Any thoughts on reducing my RERAs?

[whocansay]

I would appreciate any advice you might have on what I can do to reduce my RERAs. I have been on therapy for about a month. FYI, for the first 3 weeks, I was using the AirFit N30i but couldn't manage the leaks. Last week I switched to the Respironics Dreamwear nasal mask and have had much more success with very few, if any leaks. I have attached 3 nights. September 8th was with the N30I and the other two were with the Dreamwear.

My RESMED 10 was set up by a technician. I am currently on pressure 6, EPR 3 fulltime (though really it is basically 2 since the machine doesn't go down to lower than pressure 4). The 6 was determined by her after having been on a range. She told me she picked six because I was using six 95% of the time. I suspect she meant 6 was at my 95th percentile. Since my AHIs are below 5, she feels like her job is done.

I discovered OSCAR last week and have since been digging into my own therapy. I so appreciate this group! My AHIs are generally pretty low. However, now that I have OSCAR, I can see that I have a ton of RERAs. I noticed on this board that the recommendation is using EPR 3 fulltime when you have a lot of RERAs. What would make sense in my case? Would it help things to increase to 7 so that I would have a true EPR 3? Or would that not help since I am basically already at 4 on the exhale and would still be at 4 on the exhale with a pressure of 7? (Hope that makes sense!!)

Any and all thoughts on what I might be able to do to reduce my RERAs would be super appreciated!

Thank you!

[Pugsy]

Are you experiencing any nasal congestion at night?

How many times are you waking (that you remember) during the night?

[whocansay]

I have a little bit of nasal congestion but not much and not every night. A while back we raised the humidication and it seems to have taken care of most of it.

I wake up a lot. There are stretches where it feels like I'm tossing and turning quite a bit. Particularly later in the night, like after 4am. The first stretch of the night tends to feel pretty solid. The last stretch less so. There's variability to it, but generally.

Thanks for the questions. Hope this helps!

[Pugsy]

The flow limitation graph is very active and adding a little more EPR might help. They could be a big factor in the RERAs since you reporting waking often during the night.

2 ways to try to reduce FLs....EPR being added in and also simply increasing the baseline pressure.

You are already using EPR but at 2 since your pressure is set to 6 and the machine won't go below 4.

You need to increase your baseline pressure to at least 7 so you can give EPR set to 3 a chance.
Worth trying. To be honest I think you are going to need a little more than 7 baseline because we can't increase EPR.

So....if it were my report I would increase the baseline pressure to 7 and have EPR set to 3 and give it a shot.

[whocansay]

Thank you! I will give that a go for a few nights and see how I do. Very much appreciate your thoughts and suggestions!