New User - Optimization Help Please!

[Sam R Squared]

Thank you all again for your help. I've been using 2 segments of extra tubing for EERS.

This morning was very difficult, as I had cramps like no other for 30+ minutes after waking. The only way I could stop the pain was to lay back down and sleep. I think that this has given me some subconscious adverse feelings towards my CPAP, as I've had difficulty putting it on several nights this week. Any tips on how to avoid aerophagia?

However, waking up without using my CPAP at all, I feel a pounding in my head and chest and my nose typically is bleeding. Using the CPAP still helps, but I'm still pretty tired throughout the days.

Seasonal depression has made things even more difficult. Not quite sure if anyone else has insight/can relate?

I haven't reset my CPAP yet, but I think I can just keep shifting it back for a few more days.

Here is my data from last night:

[Dormeo]

Sorry to hear about the aerophagia. Try lowering your pressure bit by bit to see whether you can hit a sweet spot with few obstructive events and no painful aerophagia. For example, I find that when my inhalation pressure is 9.8, I very rarely have any pain; when it is 10, I'm in trouble.

You're having some large leaks -- any thoughts about what is causing them? They mean you aren't getting effective therapy during the LL intervals, and they may also be disturbing your sleep.

[Sam R Squared]

            Honestly I'm not sure what causes them, as when I fall asleep things seem fine.

I've been washing my mask frequently, which I had initially presumed caused some of the leaks.

However, the leaks persist. I really want to continue with this F30i mask but if anyone has other suggestions, please let me know.

Here is more data the past few days:

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Part 2.

[Sleeprider]

With leaks like that, your mask is being pushed off your face opening a large leak. We can see the leak suddenly correcting as you adjust multiple times, and it almost immediately becomes a large leak. It appears your machine may have even turned off at 04:05 and 05:18.  With leaks this large, it shouldn't require a lot of detective work. Those are huge, loud leaks, and you should be very aware of them.  You need to figure out what is causing the displacement, and of course eliminate the possibility of an inline leak at a connector.

[Sam R Squared]

I'm certain it comes from the seal between my face and the cushion.

I had tried two different F30i cushion sizes and realized the SW is the right size for me. However, I've been tightening it a bit more than the recommended "floating above the face" as I know I move around a lot at night and I found that this usually causes leaks...but perhaps I should just try a different mask?

Any thoughts?

[Sleeprider]

Another possibility is a chin strap. I just came across the Snore Relief Adjustable Chin Strap for $7.95 at "Yourstoreonline". It looks promising and cheap without the bulk of the Knightsbridge and it seems to have an upward rather than rearward pull. Might stop the leaks.

[Sam R Squared]

Unfortunately, these chin straps iritate my skin. I had previously purchased several from Amazon in the past. I'll consider trying this one, but at the same time, the F30i mask will probably not be compatible with these straps that cover more of the chin/jaw.

Any suggestions on other masks similar to the F30i? I began CPAP therapy with the N20 + chin strap but it did not help much, and the F30i was initially helpful but it's not working out too well for me lately. I can't keep it on for more than 3 hours each night, perhaps because I tighten it too much to prevent leaks.

[Dormeo]

For any strap that irritates your skin but otherwise works, try making a liner out of an old teeshirt or something else soft.

[Sleeprider]

I would fall back on the Knightsbridge dual chin strap from Supplier #37 since it is natural materials. I have not heard of a reaction to that one, although it is more expensive.

[Sam R Squared]

Hi!

Back for more help--and the hiatus was not due to optimized therapy

I feel more motivated to try to optimize things, while I wait for an oral appliance authorization.
I've attached some screenshots of my current data.

A few notes:
24 year old, first year medical student, mild sleep apnea, 5'7", 148lbs. Schedule is a bit messy but trying to get a healthy sleep habit of 11pm-6am (not reflected by the past two weeks   ). Have been prescribed modafinil for daytime sleepiness, which I find helpful but I still fall asleep even w/ 200mg modafinil. Would like to stop taking it if I can improve my sleep...I do not drink coffee/caffeine as it makes me jittery.

Originally had several issues with CPAP therapy spanning from taking off the mask while sleeping, a bit of TMJ, aerophagia, ear inflammation/infection. Sleep doctor now suggesting we try oral appliance therapy.
Originally started with N20 mask, then F30i, and now on Fisher and Paykel Vitera - highly recommend it, not many leaks lately.

Due to high counts of CAs, I was recommended to try EERS. I found it helpful for about a month, my data reflected this, but then more issues came up including severe aerophagia.

I currently have my Fisher and Paykel Vitera mask set up w/ 18 inches of rebreathing space, and find that it's somewhat helpful. I've kept the same settings for the past 4 days (7.4 cm H2O max and min, EPR 3) and while my APIs are lower than 5, my FL 95% is still higher than .10

I've kept my pressure at 7.4 as I'm worried about aerophagia...however I'm open to increasing it again to find a balance.

I would appreciate some help in optimizing my therapy. Thanks so much.