increase my upper pressure limit too?

My starting pressure is 8.2, upper limit is 9.6.
EPR: 1

Below are my charts:

   

[staceyburke]

I not sure what you mean EPR makes it harder to breath in.  All that EPR does is lower the EXHALE pressure by 1, 2 or 3 CM.  It does NOT raise or lessen the inhale pressure.  

second thing is you do NOT have a lot of CA events.  You can try EPR and see how that effects the flow limits.

[Deborah K.]

Raise your pressures to 9.4 - 11.  Your median pressure is 9.4, so that's a good place to start.

I also suggest that you turn EPR on full time set at 3.  This should be more comfortable, and, more importantly, it will lower flow limits, which are short, unreported apneas that we want to get as low as possible.

[throwaway1242]

Raise your pressures to 9.4 - 11.  Your median pressure is 9.4, so that's a good place to start.

I also suggest that you turn EPR on full time set at 3.  This should be more comfortable, and, more importantly, it will lower flow limits, which are short, unreported apneas that we want to get as low as possible.

Increasing my EPR means increasing my starting pressure, and I found higher pressure causes nasal congestion, which is partly why I keep pulling the mask off after two hours

[throwaway1242]

I not sure what you mean EPR makes it harder to breath in.  All that EPR does is lower the EXHALE pressure by 1, 2 or 3 CM.  It does NOT raise or lessen the inhale pressure.  

second thing is you do NOT have a lot of CA events.  You can try EPR and see how that effects the flow limits.

Raise your pressures to 9.4 - 11.  Your median pressure is 9.4, so that's a good place to start.

I also suggest that you turn EPR on full time set at 3.  This should be more comfortable, and, more importantly, it will lower flow limits, which are short, unreported apneas that we want to get as low as possible.

Increasing my EPR means increasing my starting pressure, and I found higher pressure causes nasal congestion, which is partly why I keep pulling the mask off after two hours

[Phaleronic]

Increasing my EPR means increasing my starting pressure, and I found higher pressure causes nasal congestion, which is partly why I keep pulling the mask off after two hours

It's the inverse, turning EPR on to 1 decreases min/epap pressure by 1cm, EPR on @ 2 decreases min/epap by 2cm.  The issue is that when EPR is turned on the delivery of inspiratory pressure is delayed, so if you're having congestion issues, turn it off.

[SeePak]

Hi throwaway.

I also just got the micro pillow mask, working out ok for me so far.
Now using the large pillows, seems to sit better on me when moving around and less leaks.

What setting are you using for mask on the machine?

Your stats show 6.6 cm for pressure, is that from a sleep study?

How have you been sleeping?
Are you tired or fatigued during the day?

Do you get exercise during the week?

Also, for your Oscar chart, if you could get rid of the calendar, we can see more of your statistics and settings.

Thanx

[Deborah K.]

You don't need to raise your start pressure to use EPR set at 3.

[OpalRose]

throwaway1242,
I've gone back and looked at all your threads.  You've received some good basic advice here.  

I know you have an aversion to higher pressure, but if you study your pressure graph, you'll see that your pressure and Epap have been pretty steady.  Your pressure is not going past 9.4 and your maximum is set at 9.6cm.  You are already at those pressures for most of the night.  

I can't say what is exactly causing you to remove your mask except maybe the high flow limitation rate. This is known to be disruptive to sleep. And as you're aware, the one proven way, which we have seen many times on this forum, to lower FL is to use EPR and/or raise your pressure a bit.

You don't have to raise the pressure if you don't want to, but as I said, you are already at 9.4 for a good part of the night.
Go slower with this until you feel more comfortable. The FL is what is trying to raise your pressure and that may be what's waking you. At least try setting the minimum at 9.4 as suggested above and try EPR set at 2. Let's see if that helps.

In the meantime, try using your machine and mask an hour or so before bed, just sitting up reading or watching TV.
You would be surprised how fast you could adapt if given a chance.

[throwaway1242]

               

throwaway1242,
I've gone back and looked at all your threads.  You've received some good basic advice here.  

I know you have an aversion to higher pressure, but if you study your pressure graph, you'll see that your pressure and Epap have been pretty steady.  Your pressure is not going past 9.4 and your maximum is set at 9.6cm.  You are already at those pressures for most of the night.  

I can't say what is exactly causing you to remove your mask except maybe the high flow limitation rate. This is known to be disruptive to sleep.  And as you're aware, the one proven way, which we have seen many times on this forum, to lower FL is to use EPR and/or raise your pressure a bit.

You don't have to raise the pressure if you don't want to, but as I said, you are already at 9.4 for a good part of the night.
Go slower with this until you feel more comfortable.  The FL is what is trying to raise your pressure and that may be what's waking you.  At least try setting the minimum at 9.4 as suggested above and try EPR set at 2.  Let's see if that helps.

In the meantime, try using your machine and mask an hour or so before bed, just sitting up reading or watching TV.  
You would be surprised how fast you could adapt if given a chance.

Hello OpalRose, thank you for going through my posts and helping me out. I have tried EPR 3, and minimum pressure of 9.4, unfortunately I still rip the mask off without me knowing .
Is there anything in the leak rate that could be causing this?

Thank you for your time!
Below here are my data.