Hi there

[Pugsy]

Using EPR and/or at what setting is really a big YMMV thing. Using EPR changes the overall pressure average a bit...lowers it but increasing the minimum will offset that lowering.
You might really like EPR at 3....I know I like it much better than 2 but it's a pure comfort feel good more natural breathing thing for me. You might like 2 better...heck you might like it reduced. I always tell people to try all the settings including off and settle on whichever one simply feels more natural and comfortable to them. In my mind more comfortable always equals more chance at sleep.
When I am not comfortable I simply don't sleep so great or I have trouble falling asleep or whatever.
If truth be known I actually really prefer an exhale relief of 4 cm...available of course from a bilevel machine. I do okay with EPR of 3 but I really, really prefer 4 cm drop. It feels the best FOR ME.....someone else may not care for it...heck, someone else might like a 5 cm drop better.
My perfect machine would be the ResMed that would let me use 4 cm exhale drop AND let me use the for Her mode so that if I had 2 OAs within a minute (which I do have happen fairly often) so that the machine adjusts the minimum pressure up so I don't get a repeat of those 2 OAs. Now I know I could simply use a new minimum all night to pre empt those 2 OAs...but it's not an every night thing and I simply prefer lower pressures for the bulk of the night if I can have them.

I have sleep maintenance insomnia issues myself but it's not related to my sleep apnea. It's related to some other health issues so I deal with those issues as best I can. The bulk of my AHI is always SWJ stuff...sleep/wake/junk false positives from irregular breathing while awake during the night. Fortunately most of the time I just roll over and go right back to sleep but sometimes the insomnia monster sets up shop and I end up with a really short night.

I have experimented a lot over the years and that's just what someone has to do in an effort to figure out what suits them the best.

My primary goal has always been sleep quality though...not AHI. I learned a long time ago that for me...my sleep quality and hours of sleep is the biggest factor in how I feel during the day. 5 or 6 hours of fragmented sleep with an AHI of 0.0 is still going to come up with my feeling like crap.

I have also learned that sometimes even a relatively small change in something can make a big impact so it's always worth trying.

And there is some truth to that old "give it time" thing. It does take the body a bit of time to adjust to any change.
Plus we don't sleep the same each night so changing stuff willy nilly base on last night's results is a recipe for failure. The body never gets a chance to adjust.
Unless a change gives disastrous results a person needs to give it more than one night.

You have to go at it like a science experiment...controlled with ample time to evaluate results and always keep your variables to a minimum if at all possible.

[Guitarist]

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