corgan115 - therapy thread

[Sleeprider]

You are in control. We can look for other ways to improve other than higher pressure.

[corgan115]

Any suggestions outside of experimenting with different masks?  It took me a while to finally find a mask I like 

On a side note, with no changes, last night my AHI for the first time ever was below 2.  The "how I feel in the morning" factor was also pretty good this morning.

   

[corgan115]

Hey folks,

I am needing some help with my therapy.  I have never had a proper titration study (insurance wouldn't cover it) and have been using an APAP.  Original settings were 4 - 15 but over time I've been slowly bumping the bottom number up.  This has reduced my average AHI from 3.5 - 4.5 to 1.5 - 2.5.  Still, I find myself pretty tired during the day and was hoping to get my AHI < 1, as I know a lot of people achieve that regularly.

Last night I decided to try another bump from 11 - 15 to 12 - 15.  I woke up significantly more tired and with a higher AHI.  Reviewing my Oscar I see last night I had more OA events than usual an even some CA events, which I normally don't have.  It's normally all OA.

I have attached my last 3 nights of OSCAR data.  Hoping someone might be able to provide some suggestions based on this data.

Thanks!

   

   

   

[OpalRose]

corgan115,
I have merged your most recent post with your original thread that you started in December in order to keep your history in one place.

This way, anyone wanting to help can easily see prior advice.

[Sleeprider]

Corgan, your settings are 11-15 with EPR 3, so your minimum pressure is 8.0 cm at exhale. If you increase the minimum pressure by 1-cm to 12.0, I think your results wil be better. All events are obstructive, and that suggests we need to increase the minimum pressure, and especially considering the EPR you are using. Just increase minimum pressure to 12.0 and I think the event rate will drop.

[corgan115]

Thanks Sleeprider, do you think there would be any benefit in lowering the EPR in addition to or in lieu of raising the pressure any higher?  If I'm not mistaken OAs occur during exhalation.

EPR was set to 3 when I got the machine and I have never tried modifying it.

[Sleeprider]

Corgan, there is no problem with trying a lower EPR setting. Your 95% flow limitation is zero, so you may not need the pressure relief or pressure support at this level. You are correct that reducing EPR will raise the minimum EPAP which should help with the OA events.