Many flow limitations but AHI 2/3 and Sp02 always above 95%.. is this an issue?

ozij wrote: ↑

Fri Jan 09, 2026 4:36 am

I asked CoPilot for professional info about the Prisma Smart.


https://www.docdroid.net/LPC2YQl/prisma ... glish-pptx
Do you (plural) know it has (or will have?) two kinds of APAP pressures? (see pages 15-16)

Here's how it describes SoftPap:
softPAP
1 and 2 in CPAP and APAP
With pressure reduction during early phase
of exhalation: especially for patients who
find it unpleasant or difficult to exhale
against positive pressure
With pressure increase in time at the end of
critical end expiration phase to prevent
obstructive events.
respiratory

And page 7 shows SoftPap's pressure reduction varies by pressure!

And look at page 22:

APAP: Algorithm Details
•
Pressure range ( Pmax Pmin ) is
divided into four quartiles
•
Dynamic reactions depend on
pressure range

Its a good point... I could try Dynamic rather than standard... I can see on that link it seems to be better for UARS, which seems to be my issue. thanks!

Charlieboy UK wrote: ↑

Fri Jan 09, 2026 4:30 am

I reduced my SoftPAP (ERP) from max 2...to 1... and it cut my FL rates in half last night... how odd..

If you think that's odd, Dynamic APAP responds more aggressively to eFL so the more SoftPAP comfort you add the more pressure you get.

Seems a little counterintuitive to me.

As an aside, I think your overall sleep quality kinda sucks but that's another thing...

Charlieboy UK wrote: ↑

Fri Jan 09, 2026 5:42 am

I can see on that link it seems to be better for UARS, which seems to be my issue.

You mean the UARS that the SoftPAP caused?

Nocibur wrote: ↑

Fri Jan 09, 2026 7:10 am

Charlieboy UK wrote: ↑

Fri Jan 09, 2026 4:30 am

I reduced my SoftPAP (ERP) from max 2...to 1... and it cut my FL rates in half last night... how odd..

If you think that's odd, Dynamic APAP responds more aggressively to eFL so the more SoftPAP comfort you add the more pressure you get.

eFL.jpg


Seems a little counterintuitive to me.

As an aside, I think your overall sleep quality kinda sucks but that's another thing...

I don't really understand all those stats...this was why i did this post...my main sleep scores seem good AHI/Sp.etc .but it does look like FLs might be causing an issue. I'll try turning off softPAP, when i took it to 1 it halved my FLs. Looks like SoftPAP can make matters worse for lower pressure.

Nocibur wrote: ↑

Fri Jan 09, 2026 7:12 am

Charlieboy UK wrote: ↑

Fri Jan 09, 2026 5:42 am

I can see on that link it seems to be better for UARS, which seems to be my issue.

You mean the UARS that the SoftPAP caused?

Oddly yes it does seem SoftPAP is maybe not helping, because of the low pressure i use...i tried higher pressures, but that made leaks and AHI worse...when on APAP at 20...it was going to 16...and gave me terrible belly issues...like i was blowing up like a balloon.

Nocibur wrote: ↑

Fri Jan 09, 2026 7:10 am

Charlieboy UK wrote: ↑

Fri Jan 09, 2026 4:30 am

I reduced my SoftPAP (ERP) from max 2...to 1... and it cut my FL rates in half last night... how odd..

If you think that's odd, Dynamic APAP responds more aggressively to eFL so the more SoftPAP comfort you add the more pressure you get.

eFL.jpg


Seems a little counterintuitive to me.

As an aside, I think your overall sleep quality kinda sucks but that's another thing...

where did you get that chart from, is it my info? I cant see it on SleepHQ.. is it Oscar

It's from ozij's link page 22.

Nocibur wrote: ↑

Fri Jan 09, 2026 7:10 am

Charlieboy UK wrote: ↑

Fri Jan 09, 2026 4:30 am

I reduced my SoftPAP (ERP) from max 2...to 1... and it cut my FL rates in half last night... how odd..

If you think that's odd, Dynamic APAP responds more aggressively to eFL so the more SoftPAP comfort you add the more pressure you get.

eFL.jpg


Seems a little counterintuitive to me.

As an aside, I think your overall sleep quality kinda sucks but that's another thing...

Its ok ive found it now

Well this is rather conclusive ...i turned off SoftPAP on my Prisma SMART... and ALL my flow limitations went.. but did it really make any difference... no... AHI still stayed in the same area it has been, Sp02 still above 95%.. I might now try and increase the pressure a bit to see if it help clear down some RERA...but they are all very short circ. 7 seconds

For anyone following this thread: SoftPap and EPR are not the same thing,
And on Prisma machines that have SoftPap 3, does nothing for exhale pressure. It's meant for people who feel "airstarved" at lower pressure, and does some kind of inhale support. See https://loewensteinmedical.com/en/sleep ... prisma20a/

https://loewensteinmedical.com/media/us ... nglish.pdf

ozij wrote: ↑

Sat Jan 10, 2026 6:31 am

For anyone following this thread: SoftPap and EPR are not the same thing,
And on Prisma machines that have SoftPap 3, does nothing for exhale pressure. It's meant for people who feel "airstarved" at lower pressure, and does some kind of inhale support. See https://loewensteinmedical.com/en/sleep ... prisma20a/

I have the Prisma SMART which has SoftPAP 1-2 .. only the top of the range Prisma 20A has the SoftPAP 3...but then that machine also has lots of other features. It seems on lower pressures that have mine set at 4-8 SoftPAP 1-2 does not really help and might matters worse. SoftPAp 3 does seem to be different on the 20A machine,
The Löwenstein Medical prisma20A softPAP settings provide exhalation pressure relief to enhance comfort, with options for Off, 1, 2, or 3. Levels 1 and 2 reduce pressure at the start of expiration, while level 3 offers a higher relief and may slightly increase pressure during inhalation.