So how are you choosing your pressure?
Do you have numbers to support your choices or are you just leaving your machine "wide open" to choose for you?
(Or something else?)
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)
"We can all breathe together or we will all suffocate alone."
Then pay particular attention to what pressure is being applied when you are side sleeping for at least 1 hour continuously. That could be the key info that might allow you to get on with your therapy with a lower pressure so you can tolerate it better. That is not to say you will never be able to sleep on your back again, you may very well be able to do that once you solve all of the newbie issues you are having (mainly the high pressure requirement).
"The last 2 nights I have had it set to min 6 and Max 14.6. I am still up around 13 to 14 AHI. What was interesting was that last week I had it set to min 6 and max 12.6 and my AHI for that night was 7."
Basically, there are a few rules:
1. When you change stuff, make small changes. Large changes will encourage an increase in Centrals.
2. When you change stuff, leave everything alone for a few days to see how the change impacts you. Otherwise your cute little body will get confused and encourage an increase in Centrals.
3. When you increase pressure significantly, say more than a 1/2 point at a time, you will see an increase in Centrals for a day or so.
At this point I'm not sure where you're at. Your sleep study came in with an ahi of, if I remember correctly 15? And your last night was 13? That's not much improvement. The good news (sort of) is that the increase is because of Centrals which are probably transient.
I'm concerned that you are reporting so much difficulty exhaling. That sounds to me like you either have respiratory issues (like mine) or you are over inflating (a term I really don't like) your lungs, and having difficulty exhaling. I believe your pressure is too high, and the range between your minimum and maximum is too great. I think you need to take that pressure back down to 10 or 11, leave the minimum at 6, leave the epr at 3 and use the machine for a few days to see what happens. Then after a few days you can think about increasing the pressure by 1/2 point at a time if that seems appropriate to help drop the remaining OA's without overly encouraging the CA's.
But even there, I'm not comfortable with your reporting how difficult it is to exhale. So I'm wondering if perhaps you should consider a different type of mask. Either a nasal mask or a pillows mask. At the bare minimum I think it would be a good idea for you to find your favorite comfy chair recliner (hopefully) and sleep in it for a day or two at the new settings until you get used to exhaling as much as you inhale.
Retired_guy - Great information! Thanks. I didn't realize that the CA's could go up as a result of increasing pressure. I'll dial it back to what you suggested and make small changes from there. I was actually looking at nasal masks on line yesterday thinking that that may work better for me, so I may try one soon. I don't believe I have any respiratory issues as I am in pretty good shape, at the proper weight for my height, never smoked, don't drink, and I stay active and excercise. I just feel like when I exhale that I am not putting out as much exhailation pressure during the last half of my exhale as the CPAP is forcing into the mask. Kind of like trying to fill a tire when the tire has more pressure in it than the air compressor is putting out.
Thanks for the suggestions. I'll put them to work!