On January 8, With pressure at 10.6 and EPR 3, your Elite CPAP is doing a very good job of eliminating all obstructive events. There are a few CA events, and if that bothers you, we can probably lower pressure a bit and maybe move to EPR 2. You have a long (45 minute) ramp that we would rather see changed to Auto or Off to minimize ramp time. Flow limits, leaks and snores are not a problem here and the ventilation and respiration all look normal. The main issues are that therapy time is short, under 3-hours and we may want to zoom in on the respiration flow-rate to get a closer view of why flow is uneven after 06:10, and biased to the exhale side (below zero line). If you want to do a zoomed shot, just screenshot a segment that is 3 to 4 minutes in view so that the flow rate wave is clearly visible.
January 9, with pressure 7.6 and EPR 3, had a lot of large leaks for a long time, but close to 4-hours of therapy time. AHI is again low, and similar to January 8, a lot of artifacts in the flow rate chart.
January 10 with pressure 8.0 and EPR 3, the flow rate looks much smoother. Therapy time is approaching 6-hours, and leaks are back under control. AHI is good with more obstructive events, so it appears that CA seen on Jan 8 has mostly resolved.
Looking at these three charts, I think we are seeing good adaptation to CPAP and your self-titration changing pressures has shown us your obstructive events are controlled throughout this range, so I think anywhere from 7.6 to 10.6 is appropriate, provided leaks remain controlled. Your efforts should focus on comfort and continuing to increase sleep-time in therapy.
Apnea Board Moderator
www.ApneaBoard.com
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