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SECOND NIGHT on an APAP Machine! Please HELP share your insight!

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DavidHorn +0 points · over 1 year ago Original Poster

Second night, Sierra and Bonjour, and others, please help share your insight? I made slight modification since first night.

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Sierra +0 points · over 1 year ago Sleep Patron

That is somewhat improved. Your max pressure has come down, and was not limited by the maximum setting of 14. My recommendations basically remain the same. When you use EPR in Ramp Only you may as well set it at the maximum of 3 cm. Also is your ramp in Auto? The first time you went to sleep it seems to be based on mask pressure, but on Pressure I see a ramp up. Your second time to sleep there seemed to be no ramp at all??

My thoughts would be to reduce max pressure to 12 cm, increase minimum to 8 cm, use Auto Ramp with a start pressure of 7 or 8 whatever you feel is comfortable. It should feel like there is no resistance from the mask when you breath in even more deeply than normal. Leave EPR in ramp only but set it at 3 cm. The idea is to get maximum comfort while you are awake during the ramp.

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bonjour +0 points · over 1 year ago Sleep Commentator

Did you have any mention of Central/Mixed/Clear/Complex/Emergent apnea anywhere in your diagnostic study? If not your Central Apnea will likely clear in 2-3 months. It doesn't always, just ask Sierra.

These results are essentially the same as before, Centrals are marginally better, but not significantly so. You are missing 2 significant charts that showed a significant amount of activity last time. Flow Limit and Snore.

Your numbers are good, and with the Centrals warrant watching at the very least. With your numbers and seeing no significant changes in your therapy, I do like to base advice on the elimination of symptoms, your comfort, and how do you feel? I will not suggest changes that would impact your flow limits and/or snores without seeing the impact on those charts from the changes that you made.

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Sierra +0 points · over 1 year ago Sleep Patron

Comfort with a good AHI is certainly the objective. My wife was diagnosed with an AHI of over 80. When the machine is not pressure restricted it responds to flow limitation and snore to increase the pressure to higher than she wants to put up with. I limit the pressure to effectively control AHI, but not the flow limitation or snore. That is the way she wants it. Despite the pressure limitation her AHI averages about 0.6. See example below. See does well as centrals are not a problem for her. The OP and myself are not so blessed... Although since the OP is just starting there is some hope the central events will reduce or even go away.

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boomer +0 points · over 1 year ago

My input is pretty minimal, looks like your max pressure is ok your not bouncing off the max. It looks like you could increase the minimum pressure to 8 you will get in to the sweet spot quicker. On the ramp I concur I found 6 or so provides pretty comfortable breathing, you want to eliminate breathing resistance With the mask on while awake, The EPR I like 3 makes exhaling much more comfortable, I read you can get rid of it with experience.

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Sierra +0 points · over 1 year ago Sleep Patron

The reason for limiting maximum pressure is to try and reduce the frequency of central apnea events. They tend to be induced by higher pressures. The idea is to reduce max pressure until OA events start to become significant.

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