hypopneas

[Kryogen]

most of my events are  hypopneas(50%+), with flow limitations and centrals.
AHI 1.5-3 average.

I have reduced EPR to 1, didn't make a difference.
Pressure is 7-12 but the machine keeps it mostly at 8.

What can I do to reduce hypopneas? Are those obstructive by nature or central?

[DeepBreathing]

Hypopneas are typically obstructive and can be treated by increasing the pressure. However if you are having centrals, then increasing pressure might make things worse, so make gradual changes and wait a few days (or more) between changes to see how your body adapts. Your actual AHI is not too bad (regarded as clinically treated) so if you are getting restful sleep, then perhaps you don't need to worry too much.

[Newbee2016]

Note you are using a Dreamstation too. One suggestion is turn off the EPR and see what happens. I no longer use EPR and my AHI dropped - I too have mostly hypopneas. To get the improved AHI I would have to up the min pressure if I continued using EPR.

[chill]

Newbie means turn off the Flex.  EPR is a Resmed term.

[Kryogen]

ok I will set flex to 0 tonight

[Sleeprider]

Nearly every titration protocol for bilevel, suggests increasing EPAP to resolve CA and increasing pressure support for hypopnea, flow limits and snores. The Dreamstation is a CPAP. It does not have EPR or pressure support. The Flex setting can be used to drop the exhale pressure momentarily, but because it is proportional to flow, Flex tends to be a poor treatment for hypopnea. Ideally, you would have a bilevel machine which can specifically target hypopnea; however, with CPAP, we raise minimum pressure and use the Flex, or better, EPR with a Resmed.

Bottom line, increase your minimum pressure in 0.5 increments, and use Flex if it does not cause CA. A very common problem with Philips Auto CPAP machines is that they tend not to increase pressure very fast, and decrease pressure too fast, resulting in hypopnea. The increase in minimum pressure nearly always resolves this, but you're going to have to keep raising the pressure until you find that sweet spot.

[Sleepster]

most of my events are  hypopneas(50%+), with flow limitations and centrals.
AHI 1.5-3 average.

That's pretty good. Keep in mind that there is no clinical difference there, so anything you do is very minor.

I agree that raising the lower end of your pressure range is the thing to do. Presuming of course that the higher pressure doesn't cause any comfort issues. Some people can be very sensitive to it, causing things like aerophagia.[/quote]

[Newbee2016]

Newbie means turn off the Flex.  EPR is a Resmed term.

Thanks Chill, I stand corrected.