Increase in Hypopnea after turning off EPR

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fdw
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Increase in Hypopnea after turning off EPR

Post by fdw » Tue Sep 16, 2014 6:45 am

Last night I turned off EPR (was on 2), I see a 3-5 fold increase in Hypopnea.

Looks like I woke every 2+ hours.

Maxed out the MAXMUM pressure setting (14.0) first time!!!!

Now What? Increase Min and Max to 11.0 - 15.0 and leave EPR off.

Again, thanks for your help!

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ResMed AirSense S10 Autoset (Ins. Pur. 3/16/2016)
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Started CPAP March 1995 with a pressure of 11.0

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Pugsy
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Re: Increase in Hypopnea after turning off EPR

Post by Pugsy » Tue Sep 16, 2014 6:57 am

Statistically in terms of therapy that increase isn't huge. We don't sleep the same each night and we can and will have wider variances than that and not change anything at all. It's still well within acceptable range. If you go making changes every night based on what you see from last night you are likely to be chasing your tail around in circles.

Turning EPR off shouldn't have increased the hyponeas..it should have decreased them. If they increased it could just be a coincidence and maybe you would have had more if EPR had been used.
Maybe your body which has been used to the comfort of EPR at 2 needs some time to adjust to no EPR....especially if you woke up more often than you normally do during the night.

I know the knee jerk reaction is to see something that we might not like and keep wanting to change little things but we can't make changes based on one night (unless the results are horrible and this is far from horrible).

Turning off EPR effectively increases the pressure and should decrease the chances of the airway collapsing....not increase it.

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fdw
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Re: Increase in Hypopnea after turning off EPR

Post by fdw » Tue Sep 16, 2014 7:23 am

Pugsy wrote:Statistically in terms of therapy that increase isn't huge. We don't sleep the same each night and we can and will have wider variances than that and not change anything at all. It's still well within acceptable range. If you go making changes every night based on what you see from last night you are likely to be chasing your tail around in circles.

Turning EPR off shouldn't have increased the hyponeas..it should have decreased them. If they increased it could just be a coincidence and maybe you would have had more if EPR had been used.
Maybe your body which has been used to the comfort of EPR at 2 needs some time to adjust to no EPR....especially if you woke up more often than you normally do during the night.

I know the knee jerk reaction is to see something that we might not like and keep wanting to change little things but we can't make changes based on one night (unless the results are horrible and this is far from horrible).

Turning off EPR effectively increases the pressure and should decrease the chances of the airway collapsing....not increase it.
I agree about the EPR off should not have caused an increase in Hypopnea events and maybe it is coincidental...sure is odd though.

The thing is I feel better today which is a good thing. I sure do like EPR on but if it's causing me not to not feel good then it's gotta go....Time will tell I suppose.
ResMed AirSense S10 Autoset (Ins. Pur. 3/16/2016)
AutoCPAP 10-15 EPR 1.0 (Latest Sleep Study 3-7-16)
Started CPAP March 1995 with a pressure of 11.0

bv1800
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Re: Increase in Hypopnea after turning off EPR

Post by bv1800 » Tue Sep 16, 2014 11:35 am

While I agree with the other comments that 1 night shouldn't be considered a determination of cause and effect.

If you keep the EPR turned off for a week and continue to see an increase in hypopnea's there may be an explanation. It is my understanding that hypopneas can be obstructive or central (the machine can't distinguish which). If EPR can help control central apneas, it wouldn't be unreasonable to conclude that turning off the EPR might lead to an increase in centrals which may be apneas or may be hypopneas. In your case, they might be hypopneas. Given the literature that I've read, sleep experts are struggling with these distinctions, so it may not be as clear cut as I'm making it sound.

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Re: Increase in Hypopnea after turning off EPR

Post by Wulfman... » Tue Sep 16, 2014 1:22 pm

You say the Hypopneas increased.......but did the Apneas decrease?

(Those are nasty looking pressure lines, too.)


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fdw
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Re: Increase in Hypopnea after turning off EPR

Post by fdw » Tue Sep 16, 2014 2:15 pm

Tonight I will be using the NEW (to me) AirFit 10F FaceMask for the first time....

I also will increase the Maximum pressure from 14.0 to 15.0, and the Minimum to 11.0 and EPR back to 2 maybe 3.

I'll consider all recommendations.
ResMed AirSense S10 Autoset (Ins. Pur. 3/16/2016)
AutoCPAP 10-15 EPR 1.0 (Latest Sleep Study 3-7-16)
Started CPAP March 1995 with a pressure of 11.0

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archangle
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Re: Increase in Hypopnea after turning off EPR

Post by archangle » Tue Sep 16, 2014 10:43 pm

Tinker slowly and observe the results for a while before drawing conclusions.

I'm firmly convinced that EPR is one of the things that's simply trial and error. What helps one person has the opposite effect on others.

The human respiratory system is complex with a lot of inputs and a lot of feedback mechanisms. The way is responds is often puzzling and contradictory. EPR seems to be more paradoxical than most CPAP parameters.

Yet another reason everyone needs a good data capable machine and needs to monitor the results when they have problems.

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