Hi everyone,

First , let me say how helpful I find this forum. And overall how pleased I am with my first couple weeks on cpap. My migraines and headaches are greatly improved-- by like 80%. I still wake up quite a bit, and still catch myself snoring, though.

I do think, however, that I'm not getting the full benefit, and talked to my doc yesterday on the phone. I am still getting AHI's between 5 and 13. My pressure is set for 7, with an epr of 3. In the lab, that eliminated all apneas and hypopneas. At home, not so much. I have a resmed s8 elite.

No matter what I do, the efficacy data rarely show more than a pressure of 6.2, despite its setting of 7. I've been officially eliminating leaks (stated as 0.00). But I wonder if the machine they used on me in the lab was able to give me a consistent 7, whereas my home machine doesn't for some reason. And this .8 difference is enough to change my ahi.

(I use a quattro mirage full face mask, and the machine is now on the correct mask setting.)

So I'm trying to figure out where/how I'm losing pressure. I"ve cut the ramp time to 5 minutes when I first go to bed, and when I wake up in the middle of the night to use the bathroom, I use no ramp time when I return.

The doc suggested gradually eliminating the epr. But they had the epr on in the lab, and it didn't affect my overall pressure. And last night, I cut the epr down to 2, and I still got a pressure of 6.2. I'll cut down another point of epr a night, but I don't know if that will do it. Still I'll see if I can cut it out altogether over the next several days and see how/if that changes anything.

Can you guys think of other reasons I'm not getting my full 7 that the machine is set for (when it's fully on, it says it's giving me 7, it's just that the efficacy data report something less).

The doctor understandably is reluctant to increase the pressure until we've done all troubleshooting. But I ultimately do want to get as much benefit from cpap as possible. I've had a taste of improvement, and I want a full serving!!!




Thanks!!

It could be the epr. I had the same problem, and when I stopped using epr  the effiencency rating started showing as the prescribed pressure, or .2  more if  I have leaks.  You could need a little tweak in the pressure, after all, you don't spend every night sleeping in a lab, things are different at home. Virginia


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Resmed elite , 17, mirage quattro ff . 25 + years of untreated OSA

EPR is expiration pressure relief. It reduces the pressure you receive where you are exhaling. Assuming you normally exhale half of the night and inhale half of the night it only stands to reason that your reported pressure is lower than your set pressure when your EPR is turned on.

Keep in mind too that your Elite is reporting the pressure at or below which you spent 95% of the night.


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Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.

mkoven wrote:

I still wake up quite a bit, and still catch myself snoring, though.

You should not be snoring at all...if you are, than the CPAP is not doing it's job.  You should speak to your doctor about your pressure.

mkoven wrote:

No matter what I do, the efficacy data rarely show more than a pressure of 6.2, despite its setting of 7.

The morning pressure reading is an average.  EPR reduces the pressure when you breath out so it will skew the average down.  If you want consistent pressure, you would need to turn EPR off.

Indeed, I'm off the epr and the pressure now reads the prescribed 7. the ahi is better, but still not as low as I'd like. So it seems like epr can make things more comfortable, but at a price.

Then there's the issue of the mask abrading my face, but that's another topic altogetehr!

You might try loosening your straps a bit and if using a full face or nasal cushion type mask using the Mack's Silicone Ear Plugs "fix" for leaks and comfort. AND, don't overlook the possibility of the "lip flutters", the gentle escape of air thru the lips as a cause of a higher than desirable leak rate.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.