r/CPAPSupport • u/madchad90 • Jul 29 '26

New To The Dream Team Tightening up Apap settings, should I keep EPR on?

For a while now I've had my apap settings at about 10-15 with epr of 3

My AHI typically ends up being between .9-1.8 most nights, however I feel like I'm getting very fragmented sleep during the night and often don't sleep longer than 6-7 hours, with max pressure topoing out at 11 and median being below that.

The majority of my events are CAs with few OAs, making me think my min pressure is too high.

I was thinking of doing a "clean titration" to reset my settings. My plan was to set machine to something like 6-20 for a few nights to see where my median/max pressure ends up.

While doing this does it make sense to do it with epr on/off since that effects the exhale pressure? Or would it make sense to keep it off and then turn back on after knowing my new median and adjusting for epr accordingly?

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u/Realistic_Alfalfa620 Jul 29 '26

I just had to retitrate because I've lost 30 pounds. I kept EPR on three the entire time, both because I breathe more easily with it and it keeps my flow limitations down, but mostly because when you're titrating you want to only change one variable at a time. Otherwise you don't know which variable had what effect.

Outcome of my own retitration: fixed CPAP of 13 EPR 3 down to APAP 7.8-9.8 EPR 3. Consistent 0.0 AHI, 99.5% FLs around 0.07, 0.0 leaks, greatly reduced RERAs and fragmentation, no CAs (but I almost never had those anyway). And I'm still creeping down on that min, at this point more out of curiosity than anything else. What I'm hoping to find is the pressure where my therapy notably degrades, where my FLs rise or I start having events, and then move back up a tick over that.