I could use some help

[tiredaf]

Exactly, I want patience as of yesterday! 

In your opinion, the range has been 8-15 for only a couple of nights, should I leave it alone for a while? What would changing the EPR do?

[Crimson Nape]

Theoretically, an EPR reduction "should" reduce your CAs.  EPR is a double-edged sword.  Increasing its value will help to reduce your flow limitations, but at the risk of increasing your CAs.   The EPR's pressure difference aids in washing out some of the CO₂ that your body uses to signal a breath, thus the increase in CAs.  Over time, your body will adapt to the CO₂ reduction. . . to a degree.

- Red

[tiredaf]

I've been trying to give these settings some time but the CAs are killing me. If you look at the attached, you'll see a ton of them right before I woke up at around 4:30. I then read a book for a bit before falling back to sleep. I'm trying to get my AHI below 5 in order to be FAA compliant (trying to earn my pilot's license) Should I try turning the EPR down to 2?

[Gideon]

Yes, try EPR=2

[tiredaf]

Will do.  Are the CAs waking me up,  or are they a byproduct of waking up? Kind of a chicken before the egg type of scenario?

[tiredaf]

Dialing the EPR down to 2 to reduce CRs was a success! THANK YOU!

2 problems though. 1 Large Leak event starting around 2:20am which I may have to solve with a chinstrap or tape. The second was the rapid succession of events right after the Large Leak and prior to me waking up. I'm hoping the CR events continue the downward trend but why are so many of them popping up right before I wake up? Is it simply because of the increased brain activity?

[Sleeprider]

Try to avoid a chinstrap as it can often pull your jaw back and obstruct your airway. Find a way to apply upward pressure to the back of your jaw to encourage your mouth to remain closed. A soft cervical collar can often do this, or if you lay on your side pull a corner of a flexible pillow between your shoulder and jaw. The cluster of obstructive apnea at 02:55 suggests a cervical misalignment consistent with chin-tucking which can be resolved with a soft cervical collar. Both Bonjour and I have the soft cervical collar wiki linked in our signature. Your therapy is looking a lot better.

[tiredaf]

Thank you,  my AHI has finally been below 5 for the last several nights with only a few (if any) large leaks per night. If it continues to be a problem, I will definitely look into a collar. I wouldn't mind getting my AHI down even more but this is acceptable until the treatment emergent CAs run their course.

[tiredaf]

Here's where I'm currently at. After dialing my EPR down to 2, it reduced my CAs down just enough to keep my AHI barely under 5 and I'd like to gain a bit of breathing room to meet FAA requirements. Since turning my pressure up from 5-15 to 8-15, I've noticed a slight increase in leaks throughout the night. These aren't mask leaks, the pressure is escaping from my mouth. What I'm thinking is, reduce my pressure a bit to 7-15 to try to reduce leaks and dial my EPR down to 1 to reduce my CAs. Right now, my obstructive apneas are the least of my concerns, I HAVE to get these CAs down more. Thoughts?

[Crimson Nape]

For me, mouth breathing normally occurs when I am using too much pressure. Also, after looking at your Flow Limits, You could easily reduce your EPR as well. This will help in reducing your CAs. Just remember, that this will increase your EPAP pressure accordingly. Using an EPR of 2 with the 8-15 is basically the exact same EPAP pressure range as an EPR of 1 with a 7-14 setting. You may wish to try a 6-13 when using an EPR of 1 to actually reduce your EPAP.

- Red