[Symptoms] New machine and some hiccups

[Gideon]

Welcome to the forum

Your current issue is Central Apnea.
On your charts drop Mask pressure and add Flow Limits.

First can you post a full copy of your sleep studies? not just summaries.  Often the summaries will indicate info about central events and I'm looking for details of when your centrals started.

You are on fixed CPAP pressure of 11 with an EPR of 3.

To reduce your centrals I want you to turn off your EPR or set EPR=0.
Since you don't have any obstructive events I want you to reduce your pressure to 8  This is your current therapeutic pressure (11-3).  Then we need to re-evaluate after this and may be able to reduce pressure further.

[PeterP60]

Thanks for the welcome!

I'll have to ask my clinic for a full copy - I wasn't sent one. Will request this coming week and post ASAP!

In terms of EPR, I think this is simply called Pressure Relief on my machine. It only has on and off functions. I'll try turning it off tonight.

And I'll re-calibrate my machine to a fixed pressure of 8 instead, and will post the results tomorrow!

In terms of my ramp function (currently set for 15 min) and humidity setting (5), are these at alright levels, or is it purely for comfort? Thanks for the help!

[Gideon]

Those are (ramp) for comfort and gradually building up to therapy. Don't worry about it for now nut feel free to turn the ramp off.. Most of the senior people here do not use a ramp.

[PeterP60]

Perhaps I'll try dialing back the ramp little by little, just in case I have trouble adjusting to full pressure. Thanks for the advice, and more soon!

[Gideon]

that sounds like a reasonable plan

[PeterP60]

Here are the results from last night, having made the following adjustments:

EPR now set to "off"
Pressure adjusted from 11 to 8

Overall, a decent sleep - AHI is around my average, so not a significant change. What do you think? Thanks!

[Gideon]

Actually quite a difference
           9/13  9/14
CA       5.05   3.03   better by 2
OA       0.14   0.25   no significant difference
H         0.29   1.84   Increase by 1.5
RERA   0        1.45   Increase by 1.5 (Implies your Flow Limitations increased) 
AHI     5.48    5.13   no significant difference
RDI     5.48    6.58   The difference is the RERAs (Flow Limitations)
We have a different balance
Setting EPR = 0 dropped Centrals by 2 and the obstructive events increased by the same Plus the RERAs
This also shows you what PS/EPR was going, treating your Hypopneas, Flow Limitations and RERAs.  See how your EPAP of 8 was managing yor OA.  

This is the balancing act.

Which night feels better?

My thought is to try 9 tonight.  Let's see if that improves your obstructive events without driving your centrals (too much) higher.

[PeterP60]

It's hard to say! I maybe slept better at night on 9/14, but was feeling a bit better rested after 9/13. I'll up it to 9 and see what difference it makes. Quite a balancing act, it seems! I would imagine, though, that dropping the central events is the most essential thing? My obstructive events are so minor in comparison. Helpful to see this kind of analysis, as I admit the charts are a bit beyond me!

[PeterP60]

Here's the data from last night's sleep, with the pressure at 9 as recommended. Slept quite well - soundly! - but was a bit tired today. Likely from lack of enough sleep in general (less than 7 hours isn't great for me) - my own fault. How are these numbers looking? Thanks!

[Gideon]

           9/13  9/14   9/15
CA       5.05   3.03   4.07 
OA       0.14   0.25   0.15 
H         0.29   1.84   0.75 
RERA   0        1.45   0.45  
AHI     5.48    5.13   4.97
RDI     5.48    6.58   5.42 

I see normal daily fluctuations,  Lets leave setting here for several days and see what the average is