Resmed APAP Pressure

[Gideon]

Blue pills??? Not sure about that reference

Typical spam, ED cure v***** or C*****

[PaytonA]

The EPR change is simple and may make some difference. All auto machines try to head off apneas by reacting to things like flow limitations and vibratory snore. Flow limitations may be what is maintaining your machine at higher pressure. Fow limitations typically respond well to increases in Pressure Support which is essentially what you are doing when you go from EPR of 0 or 1 to an EPR of 3. If that change improves things but not enough, it may be that you may require a bilevel auto CPAP in order to allow the pressure support to go higher than 3 cm/H2O. The machine does not react to an obstructive apnea that is in progress but will react afterwards. The machine will also not react at all to central apneas also known around here as clear airway apneas.

Many of us on the board are very data driven, if you could not tell that already.

If the unit is noisy, check the seals and ensure that the water tank for the humidifier is seated correctly. The unit should not be noisy and if it is not something that just needs a little adjustment then your supplier should take care of the problem.

Best Regards,

PaytnA

[RogerNZ]

Hi all,

I tried last night EPR of 3 but apart from that everything as it has been. I wasn't exactly sure how to present the data from sleepyhead so I just took screenshots and put them inside a word document for last night. Let me know if this isn't the best method.

The pressure didn't go quite so high last night and I didn't have any long obstructions with the longest only 50 seconds or so.

Best regards,

Roger.

[Crimson Nape]

Please read my Useful Links on how to organize your charts and how to upload them to imgur.  Using the F12 key to take a screenshot is the best and easiest way.  The image will be stored in the SleepyHead Data folder under Profiles > Your Name > Screenshots.   It will be a .png file.

[RogerNZ]

Thanks, I'll do that when I get home tonight.

[Gideon]

Looking at your charts and based that data and your issue with higher pressures, I'd like you to raise your min to 9 cm to help with your OA and H and drop your max to 14 to help with your pressure issues.  Numbers are based on the med pressure (11.46) rounding down and subtracting 2,  For the high rounding up and adding 2.

[PaytonA]

If I were you, I would slowly move your minimum pressure up about 2 cm/H2O at a time Until you get it up to around 12. I would go a couple of days on each increase and make sure that you are comfortable with the higher minimum and it is not causing any other problem like an increase in CAs. It should not but it pays to be careful.

Let us know how it is going.

Best Regards,

PaytonA

[RogerNZ]

Bonjour and Payton thanks for the suggestions. I hadn't thought of moving the lower pressure. Since my old CPAP was set to 10 I'll move straight to 9 tonight and then as Payton suggested move it up from there in increments as necessary. I'm a little unsure about the top pressure, since the APAP should be just doing what it "needs to" shouldn't it?

[Gideon]

Bonjour and Payton thanks for the suggestions. I hadn't thought of moving the lower pressure. Since my old CPAP was set to 10 I'll move straight to 9 tonight and then as Payton suggested move it up from there in increments as necessary. I'm a little unsure about the top pressure, since the APAP should be just doing what it "needs to" shouldn't it?

in your OP you said " I could almost live with the high pressures "  I wanted to back down your high for your comfort.  I you are not having issues with the high pressures you can leave it there, by the numbers it will not hurt.   A standard starting settings is your Med pressure +/- 2  so in your case it would be 11.4 +/- 2

[cands]

Hi all,

I tried last night EPR of 3 but apart from that everything as it has been. I wasn't exactly sure how to present the data from sleepyhead so I just took screenshots and put them inside a word document for last night. Let me know if this isn't the best method.

The pressure didn't go quite so high last night and I didn't have any long obstructions with the longest only 50 seconds or so.

Best regards,

Roger.

Hi Roger,
              For the EPR, you have it set to work only during the Ramp time:
EPRResMed Exhale Pressure Relief
Ramp Only




And, you have ramp turned off:

RampRamp Enable
Off




So, if you want to turn the EPR on, you need to change the setting for EPR to be 'full time', or something like that in the clinical menu.
My suggestion would be to start at EPR 1 for a few days, and then perhaps try 2, especially if you get your minimum pressure up higher.

In my own case, my titrated pressure for CPAP is 13.   My untreated AHI is 58.9 with lows of 60% oxygen Sats and 90 second apnoeas. With careful and slow adjustments of settings, my AHI is now constantly below 0.5 
My settings now are 12.2 to 17.2 with EPR of 2.

I didn't end up bringing the maximum pressure down much, but I found keeping a reasonably tight range minimises leaks due to big pressure changes.
I took the minimum pressure up 0.2 cm at a time from 5 to 13 and then gradually down to 12.2.  I was new to CPAP and so wanted to take it very slowly and carefully.

Take care
Steve.