Trying to narrow in on optimal settings

[CPAPUserDave]

After 2+ years on CPAP, still feeling too much daytime tiredness. been on fixed pressure since the beginning, changing it from 8.0 to 10.0 along with experimenting with EPR. Still searching for the best settings. Will post sleepyhead charts for review as/when i figure out how to do so. Thinking a set from using 8.0 pressure with EPR=1 and a set using 10.0 pressure with EPR=3. that's basically the range I've been experimenting with. hopefully someone can spot something and help me achieve the best settings to use.

other ideas on why still too much daytime sleepiness could be because of a vitamin D deficiency from past year that was finally diagnosed and treated. Maybe still recovering from that? Now that deficiency is treated, my body now concentrating on recovering from years of untreated apnea?

Now on to posting those charts...

[CPAPUserDave]

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[CPAPUserDave]

don't know if i did it the most efficient way, but above are two sets from two different nights of sleepyhead charts

if anything else needed, let me know.

by the way, how is the new OSCAR program different than Sleepyhead? what main new features does it have and would it be better for me to download OSCAR and discontinue using Sleepyhead or does Sleepyhead work fine for now?

[WhyMe]

While new features may show up in the future, my understanding is that OSCAR is more of a maintenance release, so what you have should work fine for now.

[imrj]

After 2+ years on CPAP, still feeling too much daytime tiredness. been on fixed pressure since the beginning, changing it from 8.0 to 10.0 along with experimenting with EPR. Still searching for the best settings. Will post sleepyhead charts for review as/when i figure out how to do so. Thinking a set from using 8.0 pressure with EPR=1 and a set using 10.0 pressure with EPR=3. that's basically the range I've been experimenting with. hopefully someone can spot something and help me achieve the best settings to use.

other ideas on why still too much daytime sleepiness could be because of a vitamin D deficiency from past year that was finally diagnosed and treated. Maybe still recovering from that? Now that deficiency is treated, my body now concentrating on recovering from years of untreated apnea?

Now on to posting those charts...

you are not alone....i been 2y also and not much relief from CPAP use....still tired during day...am going to have morning cortisol level check along with thyroid hormones (T3, T4, free) because even if you sleep like a baby if your hormones are a mess it wont matter

[Melman]

I suggest since you have an autotitrating machine that you take advantage of the auto feature. Your AHI numbers look good at both pressures but they are close enough that it would be hard to say one pressure is better than the other. Try an auto setting with the low at 8 and the max at 20. Don't worry, it won't go to 20 unless a high pressure is necessary. Set EPR at 3. You have significant flow limitations which are best handled by pressure support, the difference between inhale pressure and exhale pressure. Changing from fixed to auto pressure made a world of difference to me. Try that and post more data and we will be able to advise you on optimizing you settings.

[CPAPUserDave]

Melman: i will try the suggested settings and post charts in a few days. if my tired brain understands, these changes will allow the machine to dictate the pressure needed to control apneas (obstructive, hypopnea?) while the EPR at 3 will help control the flow limitations? What about controlling RERA?

if so, why would anyone set the machine at a fixed pressure and not use the auto feature?

[Melman]

There are some cases for which fixed pressure works best but the auto feature provides the best therapy for most. Many sleep clinics and Doctors prescribe fixed pressure when auto pressure would be better. That was what happened in my case. Pressure support is the most effective treatment for hypopnea and RERA so EPR should reduce RERA. Your RERA numbers are low so you may not see any significant difference.

[Dormeo]

At least for now I am using a fixed pressure because I found I am easily awakened by pressure changes. I’ll be curious what happens to your flow limitations if you give the machine a free rein.

Are you awakened by mask leaks, or do you sleep through them?

[CPAPUserDave]

Dormeo: once in a while mask leaks wake me but not until the early morning hours after i have slept 6-7 hours already. in the past i have used a small fan blowing on my face (very low setting) which not only helped me from getting too hot with a mask on my face but perhaps help 'mask' some of the leaks so I did not get bothered by them.

the past week i have tried fixed pressure at 10.0 with EPR at 3 and the pressure difference has not bothered me. hopefully that continues...