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I agree to try constant pressure mode with EPR on. If you change two things at the same time, you don't know the cause of any changes in your results. Also, I've found constant pressure to work better for me in regards to my CA events.
Paula
"If I quit now, I will soon be back to where I started. And when I started I was desperately wishing to be where I am now."
Quite a bit of flow limits and events likely triggered by being at too low a pressure.
Rather than guess at what a fixed pressure should be, why not do a bit of self-titrating and set your pressure to 8-15 EPR 2? From there we can help narrow things down to what fixed pressure and EPR setting should be used.
OK so, PeaceLoveAndPizza, your message came in at the same time as I sent mine. I see it now. I really don't know what is best. All your answers make sense to me.
Occam’s Razor. The simplest answer typically is just that.
The gang here are most helpful and whilst our recommendations may be a bit off from each other, we will all move you in the same direction. Just different ways to get there based on our own experiences.
Try not to get overwhelmed. I think everyone agrees that more pressure is needed, and EPR may also benefit you. What you do first or how you do it is up to you. Setting the machine to auto and giving it a max pressure around 12 will let the machine increase your pressure in response to disordered breathing without boosting the pressure you are feeling as you fall asleep. We can look at the max and average once that is done to see if going back to CPAP makes sense, and have a more educated guess as to what pressure to do it at if so.
Or, you can increase pressure in CPAP mode until you're happy with the results. Once the extra pressure bothers you in some way or seems to not help much anymore, we can back off to where you were happy and look into EPR to further refine your therapy if it still looks like you need more tweaks.
Flow limitations continue to dominate things. Whether they are significantly impacting your sleep is the question.
As I read the charts, CPAP mode at 8 manages CA’s, but you get hypopnoea’s. With APAP mode you get CA’s with EPR at 2 and you need a top end above 12, probably something like 15.
Whether you use CPAP or APAP mode, you need more pressure to control the OSA.
Something to consider trying is setting you CPAP pressure to 11, with or without EPR set to 1 or 2. EPR will be mainly to make it more comfortable to breathe, so you decide whether you need it or not.
I think you need EPR, quite possibly more than your current machine can handle. You are likely a good candidate for a Vauto as it offers more options for treatment.
