need your advices

[Metehan]

Since my titration report is not in English, I did not include it in its entirety. I only put the pressure graphs in the report

[Metehan]

Hi Again!
My pressure has been 8.5 - 12 for 11 days. My results are very good as in the attachment, I am not bad myself. Should I increase the pressure to 9? Should I make changes to EPR?

[Sleeprider]

I'm not seeing a need for higher pressure and your Philips CPAP uses Flex not EPR. We see more residual events with Philips machines than Resmed, and there is a mix of CA and H events here along with variable breathing that may not be helped by increased pressure. There is some variation from night to night. I notice that your machine is varying pressure according to the auto-algorithm between 8.5 and 10.0. These have nothing to do with events. I'm tempted to suggest a more fixed pressure, then trying small pressure changes. If you will set the minimum and maximum pressure both to 9.0, we can try a slightly higher pressure and eliminate the pressure variations.

[Metehan]

Should I set it to 9-9 in apap mode? Or should I set it to 9 in cpap mode?

[Metehan]

Hello again
I have been using autocpap since October 2023. My ahi values are generally less than 5. My leg pain and general fatigue disappeared and I lost approximately 10 kg of weight. But insomnia and inability to get full sleep continue.
With the advice of experienced friends here, I tried increasing my pressure and raised it up to 9. But my doctor said I didn't need to increase it that much. He said 4-10 pressures are enough. He advised me to use an oro-nasal mask, not a nasal mask. I reduced the pressure but continued to use the nasal mask.
I noticed that there were respiratory flow disturbances that my machine did not recognize as apnea. I think these interrupt my deep sleep. These disturbances occurred at all pressures between 4 and 9.
1- Would an oral-nasal mask be better for me?
2- how do I fix these flow disturbances

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1- Would an oral-nasal mask be better for me?
2- how do I fix these flow disturbances

[Metehan]

In Addition In addition

When these respiratory disorders occur, there are sudden increases in tidal volume and inspiration time. These increases do not occur during times of hypopnea.

[Sleeprider]

Increase pressure to 7.0. Most of the events are actually a breath-hold. For example at 06:27:50 and 06:25 we see a strong inspiratory peak followed by zero flow. That is an inhale and no exhale or breath-hold. This results in longer inspiration time being recorded, and the event is a brief voluntary non-breathing. This increases CO2 in your blood which results in some hyperventilation, followed by a dip in respiration rate and volume as you come back into balance again.  All of this is normal. The remaining hypopnea are a feature of pressure being too low.  What Flex setting are you using?

[Metehan]

A fllex 1

[Sleeprider]

Let's use a pressure range of 7.0 to 9.0. Flex is okay at 1, and you may want to try 2.

[Metehan]

Mr Sleeprider
I am trying to understand.
Why 7-9 pressure?
Is it because my median pressure for 189 days is 6.39?