What is the lowest possible pressure setting with EPR at 3?

[ronragus]

Hi, currently my pressure is set at 7 with EPR at 3. Would I be able to dial down the pressure lower while still keeping my EPR setting? What would be the minimum pressure level I can set? thanks

[Pugsy]

You are already at the lowest possible pressure setting if you want to get the full 3 cm drop when using EPR set to 3.
The machine can't go below 4 cm....so with the pressure set to 7 and EPR set to 3...upon exhale your machine drops the pressure to 4 which is the lowest it can go.

Now you can use 6 setting but even though you have EPR set to 3 you will only get a 2 cm drop down to the lowest the machine can go which is 4.

The machine can't go below 4 cm.

[ronragus]

Thanks Pugsy, just so I make sense of this:

With a airsense autoset the lowest setting I can go while keeping a full EPR of 3 is a pressure of 7. Now- if I were to get a Aircurve Bipap, I can increase the EPR to more than three, but it still wont go below 4cm on exhale, correct?

[ChicagoGranny]

but it still wont go below 4cm on exhale, correct?

Minimum EPAP on that machine is 2.0.

Page 14 - https://www.respshop.com/manuals/37212_ ... n_menu.pdf

[Pugsy]

but it still wont go below 4cm on exhale, correct?

Minimum EPAP on that machine is 2.0.

Page 14 - https://www.respshop.com/manuals/37212_ ... n_menu.pdf

Everyone please note...that minimum EPAP of 2cm (per the manual) is available on in S mode...or fixed bilevel mode.
If using auto bilevel mode....the minimum EPAP is 4cm

Edit.....I know the manual says 2 EPAP in S mode but I had always heard and thought it was 3 cm.
So I went to my AirCurve 10 machine and tested S mode. It absolutely will NOT go below 3 cm minimum EPAP.

[chunkyfrog]

Is the intent to get compliance without treatment?
For CDL requirements?
I certainly hope not!

[ronragus]

Is the intent to get compliance without treatment?
For CDL requirements?
I certainly hope not!

My intent is to sleep as comfortably as possible. My machines has been consistently recording my AHIs as below 5 (not sure how accurate it is, as I registered 59 in sleep study without cpap), so naturally I want to decrease my pressure settings as much as possible?

Compliance doesnt mean much to me, since no one cares to follow up once the monetary transaction in buying the machine is done....

[ronragus]

Oh another question- currently I have auto ramp turned off, because when the pressure starts at 4, I felt that I couldnt get enough air. Which bring to my question, why would I feel like I cant breath at pressure at 4? The air pressure should still be much stronger/available than atmospheric air?

[palerider]

my AHIs as below 5

5 is simply not a good enough level to get adequate rest.

below 2 is a more realistic target to actually get rest.

[ChicagoGranny]

Oh another question- currently I have auto ramp turned off, because when the pressure starts at 4, I felt that I couldnt get enough air. Which bring to my question, why would I feel like I cant breath at pressure at 4? The air pressure should still be much stronger/available than atmospheric air?

I feel "starved for air" at anything below 7.0 cm. Others have reported something similar.

My guess is 1) it is psychological and 2) I could breathe fine at 4.0 once falling asleep. (Assuming 4.0 is enough to maintain airway patency.)

[ronragus]

Any pointers? Should I continue to lower pressure? Or increase pressure to dial the AHI lower? 3 nights at 6.8 with EPR at 3. I still wake up in the middle of the night (not sure if it shows) so I want to minimize that occurring. All three nights I had humidity at 5 with tube temp at 30C without rainout in a relatively cold room (15C ish).

[ChicagoGranny]

Should I continue to lower pressure?

Is there a reason you are wanting to do this? You certainly could experiment, but I don't know why you would want to.

I still wake up in the middle of the night (not sure if it shows) so I want to minimize that occurring.

Do you fall back to sleep fairly quickly? If so, I wouldn't worry about it. It's normal for humans to awaken several times during the night.

Personally, I would concentrate on good sleep hygiene (google it) including good diet and moderate exercise. Restful sleep involves a lot more than a good CPAP therapy. You want to feel good during the day and not worry about minor issues on an OSCAR report.

[ronragus]

Should I continue to lower pressure?

Is there a reason you are wanting to do this? You certainly could experiment, but I don't know why you would want to.

From the moment I woke up in the middle of the night, all I get frustrated about is that 1. It take forever to get back to sleep(sometimes never) and 2. Craving to tear off the mask(p10, already a minimalist mask) due to the overall discomfort of air pressure. So in my mind, lower pressure setting potentially = increased comfort and reduced disturbances = even longer sleep duration? I guess my concern is that I don't get sufficient deep sleep under CPAP, instead spent too much time awake breathing with the machine. I can only take so much magnesium and malatonin before bedtime, kinda screwed when I wake up in the middle of the night still tired but being inefficient in falling asleep again.

[Pugsy]

When you wake up in the middle of the night try to have the presence of mind to reach over and turn the machine off and then right back on again. This will give you a break in the therapy line so you can better evaluate any flagged events that might happen at the same time. If it takes you a prolonged amount of time to get back to sleep go ahead and turn it off and on again.

There's a chance that some of your flagged CAs/centrals are awake breathing false positives being flagged.
Other than pointing to not being asleep they don't mean much. To reduce those you obviously just need to sleep more soundly and not have the wake ups.
You might watch the videos here
http://freecpapadvice.com/sleepyhead-free-software

Also you might take your long hose and do a water test to see if there is a small hole in it somewhere that you can't see or feel. Your baseline leak never goes down to the 0.0 line. That's a bit odd to see.
Water test....fill the hose with water from end to end and look for leaks.
I had the weird baseline not long ago myself. Swore up and down it wasn't leaking because I couldn't hear or feel it but I did the water test and sure enough I had a tiny pin hole leak.

[ChicagoGranny]

I can only take so much magnesium and malatonin before bedtime, kinda screwed when I wake up in the middle of the night still tired but being inefficient in falling asleep again.

I would cease using melatonin supplements and see what happens. Anyway, it's not helping you. Despite some people swearing by it, there is no good science that shows it helps except maybe for jet lag and shift worker changes - https://www.nccih.nih.gov/health/melato ... ed-to-know Anyway, it doesn't seem to be helping you.

I would develop a strict sleep hygiene routine. This is not so easy the way we live these days.

Usually, I have been in the habit of taking early morning walks. Where I live, this winter was wet and cold. I got lazy and started going to the gym in the morning and not walking/not getting early morning sun. My sleep began to be like yours - four hours of sleep and then awaken at 3:00 or 3:30 and absolutely couldn't go back to sleep. This went on for weeks. Then I saw a video about "anchoring" your circadian rhythm with sunlight in the morning. I started doing this, and surprisingly I started sleeping the night through. My rhythm was out of sync, so it took four days before the dramatic results hit. Occasionally, I will awaken after four hours, but now I fall asleep again quickly. Instructions on the sunlight therapy are in the linked video below. Part one of the video gives the instructions. Part two is a different but very interesting topic. https://www.youtube.com/watch?v=5YV_iKnzDRg

Easy to remember:
1. 30 seconds to 30 minutes depending on brightness
2. As sun as arising, but always before 9:00 a.m.
3. Don't look directly into the sun
4. Must be outside (Most home and car windows block beneficial rays)
5. No sunglasses, but regular eyeglasses and contact lenses OK.