CPAP Newbie – High pRDI, Low AHI, and Pressure Issues: Help Review My Data

[KittyPuff]

Hi there,

I’m new to using a CPAP and recently began with the AirSense 11 and a P30i full-face mask. My initial impression, based on this forum and Reddit discussions, is that I may have UARS rather than OSA, given my low AHI and high pRDI.   

However, I’ve only used the CPAP for 2-3 hours each night (after initially struggling with pressure on the first night). The first night felt suffocating, so I adjusted the pressure upward. I’m still waking after 2 hours and would appreciate guidance. 

If there’s a simpler/better way to share my Lofta and OSCAR data here, please let me know! Thanks for the help! ?  

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[ejbpesca]

Adapting to PAP therapy can take weeks or months.  Waking while adapting to therapy is common.  

What pressure settings were prescribed by your Sleep Study?  

Your AHI is so low that your Min. setting may be higher than it needs to be.  If a lower Min. pressure treats your apnea it can be easier for you to adapt.

I find it interesting that your Min. and Max. pressures are 1 cm apart which is 1cm away from CPAP mode as opposed to APAP mode.  You may want to give headroom to the Max pressure by raising it allowing the machine to go to more than 13 cm pressure which may help with the suffocating feeling.

For example: My Min. pressure is 12, Max 20 by in-lab sleep study prescription.  After some time, I was able to lower the Max to 17.

It took me four months to adapt to PAP therapy and be able to remain asleep with it.  Hopefully, you will adapt sooner than that.  Please check your prescribed pressure settings.  Unnecessary higher pressure can lengthen the adaptation time.

Spending some time awake with the headgear on before sleeping may help.

[KittyPuff]

Gotcha - I only just now saw your reply this morning so I will try tonight with a higher max setting. Posting my results for last night as I was able to sleep for 7 hours total with the mask on so that was a positive. Feeling still sluggish this morning, but looking forward to trying it with a higher max pressure tonight - thank you!

[gohoos1998]

Definitely looks solid from afar besides the flow limitation, which is non-trivial. You are at max EPR = 3. Prob could try a higher max pressure again. Your flow limits looked to benefit from the second night.

[Sleeprider]

Hi Kitty. You have no AHI, and so I'm going to suggest we lower machine pressure to make you more comfortable. You won't lose efficacy, and we will retain the use of EPR at 3 in order to continue treating flow limitation and your initial complaint of UARS. I'd like to see you try a nasal pillows mask at some point instead of the full face mask. Most people prefer the minimal interface, and nasal therapy is far superior if you don't breathe through your mouth. Nasal therapy will open your nasal passages and make nasal breathing much easier than you have ever known. My go-to is the Resmed Airfit P10 for her if your face is smaller, or the regular if you have average size head.

Let's change to the following settings:
Mode: Autoset Standard.
Minimum pressure: 7.0
Maximum pressure: 10.0
EPR: On, full-time, Setting 3

I will look forward to your feedback on therapy comfort and to see an updated chart.