Expiratory Pressure Relief (EPR)

[CPAPExplorer]

I'm facing challenges with my CPAP settings, specifically with Expiratory Pressure Relief (EPR). Contrary to my expectation that turning it off would improve things, it hasn't reduced clear airway, it's causing more leaks, hypopneas (a new problem for me), and my pressure is all over the place and hitting pressure limits. Despite recommendations to turn off EPR for more effective therapy, that approach doesn't seem to be working for me. Considering this, should I turn EPR back on to level 3. Should I also adjust my minimum and/or maximum pressure? For context, my weekly average pressure limit with EPR on level 3 was 6.71, and my 95% pressure was 7.58. Any insights or suggestions would be highly valuable!

https://postimg.cc/xcLJHSjw

https://postimg.cc/DStMNL3J

[Pugsy]

Despite recommendations to turn off EPR for more effective therapy

Where did you get that idea?

Considering this, should I turn EPR back on to level 3.

I would if it were me.

Should I also adjust my minimum and/or maximum pressure?

I don't see any need to but maybe you had some specific goals that you hoped to attain if you changed something.

BTW turning EPR off will ONLY reduce the centrals IF those centrals are triggered by EPR itself.
I don't see that being a concern.
If you expect to always have zero centrals you have an unrealistic expectation. We all get centrals every now and then and it's normal and not a problem unless we see large numbers of centrals either causing desats or sleep disruptions.

If it were me I would go back to using what lets me sleep good and feel good and quit over analyzing things.
Expect nightly variations in everything because we simply don't sleep the same each night.

[CPAPExplorer]

What causes clear airway on Oscar, too much EPR and / or pressure, is clear airway the same thing as central apnea ? I had 0 clear airway when using AirTouch N20 and I get over 2 since switching to Evora Full Face mask.

I set a fixed pressure of 7.4 but changed it to 7 when I woke up (so disregard the pressure of 7 on the screen shot)

https://postimg.cc/FYc5nNpS

[Miss Emerita]

Please don't fret over these CAs. They are completely insignificant. In the most recent screenshot you posted, those events occurred while you were awake. (We can see that because of the arousal breathing in the flow rate, which is deeper and less regular than asleep breathing.)

What really strikes me is that in the posted charts, you're using the machine for short lengths of time, ranging from 2 hours to 5.5 hours. Is that all you sleep, or do you take off your mask at a certain point in the night?

[CPAPExplorer]

Please don't fret over these CAs. They are completely insignificant. In the most recent screenshot you posted, those events occurred while you were awake. (We can see that because of the arousal breathing in the flow rate, which is deeper and less regular than asleep breathing.)

What really strikes me is that in the posted charts, you're using the machine for short lengths of time, ranging from 2 hours to 5.5 hours. Is that all you sleep, or do you take off your mask at a certain point in the night?

What does sleep and arousal breathing look like?

I wake up every 90-180 minutes. Sometimes I can't fall back to sleep and other times I remove my mask and sleep for a few more hours. I have a diagnosis of myalgic encephalomyelitis/chronic fatigue.

I'm hesitating between keep using evora full face or switching back to airtouch n20 and taping my mouth. Wanted to give the full face mask a try to see if i would sleep better / longer and tried APAP and CPAP but nope! I think it really doesn't matter what mask and cpap mode I use.

[Miss Emerita]

As I mentioned, arousal breathing is deeper and more irregular than asleep breathing. Take a look at the last chart you posted and you'll see what I mean.

It is completely normal to wake up during the night. Many people wake up after they have REM sleep, which may be what you're doing. In addition to full wake-ups, we normally experience brief arousals multiple times per hour.

There's nothing wrong with wake-ups; what gets to be a problem is if you stay awake too long or can't get back to sleep.

Sleep experts tell us that when we've been lying awake for 20 minutes, the best thing to do is to get up and read or engage in some other quiet pursuit until sleepiness reappears. You might give that a try.

As for masks, you want whatever is most comfortable for you. If you go back to the N20, taping is certainly a good thing to try if you have trouble with mouth leaks.

[CPAPExplorer]

As I mentioned, arousal breathing is deeper and more irregular than asleep breathing. Take a look at the last chart you posted and you'll see what I mean.

It is completely normal to wake up during the night. Many people wake up after they have REM sleep, which may be what you're doing. In addition to full wake-ups, we normally experience brief arousals multiple times per hour.

There's nothing wrong with wake-ups; what gets to be a problem is if you stay awake too long or can't get back to sleep.

Sleep experts tell us that when we've been lying awake for 20 minutes, the best thing to do is to get up and read or engage in some other quiet pursuit until sleepiness reappears. You might give that a try.

As for masks, you want whatever is most comfortable for you. If you go back to the N20, taping is certainly a good thing to try if you have trouble with mouth leaks.

I've switched back to using the Evora full face mask because I found it difficult to breathe with the AirTouch N20, which tends to pinch my nose. After reviewing my Oscar data, do you think any adjustments are needed, or does everything seem fine? I made some changes to my settings, switching from AutoSet for Her to AutoSet Standard. I increased my minimum pressure from 6 to 7 and my maximum from 9 to 12, while keeping EPR at 3. Additionally, I've noticed a sensation of hyperventilation during sleep, and I wake up with a racing heart. Looking at my Oscar data my respiratory rate seems high ? If you want to see a close up of a certain time, let me know !

First part of the night
https://postimg.cc/dhcCw0FB

Second part of the night
https://postimg.cc/MvLSQcH7

[Miss Emerita]

Your settings seem do be doing a good job for you. I'd leave them right where they are.

People sometimes breathe faster during REM sleep. It's possible that's what you're experiencing.

[CPAPExplorer]

Your settings seem do be doing a good job for you. I'd leave them right where they are.

People sometimes breathe faster during REM sleep. It's possible that's what you're experiencing.

Thanks