More than one year with CPAP/APAP and no progress

[otterley]

And Epr ? It is secondary in my case ?

I really appreciate your help.

[Pugsy]

And Epr ? It is secondary in my case ?

I really appreciate your help.

Have no idea. You can try turning it off and see. I seriously doubt that EPR is causing the central apneas but it wouldn't be impossible and again worth trying and an easy experiment.

[palerider]

Do you have any idea why my doctor told me to use fix pressure only ??

because most doctors don't understand the way auto cpaps work.

[SeekSleep]

As someone who has both PTSD related anxiety, and severe sleep apnea my personal experience is that the anxiety and other mental aspects have more of an impact on how beneficial my sleep is.

My sleep apnea was treated prior to my developing PTSD and the resultant severe anxiety. Initial sleep lab results were AHI of 102 severe obstructive apnea, with an assortment of centrals mixed in that would last up to 1.5 minutes. They woke me up a couple times due to low oxygen levels, and it took two more sleep lab trips to get things dialed in to where I was doing good on an ASV machine. It made a difference in how I felt, but I was actually pretty adapted to the sleep apnea, and wouldn't say it made a huge difference other than no more morning headaches.

The PTSD however really impacted things for the worse sleep wise. I couldn't sleep without meds, and while the meds put me to sleep, it wasn't refreshing and I felt like crap, which of course added to the anxiety. It was a rough downward spiral. Luckily, my situation was such that I had all sorts of options that would pay for all the counseling I wanted/needed and cost free medical coverage to get me through till I could work through the emotional stuff. In the end, finding solutions to the anxiety that doesn't involve medications are what it took for me to get back to sleeping well. I still need the machine, but the sleep apnea is only one aspect of getting good refreshing sleep. The machines are great at treating apneas, but they can't counteract the negative affects of medications, nor can they take care of the issues that resulted in your needing the medications.

Your sleep apnea treatment shows some room for improvement, but you appear to be doing relatively well with it. My personal experience would lean me to believe you can make a significantly bigger difference if you find a way to take care of the anxiety, preferably without medications as they always have side affects. That is something that can make a huge difference

[otterley]

Hello !

Last night was better with a mixed with the settings of you and mine, but rather near what you advised : Min 10.6 max 14.6 EPR 1
It went up to 14.4 and 95% 13.6
Never had so high pressure.

AHI 1.91 and CA 1.5 ! it's good I think ? Still some flow limits...
Deep sleep 1 hour and quality near 6 hours !

What bother me with high pressure is when I am in ramp mode, I have a lot of User Flags which prevents me to fall asleep quickly maybe ?
Screenshot of that case :

Screenshot 2021-09-25 144426.png (259.19 KiB) Viewed 1016 times

And I need lower pressure to fall asleep.

Maybe why not try pressure for instance 8-16 EPR 1 without ramp ?

Or 11-16 with 8 ramp (40 minutes) ?

Thanks again and have a nice day.

[otterley]

And last screenshot of another wake up event just for information

Screenshot 2021-09-25 133041.png (275.26 KiB) Viewed 1016 times

[palerider]

please organize your charts so they look like the example in this tutorial:

https://www.cpaptalk.com/wiki/index.php/Oscar:organize

resize them so that the six requested ones fill the space, with the majority of the space being flow rate, pressure, and leaks.

bump you min pressure to 11 and set max to 20, and just leave the max there, it's largely irrelevant.

[otterley]

please organize your charts so they look like the example in this tutorial:

https://www.cpaptalk.com/wiki/index.php/Oscar:organize

resize them so that the six requested ones fill the space, with the majority of the space being flow rate, pressure, and leaks.

bump you min pressure to 11 and set max to 20, and just leave the max there, it's largely irrelevant.

Ok I will be careful for better charts format, sorry...

Ok for settings 11-20, but what about ramp ? no ramp ?

[onward60]

About medication I take melatonin around 10pm. Go to sleep at 11 max.
I take diazepam. A few drops. Sometimes I add some antihistamine sleeping pills. I tried many meds.

For years antidepressant. Sertraline at the moment.

Diazepam is a benzodiazepine. They can make sleep apnea worse in some people.

https://www.sleepapnea.org/bad/

However, never abruptly stop a benzodiazepine. They need to be tapered over many months. There are forums online to help with getting off of them safely. Benzobuddies.org is one.

[palerider]

Ok for settings 11-20, but what about ramp ? no ramp ?

That's up to you, if you feel you need a ramp time before getting to treatment pressure, then use ramp. If you don't, then don't.

Ramp has nothing to do with therapy.

[otterley]

Hello

I keep you in touch : No doubt there is a progress with Palerider settings after a few days.
I am very grateful, I hope it will continue like this.

Just another question : my flow limits are still high, do you think it is a good idea to try EPR at level 2 ?

Regards

[onward60]

About medication I take melatonin around 10pm. Go to sleep at 11 max.
I take diazepam. A few drops. Sometimes I add some antihistamine sleeping pills. I tried many meds.

For years antidepressant. Sertraline at the moment.

Sorry to hear about your troubles. The diazepam caught my eye. How much is a few drops? It can worsen sleep apnea in some people.

https://pubmed.ncbi.nlm.nih.gov/1968716/

[otterley]

About medication I take melatonin around 10pm. Go to sleep at 11 max.
I take diazepam. A few drops. Sometimes I add some antihistamine sleeping pills. I tried many meds.

For years antidepressant. Sertraline at the moment.

Sorry to hear about your troubles. The diazepam caught my eye. How much is a few drops? It can worsen sleep apnea in some people.

https://pubmed.ncbi.nlm.nih.gov/1968716/

It's only from 4 to 8 drops.

[Miss Emerita]

About EPR: I see no harm in your trying 2. It's possible you'll see an uptick in your CAs -- or not.

In one of the zoomed-in shots you posted, we see FLs followed by an arousal. For some people FLs make no difference to the quality of their sleep; for others, they can pose some problems.

So some experimentation would be reasonable, I think.

[otterley]

Ok I will try EPR 2 tonigh and I'll make a report