New to the board, not CPAP.

[Sleeprider]

As your pressure drops we really don’t see more event, in fact tho is among the best OA you have posted. Flow limitation appears to be rising, so I think you may be at a crossroads of diminishing returns for reducing pressure. What is needed is more pressure support as in an Aircurve 10 VPAP S which affords more PS and fixed pressure.

[Gideon]

Of these two charts, we have one that says try lower and one that says that's enough, stay here.
Which of the 16,15,14 feels better to you?

To go forward you need a BiLevel, I recommend a ResMed AirCurve 10 VAuto going forward.  It differs from the "S" that Sleeprider mentioned in that it has an additional 'Auto" mode and as such is more flexible.  Otherwise, I'm in complete agreement with him.  There is more to this machine than just Pressure Support.

[codemajic]

As your pressure drops we really don’t see more event, in fact tho is among the best OA you have posted. Flow limitation appears to be rising, so I think you may be at a crossroads of diminishing returns for reducing pressure. What is needed is more pressure support as in an Aircurve 10 VPAP S which affords more PS and fixed pressure.

So you advice me to keel it at 14 for another week or so and then put it at 13 and keep it a week or so and so forth until i get a lower AHI? 

That other machine looks expensive but if I need it I need it. At what point should i really consider one? Thanks guys!

[Sleeprider]

With regard to the Vauto, they come up from time to time at very good prices. Supplier #2 was selling them at a significant discount for a while, but places like Facebook Marketplace, Offerup, Craigslist, and DotMed have used machines at good prices. Just make a habit of watching for a good deal.

In changing pressure, it's hard to call a single night conclusive, and your response has been pretty subtle and mixed. So give any changes a couple days to settle in and show a trend. Do you understand what flow limitations are and how they are affecting your sleep and arousals?

[codemajic]

Of these two charts, we have one that says try lower and one that says that's enough, stay here.
Which of the 16,15,14 feels better to you?

To go forward you need a BiLevel, I recommend a ResMed AirCurve 10 VAuto going forward.  It differs from the "S" that Sleeprider mentioned in that it has an additional 'Auto" mode and as such is more flexible.  Otherwise, I'm in complete agreement with him.  There is more to this machine than just Pressure Support.

 
Honestly I havent been able to tell much of a difference. Ill keep the 14 for a few more days and try 13 next.

So what I drew from your post is that I need a AirCurve vAuto if i really want the best results of Cpap therapy in general. Ill be on the lookout for one.

[codemajic]

With regard to the Vauto, they come up from time to time at very good prices.  Supplier #2 was selling them at a significant discount for a while, but places like Facebook Marketplace, Offerup, Craigslist, and DotMed have used machines at good prices. Just make a habit of watching for a good deal.

In changing pressure, it's hard to call a single night conclusive, and your response has been pretty subtle and mixed. So give any changes a couple days to settle in and show a trend.  Do you understand what flow limitations are and how they are affecting your sleep and arousals?

Ill stay on 14 for some more days and then try 13 until I can get a AirCurve I suppose.

I do not understand flow limitations and how they affect my sleep but I guess i can do some research.

Im also not completely understanding the need for a AirCurve (not that Im questioning your advice; im completely on board with getting one and currently hawking ebay, fb marketplce and offerup). Do i just need more pressure than an regular air sense can give me? Didnt think my apnea was this bad haha

thanks guys!

[Sleeprider]

Establishing a medical need for the VPAP would be difficult. What we see is a pattern of flow limitation and arousal that is present at the EPR 3 and the pressures you have tried, that would likely resolve with higher pressure support and possibly better timing that the Vauto is capable of. You have very good AHI, but I'm not hearing a lot of enthusiasm for how you feel with the therapy.

Another source to watch is the DotMed marketplace. You have to look under the Respiratory/Bilevel-BiPAP category. These are mostly low-hour machines taken back on insurance noncompliance, and I'm seeing prices around $650 for low hour machines, compared to $799 on Supplier #2.

[Crimson Nape]

codemajic - Add "dotmed" to your search sites. Use the term, "resmed aircurve 37051". (Aircurve 10 VAuto model) The site will display more than just the model you asked for, so be diligent when reading its model and run hours.

[codemajic]

Thanks will do. Whats considered to be good and bad hours for pre owned AirCurve 10s?

Currenly negotiating for one that has 8597 hours used... she wants 600 but trying to negotiate

[Crimson Nape]

The run hours basically depend on the price of the machine. You just have to go with how you feel about the price. A lot of them are being sold with 100 to 500 hours. I use a figure of 8 hours per night * 30.4375 days to determine the number of months the unit has been in service. This equates to 243.5 hours per month. The odd number is based off of 365.25 days(allowance for leap year) / 12 months. So a 500-hour machine would be a little over 2 months of use. A machine should be good for around 15,000 hours. This is over 5 years of service. Many here have reported 20,000+ hours and going strong. The hardest thing to find out is, if the CPAP was used in a smoking environment. This should drive the price down, big-time! A lot of the CPAPs are now offered without power supplies or humidifier tanks. For a Resmed 10, a power supply is about a $20 USD item from a third party manufacturer. The humidifier tank or a replacement side plate is around $26USD, Unless it's one of those "Deals", don't jump on the first one you find.

Good luck!