(08-05-2017, 10:06 PM)pholynyk Wrote: In my experience, with no CA, few OA, and lots of hypopneas, the thing to do is to increase your EPR to 3. You may want to increase your maximum pressure by 2, to 19, to compensate. In addition, your minimum pressure is quite a bit below your median pressure; it could probably be increased to 12 or 13 (with EPR at 3).

Now it's never a good idea to change more than one thing at a time, and always to wait 3 to 4 days (or more) before making new changes. I would recommend changing the EPR first, then slowly increasing your minimum, 1 cmH2O at a time, before increasing the maximum pressure. During this time, I would compare my charts from day to day looking for trends. You want to lower those hypopneas without getting any central apneas showing up.

I hear you about the foam collar problems. Mine was big enough to go around my neck, but so tall it pushed my jaw forward and made my teeth hurt. I think I've found a place locally that sell various sizes, so I'll try again.

(08-05-2017, 10:42 PM)pholynyk Wrote: Trust me. One thing at a time is better. And post screenshots anytime you see something you don't understand.

(08-06-2017, 07:50 AM)Sleeprider Wrote: Pholnk touched on the fact the using EPR would lower your EPAP (exhale) pressure.  This does need to be compensated for by increasing the minimum pressure.  Whereas before your minimum pressure was 9/8, it is now 9/6.  You really need to increase the minimum pressure to 11 to keep EPAP above the threshold for OA.  This will result in minimum pressure of 11/8 which I think you will still find comfortable.  

It's fine to change one thing at a time, but in the case of EPR we are really changing two things.  EPR changes EPAP which is critical for preventing OA events.  The pressure support (difference between inhale and exhale pressure) is an effective way of treating hypopnea, but we don't want to let the obstructive apnea in.

(08-07-2017, 03:12 AM)ajack Wrote: Looking back over your charts, raising the pressure isn't doing that much. It looks like there could be position clusters to me. I would make sure you aren't tucking your chin. For $10 you can get a soft foam cervical collar, to eliminate any neck airway obstruction. If needed try and stay off your back. The collar is a simple tool to determine if there are issues, without the expense of new pillows and such.

the max 17 may need to be raised and min increased more, At this stage with the charts I would guess 15 - 20, if nothing else works and then you may be better with bpap.
I would try positional therapy. some find it very successful without the need to raise pressure.