RE: JKan Therapy Analysis
Thanks for the graphs and your great... the results speak for themselves!
You probably have seen this video link - EPR negative opinion as well as several Lanky Lefty' s videos.
It works for some, as clearly evidenced as above.
Your last graph seem to prove quite conclusively that EPR off works just fine also.
If it continues this way, you are in a good place to stay. Obviously keep monitoring until completely settled down.
It looks like perhaps EPR was causing after all C02 flushing.
Only you will know. Hopefully the flow limitations will reduce over time, but if you are sleeping well, who cares anyway!
Most likely you may be quite insensitive to these. Which is a piece of real luck!
Your graph presentation and method were extremely well thought out,
Keep on track!
RE: JKan Therapy Analysis
Hey Expat31,
Thank you very much for your feedback!
Yes, I did see both Nick and Jason's videos on EPR. As of late, I am having NO issue with EPR being off. I wonder though, if I bring it back to some degree or full, will it have a positive effect on my flow limitations numbers? Also, lately I have been having a few more hypopneas. My central's have dropped significantly, though. It has been over a week since I have had any obstructive apnea, and it seems a fixed 9.6 has cleared those up. Tonight was the 4th night in a row at 9.6 and EPR off.
I feel pretty good right now for only having 6 hours of sleep tonight. I woke up at 3 am and thought I'd hit the bathroom and go back to bed. But after reconnecting, I thought, No, I'm ready to go. I'm not sure what's up with that. LOL
I am amazed at how smooth my breathing has been lately with EPR off. But have I gone to far? How do I bring hypopnea's and the occasional RERA back in line? I do feel better in general, although one of the things I focus on first every morning are the flow limitations.
I had some SWJ at the beginning of the night, and I fell asleep around 9:45 pm
RE: JKan Therapy Analysis
Hi,
I think most people on this forum prefer at least some degree of EPR, as it really is a comfort feature.
What's left now, is the balancing act between EPR, flow limitations, but keeping at the same time efficient control of apnea events.
What I think is likely needed are the following:-
- Set EPR to 2, (ie reducing of 1), then create an equivalent offset, by replacing the current fixed pressure with a 1cm gap between minimum and maximum pressure.
The gap might be something like, minimum 8, maximum 9; or minimum 9 and maximum 10, or somewhere around these values, as a basis. Pure trial and error until you find the optimal settings. Only you will know when you get there.
Hopefully this all makes some sense....
Keep going, you can't be too far off now.
RE: JKan Therapy Analysis
My last post was just before going to bed.
Woke up this morning just realising an important typing error.
The lined out paragraph in my original text below should have read
"Set the EPR to 1 (replacing OFF)"
Really sorry, was quite knackered last night. School holidays here, and two young grandchildren staying.
I should have got a good night's sleep in first before replying.
Original text
Hi,
I think most people on this forum prefer at least some degree of EPR, as it really is a comfort feature.
What's left now, is the balancing act between EPR, flow limitations, but keeping at the same time efficient control of apnea events.
What I think is likely needed are the following:-
- Set EPR to 2, (ie reducing of 1), then create an equivalent offset, by replacing the current fixed pressure with a 1cm gap between minimum and maximum pressure.
The gap might be something like, minimum 8, maximum 9; or minimum 9 and maximum 10, or somewhere around these values, as a basis. Pure trial and error until you find the optimal settings. Only you will know when you get there.
Hopefully this all makes some sense....
Keep going, you can't be too far off now.
RE: JKan Therapy Analysis
Hey Expat31,
No worries! I appreciate all your efforts and advice over the last couple months.
When I read through it yesterday, I was confused by the Set EPR to 2, (ie reducing of 1) but I went with it for last night. It's funny that when I first set it after reading your post, I did put it on EPR 1. I thought it was kind of a big change. But after it bounced around in my brain for a bit, I thought, No, I'm sticking with Expat31's suggestion! Haha, I think it's good that I questioned it at first. I'm slowly learning 
I don't think that was the issue for the late cluster, right? I figure that was positional. I remember turning from my left to my right side about that time.
I'll change that EPR to 1 right now and give it another go tonight.
As always, a huge thank you for all the help!
Last night's Oscar
Here is a close-up of that cluster. I'm not sure what this tells you. I hope to be able to read these graphs one day!
RE: JKan Therapy Analysis
Hi,
It was more than a simple typo, just a flat out error - sorry.
Trying to balance the books between EPR impact and pressure changes. (Or more like cooking the books!)
You are right, the last minute cluster certainly appears like positional, but mixed up with some periodic breathing, and perhaps also some sleepwakejunk.
I wouldn't be concerned about these events , as can happen from time to time.
If however it is a very regular and persistant occurrence, then that is another matter.
RE: JKan Therapy Analysis
Hi Expat31,
I just got up, just shy of 6 hours of sleep. I feel okay; I wanted to sleep a bit longer. I have a lot on my mind, one of which is my 3-month sleep doctor appointment tomorrow. I'm dreading her giving me heat for all the adjustments I've made during these first 2 months. I don't care if she does, but I'm hoping the appointment goes smoothly.
I feel like I need to tweak something with the consistent RERAs that I've seen recently. I am happy to not see any CAs today, and only 1 H and one OA. The 3 RERAs have me a bit puzzled. They are uncommon, but I figure a slight change might correct them. My guess is I need more EPR since the flow limits are up to 0.15
Looking over my records, when I was running 10/13 EPR 3 or 10/12 EPR 3, my flow limits were typically under 0.05, but I would have more centrals. (not a ton, but a few) with the occasional RERA.
I guess I just answered my own question. What are your thoughts?
Last night's 6 hours sleep
RE: JKan Therapy Analysis
Increase EPR, a definate yes, as flow limitations too high. One thing is important, not to make precipitous changes based on just one night.
You have tried a good number of setting options already, and I am sure your doctor in fact will appreciate the fact that your "proactive" stance in participating in your own therapy adjustments, has achieved an AHI of 0.34.
This of course is all on paper.
You may have a good idea already what settings potentially may be good for you, especially the excellent results obtained on July 17th with fixed pressure.
You still have some margin on PR to work with, together perhaps some minor tweaking with pressures.
Just trial and error now.
If this doesn't work, check with your doctor, as an Aircurve 10 VAuto. (Bi-Level machine) may be better, with a wider range of EPR adjustment possibilities. Unfortunately I cannot offer any insight on this type of machine.
RE: JKan Therapy Analysis
Nearly forgot, fixed pressure 9.6, EPR 3?
RE: JKan Therapy Analysis
Do you think I should try that? When I look through my spreadsheet that I use to log my daily progress, I never tried a fixed 9.6 with EPR 3, It was always off.
If that is a suggestion, I like it!
Here is a snippet of my spreadsheet. I noticed before I went into the 3 days of the fixed 9.6, I tried a 9.4, and it had a lower AHI and fewer events that day. Granted, it is only one day of data, but I was thinking of going back and trying that tonight before I read your response.
I'm going to go with your suggestion of 9.6 fixed and EPR 3. Tonight is the last night before I see the sleep doctor.
Thanks Expat31! I really appreciate your guidance!
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