The Dangers of Being Lazy

[LJA]

My guess - the 95% number is an average of the total session. Since EPR lowers pressure for every exhale, all other things being equal, increasing EPR should lower the average pressure.

Thanks Alan!  So, if lowering pressure causes my AHI to go down and the subjective quality of my sleep to improve, what does that mean?  Another 0.0 night last night!  Feel awesome this morning.  At EPR 1 and a base pressure of 9.0, the 95% pressure was 11.8 - changing the EPR to 2 lowered the 95% pressure to 10.2 and AHI to 0.0 and increased sleep quality subjectively - for two nights in a row.  Turning EPR off dramatically increased pressure and AHI!  What does that mean?

[eseedhouse]

At EPR 1 and a base pressure of 9.0, the 95% pressure was 11.8 - changing the EPR to 2 lowered the 95% pressure to 10.2 and AHI to 0.0 and increased sleep quality subjectively - for two nights in a row.  Turning EPR off dramatically increased pressure and AHI!  What does that mean?

Two is a very small sample.  I wouldn't draw any conclusions until you have a week of data with nothing changed.  If you do get a week of data and it suggests you should change things, change one setting at a time and give it at least a week.

[LJA]

At EPR 1 and a base pressure of 9.0, the 95% pressure was 11.8 - changing the EPR to 2 lowered the 95% pressure to 10.2 and AHI to 0.0 and increased sleep quality subjectively - for two nights in a row.  Turning EPR off dramatically increased pressure and AHI!  What does that mean?

Two is a very small sample.  I wouldn't draw any conclusions until you have a week of data with nothing changed.  If you do get a week of data and it suggests you should change things, change one setting at a time and give it at least a week.

Thanks for the advice, but I have been using APAP'S for over twenty years - the size of the sample is not an issue - the effects I noted were immediate and repeated at least twice.  The question is, without regard to sample size, how or why would increasing EPR cause a decrease in titrated APAP pressure and a decrease in AHI - just assume that phenomenon happened for seven days in a row.  The other way to ask the question is, "can too much pressure cause more apneas?"  Would they be obstructive, central, or hypopnea?

[Marillion]

Too much pressure often results in more CA Apneas.

Ed is right. Two nights is too small a sample size to draw a final conclusion. A week's worth of data at a desired setting is much more conclusive.

For many people (including myself), increasing the EPR setting often results in increased CA events.

[AlanE]

Were the events before mainly hypopneas or obstructions? I read back through the thread and may have missed it if you posted that.

Your o2 saturation could be a factor. Having a constant higher pressure that you are fighting to breath out against may not allow you to exhale enough co2. Your o2 level could decrease and your sleep is disturbed. You can test that with an SpO2 meter that can record the data.

I suppose it could also be the constant higher pressure annoys just enough and you don't sleep well. I know my cat loves the air coming out of my mask and he head butts my nose. Either that or he wants to eat and is trying to wake me up but I haven't had to set an alarm in a couple of years.


congrats on a couple great nights sleep.

[LJA]

Thank you all for your replies! The prior events were primarily divided between obstructive and central - about even. I think the co2 level is a likely suspect in the phenomenon as well as higher presssure increasing CA'S. Last night's data was different - AHI was 0.7 - primarily due to my nose being clogged by allergies - and pressure was up to 11.7 - but, again, I slept great! I need to look at the ResScan chart and compare the graphs. I do notice a lot more shallow breathing when the EPR is off. My initial titration 23 years ago with fixed pressure was 6 - but my APAP'S (from the first Resmed to the S8, the S9 and DeVilbiss) have all run in a range of 8 - 15 with a typical 95% pressure being in the range of 9 - 12. I'll get a week of data as suggested and post it. Thanks Again!