One month in and could use help

[RTC75321]

Hi all,

I've had intermittent maintenance insomnia (1/2 times per month) for the 5 years but over the last 12 months my sleep has gotten progressively including a couple days where I'd slept 8 hours but woke up feeling like I'd been absolutely hit by a bus.  On multiple occasions coworkers have remarked that I looked tired despite sleeping 7-8 hours every night.

So in January I took a WatchPAT One home sleep test and was diagnosed with mild sleep apnea (AHI 5.4 / RDI 12.3 with 13/23 during REM) and was prescribed a CPAP by my pulmonologist with settings of APAP 6/12.  I purchased an AirSense 10 SD Card machine in February out of pocket and have been using it intermittently over the last month and have found it very challenging to adjust to.

With the default APAP settings, I'd wake up any time the machine adjusted the pressure so I've been working on manually adjusting the pressure.  I started with it on CPAP 7.0 EPR off and have been moving up a few points every few days with the goal of reducing OSAs --> Hypopneas --> Flow Limitations.  Right now I'm at 8.6 and have reduced my AHI/RDI to single digits (as calculated by ResMed/Oscar) but still see many flow limited breathes and what look to me like RERAs.  When using it now, I wake up feeling worse than without it.  I've tried as high as 9.0 but wake up a few hours later with terrible heartburn (presumably aerophagia).

I can't post more than three attachments right now but can... Advice would be great.

A little about me:
31M
5'10" 180lbs (26BMI)
Relatively fit

Sleep setup:
ResMed Airsense 10
ResMed AirFit P30i
Mouth tape (fixed large leaks)
Bruxism mouthguard
Eyemask
Breathe right nasal strips
Airpods on noise cancellation and boring podcasts to help me fall asleep

Medication:
Flonase
Claritin D
Magnesium supplements
0.5mg melatonin 
Afrin occasionally if congested

[Crimson Nape]

Hi RTC7532! -
Try these settings and see if you start to feel better. Set your min and max to 11, EPR to 2 - Full-Time, and your choice either set the Ramp to off or to 10/auto.
- Red

[RTC75321]

Thanks Crimson Nape!

I tried those settings for two night but was still having bad aerophagia and pulled the mask off after about an hour and a half.

Last night, I dropped the pressure to 10/8 IPAP/EPAP and that seems to have helped the aerophagia, but was woken up by my wife moving around and pulled the mask off after 30 minutes...   I had a 20 minute stretch of with only 1 hypopnea and had nice looking breaths which I've never seen before so that's promising... Now just need to keep the mask on....