Help adjusting CPAP--High Pressure Waking Me

[pharmdfl]

Hi CPAP Noob here. I am new to all of this and found OSCAR and the forums and decided to post to try to figure out if adjustments are needed to my settings.  Most nights I am awaken with high pressure (sometimes the pressure is maxed at 20)and the mask is blowing off my face almost from the high pressure which is waking me up.  I am having more hypopneas than apneas.

My machine is set to APAP with settings 4-20 and EHR is on level 3.  I use a ResMed F30i mask and I sleep on my side usually.  I am not sure if these high pressures I am experiencing are normal or are the result of something with the mask or my settings.  I am attaching my graphs from Oscar showing a full night and zoomed to an event. I am also attaching a screenshot of my overall summary page showing my pressures and AHI averages.  Can someone take a look and give me some thoughts/suggestions.  When I have a good night I feel great when I wake up but I feel like the pressure is too high??

[Expat31]

Can you give us some information of your sleep study, or ideally post the report with your personal data redacted? 

In the meantime, initially I would suggest you set your minimum pressure to 8, and reduce your maximum pressure to 15 to see where it goes.

An adequate minimum pressure is important to catch apnea events early. Minimum pressure 4 will do nothing.

[SarcasticDave94]

I think you'll first need to start from the bottom. Increase min pressure to 7, both so you can begin treating events better and also to get EPR working fully.

EPR is Exhale Pressure Relief, the setting number equals the same pressure of cmH20 as the therapy pressures, it reduces exhale by that amount. It will make the AutoSet emulate a bilevel machine. EPR will not reduce below your base 4 cmH20, but only down to it. 4 is as low as you machine physically goes.

These are the minimum pressure to get EPR working fully:
Min pressure 5 EPR 1 equals 4 exhale
Min pressure 6 EPR 2 equals 4 exhale
Min pressure 7 EPR 3 equals 4 exhale


This edit is necessary, your current pressure is factory default. Most every CPAP user needs somewhat personalized settings.

Try Min 7, see how it helps with feel and events. Then Max can be addressed. For what it's worth, the CPAP will only increase to 20 for a need. Yours hits close to it for a reason.

[Deborah K.]

I suggest EPR full time at 3.  Also, if you remove the snore section from your chart, we'll be able to see the rest more clearly.  Right now they are somewhat scrunched together.