I feel horrible even while using APAP - advice?

[jmr106]

OK,  I'd like you to make some changes.
1. Turn off the Ramp. Your pressures are low, and you shouldn't need it
2. Set EPR= Full Time.  It is currently set to Ramp Only,  Your Sleep Study showed a large number of RERAs and your Flow Limitations are low but they are fairly consistent, and per the thread title, you feel horrible, and this should help with that

At the end of your initial post you asked "is this UARS?" and based on your Sleep Study says that is a real possibility.
Based on your latest daily charts, the answer is that it is less likely.

Setting EPR = Full Time (it is already set to 3) will help with your Flow Limitations and RERAs (only one on your latest daily).

Do that and see how you feel.

So the EPR isn't already on and functioning when not ramping? I have turned the EPR down to 2 under what was apparently still Ramp settings and I couldn't breathe very well. Turned it back up to 3 and it was fine, so that confuses me how it works but technically working until the Ramp when in Ramp mode.

What are the Flow Limitations in layman's terms?

[Gideon]

Flow Limitations may be looked at as a Hypopnea that doesn't meet the restriction requirements of 50 to 80%, so a flow of 50% or less of normal. So
Apnea: 80-100 %
Hypopneas 50-80%
Flow limitations ? -50%

RERAs are a series of Flow Limitations that end with arousal.

[slowriter]

What are the Flow Limitations in layman's terms?

Breathing restriction.

Your FL numbers and graph look similar to, and maybe even a little worse than, mine when I started with CPAP treatment.

[Dormeo]

jmr106, just to clarify per your post #11: your EPR is currently not set to be on all night; it is set to be on only during your ramp period. The advice is to turn off the ramp but make sure the EPR of 3 is set to be on all night. Let us know if you have trouble making that change to your settings.

About the mask issues: something to consider is a hose lift (hose stand). I use a P10 and like it, but I turn from side to side a lot and dealing with the hose was exhausting. I now have it routed up out of the way with a Hose Buddy, which works very well for me, and I have a lightweight collapsible hose stand for travel that works well enough. The maker of that one is Arden Innovations. With both stands, it helps a lot that the P10 short hose is quite flexible.

Other people have described DIY solutions, so if you are a tinkerer, you might be able to put something together that works for you.

[SarcasticDave94]

Yes that's how I'd interpret ramp and EPR edits too. On the hose management, there's another option, I do not know any formal name for it. It attaches to your hose on one end and an alligator clip on the other then hangs off your pj's or pillow cover taking the hose weight off the mask. I don't have either frame or clip style myself yet so No Comment on how effective personally. But I read lots of positives on both types being very effective.

[Sheepish]

+1 on the hose holder. Something like this, for example:

http://www.apneaboard.com/forums/Thread-...ose-Holder

[SarcasticDave94]

+1 on the hose holder. Something like this, for example:

http://www.apneaboard.com/forums/Thread-...ose-Holder

How'd you get my picture with the red x on it?

[jmr106]

So with the Dreamwear mask, my breathing is much, much better and easier throughout the night. Some work nights when there's a lot going on at home, we get in the bed too late and I average 5-6 hours. I also have a tendency for my body to not want to turn off until midnight or after, so that's also something that I'm working on - sleep hygiene. I've had horrible sleep for so long that I got used to a pattern of 5-6 hours a night during most weekdays and then I absolutely crash on Saturday and Sunday (off days from work). The 5-6 hours basically feels the same as 8-10 hours, so I'm used to making it on that little bit of sleep, but I'm sure that's not good for my body.

With that being said, here's last night's under full-time EPR of 3. I also raised the max pressure to 12, but of course the typical max of 8.9 is what ended up being the pressure. Very common to not even hit the 9.0, just the odd 8.9 virtually every time except for really bad nights that are far between. Minimum pressure was raised to 7.4. Might try 8 tonight and then 9 tomorrow night if all goes well.

Note the CA's on last night's data. 4 hours 58 minutes, 0.8 AHI 2L/min leak rate and 0.6 central AI. Unsure if these are RERAs being misinterpreted by the machine as central apneas.

Tonight will be my first 8+ hour night under the newer full-time settings. The P30i silicone nasal pillows apparently aren't for me and have an odd sizing compared to something like the P10. P30i has too high of a leak rate for me, so the Dreamwear is going to be my go-to mask. I also came across something called Snugs that supposedly fit around full face masks to make them less painful and uncomfortable. I have the full face mask for the Dreamwear, too...I just didn't care for it. It would be very helpful when I have a really bad cold, however. The biggest problem was the painful pressure of the part just below the nose pressing on the area just under the  nose.

[jmr106]

Also, is there some way for me to tell with more certainty if those centrals are truly centrals or simply something like RERAs being misinterpreted by the machine? The crazy part is that they are there for a day or two and then gone completely on another day, then come back again. If I'm more tired than normal due to a day or two of sleeping even worse than normal, they show up. If I'm more well-rested, 1 or completely 0 show up.

[Gideon]

No 2 nights are ever the same. Some variability is to be expected. Are they actually centrals, a close up 2 minute view will usually show.