hwnboy therapy thread

[Jay51]

If you had a large number of CA's on your sleep study (or you can prove to your Dr. that you are still having a lot - by increasing EPR to the maximum to combat the flow limitations), then my might get a sleep study with the ASV to confirm this.  

ASV was designed to stop CA's with its dynamic back up rate, but it can very effectively treat OSA also.

[hwnboy]

I decided to experiment with the effects of EPR on my therapy. For the past several weeks, I’ve been using CPAP mode with a pressure of 8 cmH2O and EPR set to 3. Curious about the impact of turning EPR off, I noticed a significant drop in central apnea events, but an increase in flow limitations, RERAs, and hypopneas. After collecting a week’s worth of data, I’m now planning to use EPR at 1 for the upcoming week to see if I can reduce the flow limitations, RERAs, and hypopneas without causing a substantial rise in central apneas.

Attached are the last 7 days of Oscar data with EPR off.

                 

[hwnboy]

October 17, 2024               October 18, 2024             October 19, 2024
                 

[hwnboy]

Here is last night, October 20, 2024 - the flow limitations bothered me over the week, although I had a significant decrease in Centrals.
   

[Jay51]

It can be a balancing act like you are seeing.  I hope your experiment works.  If it doesn't, you have some good charts that you have already posted to go back to.

[hwnboy]

Hey Jay51,

Yes, I’m hoping that this week with EPR set to 1 will prove that I should continue using it. Several friends have suggested that I shouldn't, but I have to say that after last night with EPR back on at 1, I feel like I had a better night’s sleep. I’m not sure if it’s just wishful thinking, but my head doesn’t feel as heavy this morning as it did last week when EPR was off. Granted, it’s only one night’s data, but I do feel lighter today. I’m not sure if I’m interpreting the data correctly, but it seems that when my flow limitations are higher, I don’t feel as well. I’m looking forward to this week’s experiment and will try to be very mindful of how I feel each morning.

I know what CPAP mode at 8 cmH2O with EPR set to 3 looks like—I tend to have more CA events. In the best case scenario, when I try EPR at 2 next week, hopefully, the number of CA events will be at an acceptable level. 

Also, that last hypopnea at 4:06 am was SWJ as I was lying there debating if I should try to continue to sleep, or get up.

Last night October 21st - Day 1 of 7 with EPR 1
   

[Jay51]

Not a bad looking chart here with EPR 1 full time.  Glad that you stated you felt better upon waking in the morning.  It is your call here probably based the most on how you feel in the morning.  It seems like it will either be EPR 1 or EPR 2 for you.  EPR seems to be producing more CA's.

[Sleeprider]

I agree with Jay51 and will add the Vauto with higher trigger would resolve both flow limits and CA.

[hwnboy]

Hi Sleeprider,

Thank you for the feedback. I think I’ll need to consult my sleep doctor about doing another sleep study with ASV to confirm. My first sleep study in April didn’t provide much information since I never fell asleep, so they prescribed the Resmed Airsense based on the results of an at-home ring sleep test and my high blood pressure.


I wonder if they will consider switching out my Resmed Autosense 10 with a VAuto before I have paid off the first machine?

Thanks for the help! Always appreciated!