Oscar shows pressure at max for most of night.

[Powdered]

Hello folks, 

Attached is a February 8 2025 Oscar chart.  My pressure on a Resmed 11 is set at 5-7 with EPR at 3.  I use an N20 face mask.  No humidity.  The AHI since I began using CPAP is usually under 1 and always under 2.  Does it matter that my pressure during the night is often at the upper limit of 7?  Could this mean a higher pressure might be better for me in some way ?   Not sure my sleep time is related to this question but I do need 8.5-9.5 hours of sleep to feel well rested.  

Appreciate any thoughts!

[SarcasticDave94]

While the result here is a decently low AHI, your Max pressure is where most adults begin. Lower than 7, most adults feel a bit air starved with CPAP mask on.

I would try this min 7 max between 10-12, EPR full time 1, then if it doesn't add CA events try 2, again try EPR 3 later. After the edit, post a screenshot of OSCAR and your comments.

[staceyburke]

The 2 cm difference is not much at all.  As Dave said 7 is normal for an adult.  But the reason it is at max is your flow liimits.  The Resmed machine raises pressure when it finds a flow limit so it does not progress into a H or O event.  FL are apnea but it is not long enough (at least 10 seconds) to  be classified as an O or H.  I have the classification apnea in my signature.

To help FL we use EPR (exhale pressure relief), I would recommend the following settings..
autoset
Min 7
max 10
EPR full time
EPR 3

[SeePak]

I agree with above comments, except i think you will need at least 8 cm min.

You are already using EPR3 and with 7cm getting OA events.

With higher max. of 10-12, it should be clearer what pressure you will need to control OA events

[Deborah K.]

I agree with Stacey. Powdered's pressure can easily be raised once we see his new median pressure. And with only one CA I agree on EPR 3.

[Powdered]

Thanks all. I will try a higher pressure to see how that works out. My low pressure setting is deliberate because my first experience with CPAP 15 years ago was a failure due to side effects of aerophagia -- feeling bloated and generally uncomfortable.

I started CPAP one year ago and have not had the symptoms I experienced 15 years ago. I feel quite alert all day after 8h:45m -9:00h sleep. I rarely feel that I am not getting enough air.

Flow Limit is a new concept for me and I wonder if I was to reduce it, I would have more 'efficient sleep' . Happy to try and report back. Thank you all.

[Powdered]

Hi All,

So I changed Pressure from 5-7 to 6-9.  It has been only one night but the change was not successful because... AHI, Flow Limit, RERA did not decrease and I feel average after 10 hours sleep.  I also feel like I swallowed more air.  My Average pressure last night was 8.  My conclusion so far, is that I get good results with Max pressure at 7 and about 9 hours sleep.  To improve sleep efficiency, maybe I should simply set CPAP pressure at 7 and see if this optimizes AHI/RERA while keeping me comfortable (ie. reduce aerophagia) 

Welcome any thoughts, thanks

[SeePak]

The flow rate chart shows narrowing flow indication of your Airway narrowing at that pressure.
You need  8 min to 10 CM max pressure while using epr3

If you set EPR 2 could probably use a range of seven to nine. That might help with aerophasia not sure about flow limits though.

Cpap constant pressure I would set at 8 using epr3, possibly needing to go even higher pressure.

10 hrs sleep? Wow. Are you awake much? Fall asleep fast?

[Powdered]

Yes, I do feel like I am awake quite a bit and last night was an example where i felt like I was lying awake quite a bit.  I do fall asleep normally within about 10-15 minutes maximum.   My average time with the mask on in 2024 was 8 hours 45 minutes.

For most of my life, I have needed a good 8 hours sleep to be rested but in the last ten years or so, I have felt I needed more.  My goal in posting my situation is see if there is a more optimized setting for my CPAP that will give me less sleep disruption while at the same time managing AHI.  

You suggest higher pressure but if the higher pressure continues to cause sleep disruptions while AHI remains around 1, what have i accomplished?   I can have less sleep disruptions with the lower 7 pressure with the same AHI (or even lower AHI).

My average AHI last year was 0.5 at the 5-7 pressure setting.  This January the average AHI moved up to 0.5-1.0.  

I'll give the new setting a couple more nights and see if last night was an exception to what I can expect.  

Thanks!

[SeePak]

CBT-I

Cognitive behavioral therapy for insomnia.

I've played with settings of all types and I still have problems sleeping through the night as many others do here.

Some people have no problems sleeping through the night almost no matter what they do and they're very lucky.

And others like myself and possibly yourself always seem to have issues and I don't think any amount of pressure changes and adjustments are going to help in the long run.

There are so many variables myself I have nasal congestion that can get real bad and no matter how high I put the pressure I have issues and yet I've learned how to breathe and relax such that I have a low respiration rate and minute volume.

Check out this what I mention here and see if it does something for you because it's all about sleep efficiency whereby you are able to have the solid sleep for the time that you're in bed.
No taking naps no reading in bed bed is only for sleeping.
And if you're not asleep within 15 minutes whether it's at the beginning or when you wake up through the night you get up read a book do something to get tired again.
And like I said some people can get away with eating in bed reading in bed watching TV in bed and it doesn't affect them but that's just their phenotype.
I bring this up so you can consider some other avenues to help you get rest through the night.
Cheers