Therapy Questions, EPR, CA, Low O2

[yankees123]

As usual Fred you make a great point.

[kingskid]

Here are my latest charts.  I have been sleeping the whole night through without removing my P10, thanks to Sleeprider's recommended new settings for my AirSense.  To my untrained eye, it looks like changing the settings has really improved my quality of sleep.  Still feel pretty much the same as I have been, maybe a little more energetic, but was concerned about getting enough air into my lungs during the night since I am a shallow breather and live at about 9000'!  Note:  all these five charts were recorded while having a respiratory/bronchial infection of some kind.  Am curious to see what my charts will look like once this bug is totally knocked out!

[Sleeprider]

This looks really good! Your pressure is very steady. The only down-side is the persistent flow limitation, but we are doing about everything possible with the machine you have to address it. Your AHI is exceptionally low, and this looks like a steady comfortable therapy. I think this is it and hope you are comfortable.

[kingskid]

Thanks, Sleeprider.  Maybe my flow limitation will improve once I am not so congested.  Is there an optimum flow limitation range I should look for?

[Sleeprider]

Flow limitations are not something worth chasing unless they are disruptive to sleep. My preference is to reduce flow limitation as much as possible, because that is going to be more comfortable for most of us. If you zoom in on the flow rate wave-form, you will probably see some flattening most of the night. The only way you're going to do better on flow limits is to use bilevel, so I really think your current results are as good as it gets with CPAP, even with EPR at 3. That's not too bad considering you basically have no apnea or significant events. A lot of people including myself will envy results like this, so flow limits are not something to worry about in your case. Congestion is a source of flow limitation, so if that is something that can be improved, it will probably be reflected in your results.

[kingskid]

Flow limitations are not something worth chasing unless they are disruptive to sleep.  My preference is to reduce flow limitation as much as possible, because that is going to be more comfortable for most of us.  If you zoom in on the flow rate wave-form, you will probably see some flattening most of the night.  The only way you're going to do better on flow limits is to use bilevel, so I really think your current results are as good as it gets with CPAP, even with EPR at 3.  That's not too bad considering you basically have no apnea or significant events.  A lot of people including myself will envy results like this, so flow limits are not something to worry about in your case.  Congestion is a source of flow limitation, so if that is something that can be improved, it will probably be reflected in your results.

Okay, thanks so much for that explanation!  You have given me a perspective I didn’t have before, to say nothing about peace of mind.

[trailrider]

Your charts look great to me!! Your 0.2 is better than my 0.5!! You win!

[kingskid]

Your charts look great to me!!  Your 0.2 is better than my 0.5!!  You win!

Couldn't have done it without all the wonderful help on this forum!

[kingskid]

Hello all.  I am hoping to get a read on some charts from Jun, Jul, and Aug because I have bounced around between Fixed 7cmH2O (which I was titrated at in 2014), minimums/maximums of 7/9.8, 7/10.6 and the 8/12 with EPR 3, which was recommended by this Forum.  I am going for my second sleep test on Wed. night, Aug 14, and would appreciate some feedback on my various settings.  I feel fine pretty much the same no matter the setting, but did seem to get sleepy in the afternoons on the 8/12 setting, so I went back to Fixed 7.  The EPR 3 seemed to increase my centrals and that concerned me.  My biggest concern is desaturation.  At my sleep study 4 years ago, my O2 went down to 70% and after titration it was still low at 78%.  No one recommended any oxygen therapy.  The min/max settings for five charts attached are as follows (EPR only as noted):  Jun 1 - 7/9.8,  Jun 2 - 7/10.6,  Jul 9 - 8/12 EPR 3,  (Jul 15 - 8/12 EPR 3 (did not attach for some reason!), Jul 16 - Fixed 7,  Jul 17 - Fixed 7.  Thanks for whatever suggestions and comments you might have.  If you'd like to see more charts at the 8/12 EPR 3 settings, I could try on my next post.  Thanks for all your help.
[attachment=14361][attachment=14362][attachment=14363][attachment=14364][attachment=14365].

[Dormeo]

I’ve read several times on the forum that it is best to stop PAP therapy for several nights before going in for a sleep test, lest there be a kind of hold-over effect. I hope someone who knows about this can comment.