(08-10-2017, 01:43 AM)buckrogers76 Wrote:

(08-10-2017, 12:32 AM)quiescence at last Wrote: yes. so, as SR says - the EPAP is increased to correct as much as possible the OA, and the EPR is increased to help correct the hypopnea.  

so, my action if this were my data is -
keep EPR at either 2 or 3 to battle the hypopnea, and have the EPAP minimum pressure to about 13. so, my minimum pressure would be 13 plus EPR.
>  Option 1: with EPR set at 2, the min pressure would be 15.
>  Option 2: with EPR set at 3, the min pressure would be 16.
In either case, I would put max pressure at 20, but see how it works out (tempted to set my max pressure as min pressure plus 2. so pressure 15-17 or 16-18.)

good luck with your adjustments.

QAL

Hi quiescence

Have a look at my charts for last night and then have a look at my charts from when i had the EPR set higher. My Hypoapnea score is lower now than when my EPR was higher. What do you think , as my numbers have fallen again I'm tempted not to mess with the settings and spoil it.

My biggest issue now is mask leak! it's not mask leak from how I've got it on but more from when i sleep on my side as the mask gets slightly dislodged and causes the leaks. As soon as i move to turn over it stops!

Regards

Buck

(08-16-2017, 04:23 PM)Sleeprider Wrote: The events are obstructive, and higher minimum pressure is indicated.  I don't know what background one must have to be a "consultant", but they must be really smart people to insist that you be treated poorly!

One other idea for you.  The high number and clustering of events is shouting "soft cervical collar" to me.  Your pressure does get high enough to address those events yet you're not responding.   There may be some positional issues here.

(08-17-2017, 08:14 AM)Sleeprider Wrote: The hypopnea are not a huge concern here because you have a great tidal volume at 660 mL.  It is unlikely that the hypopnea are going to be a big problem for you in terms of not getting enough air.  That said, the remaining hypopnea do line up with flow limitations, so we can conclude this remains an obstructive issue.  I think how you feel, and perhaps your eye irritation may be related to leaks.  It is quite high and this is either a bad fit or mouth leaks, and with the use of a FFM, I have to go with fit.  So you might be getting a nice blast of air in your eyes through the night.  Mask fit and leak reduction is really your next big task.  I don't see a need for more pressure, and the positional therapy has helped a lot.  Continue working with that strategy and try to get a more comfortable fit.

It's safe to say your machine is doing a lot of work to rise from a minimum pressure of 6.0 to its average of 13 and 95% pressure of 16.3.  You will eventually find a steadier pressure is more comfortable.  I recommend you start increasing minimum pressure towards a minimum of 12.  Do this at a pace that is comfortable for you, but a minimum pressure of 6.0 is pretty pointless for you, and starting at a higher pressure may help you to get a better mask fit for when pressure goes higher...and it always will.  I think your pressure is getting pretty high, so you may want to introduce EPR for comfort.  You have not had any issues with central apnea, and EPR can help provided you also adequately increase minimum pressure.