[Treatment] Clownbell PAP Journey

[clownbell]

I've been on CPAP for 90 days. OSCAR reports virtually all events are hypopneas, with only very rare OSA events of 1-2 per night. I've read the wiki on Optimizing Treatment but do not have a good science background and thus came away with no clear picture. The only thing I have gleaned from the wiki is that EPR does not fight hypopnea, leading me to conclude that I should probably wean myself off EPR. I also read in the wiki that the pressure differential between inhale and exhale pressure helps relieve hypopnea -- but I don't understand what that means (do I need a large differential or a small differential?) or what I should do.

The question: is there a layman's version (for someone without heavy science background) describing how to treat hypopnea with the CPAP machine? I have a ResMed Airsense 10 Autoset. 

Thank you.

Craig

[Crimson Nape]

Adding EPR without adding the same pressure value to your minimum pressure number will help in causing hypopneas. The Resmed AS10 subtracts the EPR value from your inhale pressure, this lowers your exhale pressure. Basically you need to raise your exhale pressure to overcome hypopneas.

[clownbell]

Thank you Crimson Nape.

So I will wean myself off the EPR. Given that the Inhale Pressure is automatically set by the machine, is there another step I should take if weaning myself off EPR does not produce enough reduction in hypopneas?

Thanks again for your expertise and the quick reply.

[staceyburke]

I suggest you put up Oscar charts and you will get better help. On the left column of your post you show a min of 5. If that is correct you can’t be using more than 1 for EPR. 

4 is the LOWEST pressure that a Cpap can go.   So if you are at min 5 you can only go down 1.

[Crimson Nape]

It's not that difficult to allow for EPR. Based off your profile pressure range of 5.0 to 9.8, if you set the EPR to '3' then you would adjust the pressure range by +3. In this case, your new pressure range would be 8.0 to 12.8.

[clownbell]

I understand, Stacey. If my pressure were running at 5, it could not go any lower than 4. However, if my machine were running 9.8 when I exhale, the pressure would drop by 3 to 6.8 -- right?

[SarcasticDave94]

Yep. The pressure setting minus EPR setting. The math is just like you did there.

[clownbell]

I have attached 3 typical nights. Lots of hypopneas but no OSAs.

Thanks again for sharing your knowledge.

[attachment=31571]

[attachment=31574]

[attachment=31574]

[staceyburke]

No your min number is the exhale number, you subtract the EPR from the min. The 9.8 is the most the machine will go up to on the inhale.

[staceyburke]

The max pressure- your machine will go up to 20 if needed and many people leave it at 20. But many people get centrals when there is a large difference between the min and max pressures. Some people find a straight Cpap settings help their centrals AND set their min and max at the same number without any EPR. So for example the machine will blow all of the time at the same number never changing. (That is how all old cpaps worked)

I thought you had set your to 9.8 to help with centrals. The reason to put up your charts so you could get some educated advise.