[Pressure] New to CPAP, Have a Few Questions

[billiemockrat]

Hello all. I technically don't qualify for an OSA diagnosis (AHI 3 during sleep study about 2 years ago, but 7 during REM) but my doctor said I have mild "REM Isolated Sleep Apnea". I got a sleep study because about 4 years ago I started waking up in the middle of the night often and was having a lot of sleep deprivation symptoms (trouble focusing, headaches, irritability, excessive fatigue, dry eyes, problems with motivation, mood/anxiety issues). One thing I'm wondering is if I technically have UARS and not OSA? On my sleep study it looked like they scored RERA's but it said I had 0 which seems hard to believe. All of my events captured in the sleep study were hypopneas, not apneas. The doctor prescribed me a CPAP and I hated it and wanted to try the oral appliance route. I used the oral appliance for about 4 days, which didn't help, and seemed more like a torture device than a medical device. So reluctantly I got my own CPAP but had trouble tolerating it so I put it away for about a year. Recently I decided I wanted to give the CPAP a real try because I'm really sick and tired of feeling like sh*t all the time. I've been using it for a little over a month now (I took a break when ordering a new mask because the F30 was blowing air onto my face and waking me up in the middle of the night). My original prescribed pressure settings were 4-10 but I found that I felt like I was suffocating with the pressure that low so I've been using mostly 6-10 (Max EPR) which feels comfortable (I'm 5'8 and about 160 pounds if that matters). My AHI has been pretty low most nights (most apneas have been central but those seem to be decreasing the more I use the machine). I'm still feeling pretty tired and unmotivated most of the time even though my events seem to be pretty limited by the machine (I will say the headaches seem to have improved quite a bit). I'm still waking up pretty frequently and/or too early in the morning. Is there any need for me to adjust the pressure? Or do I just need to get used to the machine and be patient? I have OSCAR and my data available, I'm just not sure exactly what to post. Thanks for any help.

[billiemockrat]

I figured out how to do a screen shot, here is my data from last night if that is helpful

[Sleepy Quixote]

Hey billiemockrat, people far more knowledgeable than me will be coming along here soon. A couple of your comments hit home for me. I totally agree that dental appliances are akin to torture devices, used one years ago early in my apnea journey. Professionally made by an excellent dentist, high quality, I just could not tolerate it, didn't really seem to help me much either other than quiet the snoring a bit.

On cpap they started me on 5 - 10 EPR of 3, constantly felt starved for air when falling asleep, then finally when sleeping and flow limits started the thing was on standard response so I'd get woken up at 9.8 with air coming out of every orifice, LOL! Won't bore you with my settings woes, good advice will be coming your way.

[Sleepy Quixote]

Btw, billiemockrat a min pressure of 7 will kick in the EPR right away, it doesn't start providing the pressure relief until 7 so you're probably already asleep when it kicks in after you start getting some flow limits. I like having it from the start, helps the air flow feeling a bit.

[Sleepy Quixote]

Bump

[OpalRose]

..... Is there any need for me to adjust the pressure?

Therapy wise, there's no reason to adjust your pressure, but for comfort reasons, I would raise the minimum to about 8cm, keeping EPR at 3.  This will give you an EPAP
of 5cm.  EPAP is what keeps your airway open which is when apneas (Obstructives) occur.

This will give you EPR (Exhale Presses Relief) from the start of therapy, which will keep FL and Rera's down.  

Try this for a few days and repost your charts.

Give this time to work.  No two nights will be the same, and comfort comes first.