[Pressure] Cannot find a pressure level consistently reducing AHI below 5

[Sleeprider]

The relationship between CA and EPR or pressure support (the difference between IPAP and EPAP) is that the pressure differential increases ventilation exchange resulting in some reduction of CO2. This can affect the respiratory drive in some people that are sensitive to pressure support. In bilevel therapy for obstructive apnea, doctors use EPAP to control the obstructive apnea and pressure support to control hypopnea, snores and sometimes flow limitations. In your graphs posted above, the EPAP pressure of 5.5 seems to do a pretty good job of keeping OA below one per hour, but your remaining events are CA, so using bilevel titration principles, it should be possible to use an EPAP pressure of 6.0 and see good results in OA, and by cutting pressure support/EPR perhaps eliminate the CA events if they are caused by the therapy. At least that is the theory.

Your experiment at fixed pressure of 8.4 showed a very good OA event rate, but continued CA events. Based on this single night, the event rate for CA was on-par with the best night of your previous data so far. You should know that the one sure thing about complex apnea is that the results night-to-night will likely be inconsistent, so let's not draw firm conclusions based on one night of results.

I think it might be worth trying this experiment with a slightly lower fixed pressure to see if the CA can be reduced further. If your're in, then a pressure of 7.4 seems about right. Keep in mind, inconsistent results are the one consistent thing about complex apnea.

[kgunen]

Thank you all for your posts. Especially I read the last explanation of Sleeprider, maybe six times


I will continue my experiments next year according to your advices. 
I wish you Happy New Year with good sleeps of course.

[kgunen]

Here is the "7.4 cm constant Pressure" Trial.
I am not sure what is the next step.

[Sleeprider]

The lower pressure is showing even more encouraging results. I would try 7.0 as a fixed pressure and see if it continues. You have a mild complex apnea, and results are going to be hard to make consistent night to night, so were looking for a trend. This seems to be moving the right direction with lower pressure.