UARS Advice

[tan]

I haven't really noticed any difference between EPR 3 and EPR 0 but I've kept it at EPR 3 because why not and I've heard it helps some people. There's no particular reason that I have it at a fixed pressure as opposed to a variable one, I thought it'd make it easier for me to find the right pressure for me but I've had my CPAp on APAP ranges before as well.

well, some people report better results with EPR==0 . How did your graphs look like when your APAP was free-range? 4-20, I mean

[tan]

Those spontatenus arousal are a big deal. Almost as big as UARS. I would pursue sleep hygiene, which includes everything our Chicago posted. Have you considered sleep restriction therapy?

[Jay Aitchsee]

I am under impression that he does, and not only UARS. Here is what he wrote in his initial post:
"Naturally, I went to a sleep doctor and got a sleep study which revealed that while my AHI was around 2.5, I had an average of 37.4 arousals per hour, 21.7 of them respiratory and, according to the report"
Which leaves some 15 events an hour to something else...I disagree that wakening every 3 hours is normal

I think the number of arousals and awakening per hour and/or per night is much greater in the "normal" population than many realize. Quite a few references can be found which put the number of normal eeg arousals per hour at anywhere from single digits to over 100 in the aged.

For example, this study finds a mean of 21 awakenings per hour (ASDA scoring) in a control group of normal subjects: http://europepmc.org/abstract/med/7676165 and goes on to say, "It is important that those scoring arousals on routine polysomnography recognize that high arousal frequencies occur in the normal population on 1-night polysomnography."

and this study finds an average arousal index of 14.7 (events/Hr) among a control group of young adults: http://www.journalsleep.org/articles/210404.pdf

and there are many more, such as this: http://aasmnet.org/jcsm/Articles/030305.pdf, which states, "The strong correlation of AI [Arousal Index] with other sleep variables validates brief arousals as a normal component of sleep."

With regard to Residual Excessive Daytime sleepiness (EDS), I'm not saying that fragmented or disturbed sleep should not be treated, but it is important to investigate and treat all the possible causes. I am saying, and I think you agree, Tan, that the first step should be a strict adherence to the principles of Good Sleep Hygiene.

[Jay Aitchsee]

Testing of the ResMed Autoset For Her Algorithm (funded by ResMed)

Conclusion (paraphrased): "It's not worse than the standard algorithm and it might be better"

Although a little short on substance, this paper may be of interest to those treating UARS and FL

As an OBTW, it appears from the causal examination of my data that a Flow Limitation equal to or greater than 0.05 will result in an increase in the S9 Autoset pressure, while a Flow Limitation of 0.03 or below will not. Values greater than 0.03 may result in a pressure increase dependent on duration. Again, this is from a casual examination and may not be exact, but I think it's close.