Resmed APAP vs For Her

[SevereApnea]

Hi All

In the last week I have had the Resmed set to For Her.
I did this to try and avoid too much variation in pressure changes and to see what happens, hoping to reduce flow limitations, which still seem to be one of my issues (allergies, nasal polyps, no I don't want surgery).

When the pressure goes up it stays up for longer, which means it does what it says it will do.

[attachment=26314]

I looked at some numbers:

I know this is limited data but there is a trend:
Although the 95% FLs are lower, the Max FLs are higher!

(Clearly the 95% Pressure and 95% EPAPs are higher, this is because the For Her algorithm keeps the pressures higher, so that is to be expected.)

[attachment=26315]

I thought this was interesting, and wonder why the 95% FLs are lower but the Max FLs are higher?

Any thoughts?

[Gideon]

It is the EPR that best treats Flow Limits. Your EPR is set at 1. Raise your EPR.
I suggest
Set EPR =3

[jaswilliams]

Also I believe in the for Her Mode it is more sensitive to flow limitations so the amount of flow limitation measured by the machine will be higher In the for her mode

[Coffee Man]

It would be interesting to see others post similar results, if owners of the For Her model are willing.

[SevereApnea]

Thanks Bonjour,
I will certainly do that.

Looking back at my charts, I now have around 4 months of data with my preferred mask (P30i N30i combo) and partial mouth taping.

For some reason I was keeping EPR low to avoid side effects, and because my Doc wanted me to lower my pressures down to the levels in my Titration study. (Those pressures, 7 - 8 cm H20 are too low: on that night I did not sleep well due to the usual strange environment plus spine fractures and shoulder injuries.)
I am now sleeping much better, and deeper I think, and EPAPs at the start of Obstructions ranging between 6.45 and 11.4
Average EPAP on nights with OSA = 8.0 and average EPAP at end of OSA = 8.49
Average EPAP on nights with no OSA = 8.55 so that looks like the sweet spot.
I don't mind one or two OSA per night provided they are less than 15 seconds or so.

Of the last 129 nights with this mask combo I had the EPR on
0 for 10 nights
1 for 26 nights
2 for 87 nights
3 for only 6 nights, so not enough data with EPR=3.

I will go back to EPR 3 (APAP not For Her) again and then reassess things.

Tonight I will try Ramp = 0, Min Pressure 10, Max 13 and see how I go.

[becker44a]

Hi SevereApnea,
I also have the AutosetForHer, and I tested the 3 Auto Modes when I was starting out.  The best mode for me turned out to be Autoset / Soft Response mode.  (See the review here:  http://www.apneaboard.com/forums/Thread-...rapy-Modes

I would encourage you to experiment with all the modes - there might be a pleasant surprise waiting.

[SevereApnea]

Hello there Becker44a and thanks for the reply.

Yes I remember that thread and being surprised at just how low your FLs were on the Soft Mode.
(I have replied to that thread to keep that thread valid/consistent/can't think of the best word here...)
 
Thanks for reminding me about that: I will certainly add this to my list of things to try out: there are so many variables, and I agree we need to change them one at a time for at least a few weeks: this adds up to a few months of testing! All very interesting.

My numbers are generally good (and can be good with a range of pressure and EPR settings) but I still don't feel I have arrived at the optimum situation where I wake up as refreshed as when I started PAP therapy.

I guess as individuals we just have to persist until we find what works best for us.

[SevereApnea]

@Bonjour, I have taken your advice and upped the EPR to 3 over the last 4 days, chart links attached below.

I must say it "feels" better, FLs are in the lowest range I have achieved so far, and I am waking up sooner and faster. 

So maybe the next step after controlling AHI is to optimise Flow Limitations...
Is there a correlation between low FLs and quality of sleep?

Tonight I will increase Min Pressure to 10.6 with EPR =3 and maybe higher over the next week.

However my Max Pressure is seldom more than 11.4 so I can only see 2 ways that I can get 
better control of Flow Limitations.

1. Try to go to the same Min Press and Max Pressure at 12/12 and EPR =3. 
2. To aim for higher PS than what I can get with this machine.

Thanks for valuable feed back!
________________________

epr 3 Sep 9
epr 3 Sep 10
epr 3 Sep 11
epr 3 Sep 12

[slowriter]

Is there a correlation between low FLs and quality of sleep?

One cannot generalize on this.

For some people, say with UARS, absolutely.

For others, not so much.

Can you not add your screenshots directly to your posts?

[SevereApnea]

Thanks Slowriter

Can do, here are those from 9 Sep and 10 Sep and 11 Sep
[attachment=26505]
[attachment=26506]
[attachment=26507]