Do I need more pressure????

[Cudos]

Good Morning all,

I'm still trying to find my sweet spot on my machine. In the beginning I had struggled with the feeling of suffocation, which is getting a little better. I've received some good advice here, some of which was to use a narrow set up to start with such as the one I'm using now. 6.8 - 8.2 with EPR at 1.

I still toss and turn, wake up feeling a little short on air sometimes, sometimes I wake and just have to scratch my nose,"aggravating" I turn off the machine first to do that. I am reading SH right, it looks like I'm maxed out at 8.2 most of the night?? I've always had mostly RERA's and Hypopnea's, do I need more top pressure??

Does it look like the Auto setting will work for me assuming I find the sweet spot? I feel foggy and bagged today. I've been at this setting for a week now with similar results.

Thoughts

Cheers all.

[Julie]

Don't remember the history of this, but certainly it wouldn't hurt anything to raise your low pressure x 2 cm for a few nights and the high by at least as much if not more (it seems awfully low, tho' there may have been a reason for it that I'm unaware of). Experiment a bit unless you know something I don't. 6-7 is still quite low for the lower one regardless.

[Cudos]

Thanks Julie,

If I raise the bottom pressure to 8.8 and top to 10.2 should I bump my EPR up from 1 to 2 (given my prev history with exhale) issues? or is it better to leave EPR out of the equation??

cheers

[Julie]

I think I'd wait and see how you feel and then decide. Why is the top pressure btw so low? Most leave it at least a bit higher in relation to the low setting.

[Cudos]

Julie I think it was suggested that my low and high pressures weren't too far apart due to the large amounts of RERA's I tend to have. The thought was that maybe a large change in pressure from low to high would cause even more arousals??

I suppose I'll never know until I give it a shot. Maybe I'll experiment with a low of 8 and high of 12??

If I read SH right the "time at pressure" looks like it was maxed out on both low and high for extended periods, which if I read right would seem to imply I need more pressure.

I suppose if my pressure are too low it could cause lots of Rera's too

Cheers

[Pugsy]

If I remember correctly we elected a super cautious approach due to the adjustment issues you were having initially and while we suspected you needed mostly likely both more exhale and inhale pressure we didn't want to have you back slide in terms of having significant issues breathing against the pressure and sleeping period.
The best settings in the world are useless if you can't use them or can't sleep with them.

Up to you how gutsy you want to go with the increases now. My original thoughts a while back were simply get you to see where the machine wanted to go and not destroy your sleep in the process. We now know it wants to go up to at least the max for a good bit of the time. We don't know how far it wants to go..it might not be very far at all or it might be substantially higher.

The OA and hyponea clustering...the usual suspects are supine sleeping or REM sleep or a little bit of both. That hasn't changed. From my own personal experience in my therapy and seeing it often in others...we don't know how high the machine wants to go to deal with them until we let the machine go there.
Hopefully the getting there process doesn't create other issues along the way.

I have suspected that you are going to need to increase both minimum and maximum but by how much we don't know until you try. I wouldn't suggest a big jump in the minimum unless you try a bigger jump and it is entirely comfortable to you now.
Just so you know...if you increase your EPR then that sort of lowers the exhale pressure again so it sort of negates a small increase in pressure that was used with a lower EPR. Not saying don't increase EPR if that makes the higher pressures easier to deal with...just saying that with EPR higher you might need a little more pressure than you would maybe need at a lower pressure. It doesn't happen to everyone but it can happen and that's why I mention it.
My thoughts on EPR....use whatever feels the best and if you need to compensate with a little more minimum...so be it.
If a person isn't comfortable then they aren't going to sleep ....and we have to sleep for the settings to have any chance of being successful.

I think you have a good handle on what to look for and how to best address it. I think I might still limit the max to 12 though...let's see where it wants to go and see if it going there creates any problems.
The minimum...play with it a bit to see what feels more comfortable and start there...I would suggest at least 1 cm more minimum if you are okay with it. If you aren't...start lower and move up gradually.
There is no unwritten rule that you have to make huge changes just because it looks like you might need them.

[Cudos]

Thank-You Pugsy and Julie!

I think I am going to try and bump it 1 on minimum to 7.8 and max of 12.0, maybe I will leave the EPR at 1 for the time being.

One of the hardiest things to do is resist the urge to change settings too soon. I was hoping for instant gratification but see that won't be the case.
Thanks again guys. I'll check back in a few days