Hi Sirc, here's my thinking: Jim's AHI now is comprised mostly of CA. Increasing the pressure will not prevent them and, in fact, may make them worse. His AHI net of CA is quite satisfactory. He had no hypopneas and the few OA's he had (4) could have been caused by arousals and breath holding, so I see no reason to increase the pressure unless we start to see OA and hypopneas creep in. I think his CA's are being caused by disturbances, most likely the leaks, but it could simply be the pressure as well. Maybe, after a couple days, we'll have a better idea.Sircadian wrote:I'd be more inclined to try ~9.6 or 10 as an experiment
Generally speaking, and within reason, I think the lower the pressure the better, assuming OA's and hypopneas are controlled. A lower pressure is more comfortable, not as likely to cause leaks and not as likely to cause CA's.
EPR has the net effect of lowering the pressure, theoretically, it provides exhale relief, but, if the pressure is reduced too far by EPR, it could allow OA's to occur prior to inhale. So, if the pressure is reduced to provide comfort, prevent leaks or reduce CA's, one may have to reduce or eliminate EPR to prevent OA's and/or Hypopneas. (I think Palerider did a bit on this a while back. Maybe he'll give us a link.)
Anyway, they goal is to obtain restful, restorative, sleep with a low AHI (less than 5), but not necessarily an AHI of 0.0. Sometimes, a little AHI has to be traded for rest.