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You only have these flow limitations intermittently indicating a partial obstruction at those times. Part of the problem is that you have the machine too handcuffed it isn't able to try and fight the obstruction so these obstructions always end in RERAs.
I would try increasing max pressure to 12 cm to remove the handcuffs and see if the higher pressure avoids these RERAs. The machine will only increase the pressure when these flow limitations or other apnea are occurring.
You could also try EPR of 3 which could potentially help but it also makes obstruction more likely unless you also raise pressure by 1 cm (since EPAP that fights restriction is set pressure minus epr).
I will try EPR 3 while raising the min by 1. And I'll also increase the max as suggested. I'll post an update after I try this.
As for what is waking me up, I have to get up once per night to go to the bathroom but besides that I just wake up. The assumption is it's RERAs. I've done full workups and talked to doctors about other possible causes but nothing else explains it. I'm hoping that once I dial in the CPAP settings better, the wake ups will decrease.
Hello everyone.
It's been a while since I posted. I had stopped using my CPAP but have started using it again. I've gotten used to the mask again but think there is still work to do to get to optimal settings. I don't really see much of an improvement when using it vs not using it. I wake up frequently and am exhausted during the day, often needing to nap. Dizzy, brain fog, headaches...
I have gotten used to a bit more pressure over time. I am currently at 7.6 - 11.6 with EPR 2. My AHI is always low but that has never been a problem. It's the arousals and frequent awakenings. I'm attaching 2 recent nights. I'm looking for guidance as to what I should try next. Increase pressure, increase the range, decrease the range, move EPR to 3 ? Whenever I've tried EPR 3, I've gotten more centrals. Also, with the higher pressure now, I am getting aeropahgia.
I'm looking for advice for what to try next. Determined to try to get this right to start feeling better.
I just wanted to bump this thread up so it doesn't get lost. Please see my last post from last Wednesday. I'm hoping someone can provide some guidance as to how to proceed to improve things.
One other note in addition to what I said in the last post - since increasing the max pressure a few weeks ago, I am consistently getting reflux overnight. Wondering if anyone has experienced this due to pressure increase and what to do with this too.
Not an expert but aerophagia seems to be a somewhat common issue. I experience it at higher pressures - it can be miserable!
I see the experts say that it's sometimes a balance between pressure high enough to treat your apnea and low enough to reduce/eliminate aerophagia.
Lowering max/adjusting pressures is usually the suggestion but I'll let the experts weigh-in on that. I just wanted to let you know you're not alone on the gas ;p.
Hello,
I'm hoping someone can provide some guidance for me. I posted a message last week but here are some new charts.
The one from 9/11 is with EPR 2.
The ones from 9/13 and 9/14 are with EPR 3.
To summarize:
- My AHI is usually low. It was only 7 on my sleep test but my RDI was 23.
- I used CPAP for a while but stopped because it was not helping that much. I've restarted using it for a little while now but again don't see a lot of improvement.
- My main issue continues to be that I wake up frequently during the night so do not get restful sleep. This happens when not using CPAP or while using it. It is definitely correlated to the flow limits that I have. Every cluster of flow limits that you see results in me waking up at least once, if not more times. I rarely stay asleep for more than 1.5 hrs. I think that if I can reduce the flow limits it will help me stay asleep.
- I was using EPR 2 but changed to EPR 3 for the last couple of days as I understand that pressure support can help with flow limits.
- With EPR 3, I have started getting centrals. Same thing happened last year. I feel like overall my sleep has been worse with EPR 3 (only 2 days though). Aerophagia/reflux seems better on EPR 3 but I feel like I am waking up more and have gone from feeling really bad to worse during the day (extremely tired, brain fog, dizzy, headaches).
So I am looking for advice. Should I continue with EPR 3?
I do also have some leak issues so looking for advice there too. And any advice in general to optimize my settings with my current machine. Or should I be looking into a bilevel or ASV? Willing to pay out of pocket if needed.
Increased CAs with the EPR set at 3 seem to be evident. You can try riding it out for about a week to see if you normalize, or just drop it back to 2. You could be sensitive to pressure changes, thus causing arousals. This might include tightening your pressure range to 8.6 to 11.0 or setting a static pressure to see how you feel.
I would also recommend that you upgrade to OSCAR 1.4.0.
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