7 months of CPAP and can't get it right. Please help.

[markrule]

I have a Resmed Airsense 10. I have been using the machine for the last 7 months with a lot of different interruptions. 

I've had a handful of successes with sleeping through in this time but more often than not I'm taking the mask off in my sleep. 

I live regionally and don't have much support to get it right so I've had a bit of trial and error but nothing seems to be working and I'm more tired than ever. 

I usually have the mask on between 1 and a half hours and 3 and a half hours. I mostly take it off feeling breathless or irritated and sometimes this is subconsciously. 

I have attached some daily reports.

[staceyburke]

Usually if you are taking your mask off you are not getting enough air - min pressure.

I would suggest 3 changes

Min 7
EPR full time
EPR 3

give it a night and put up the nights oscar and we can look at again.

[markrule]

Thank you.

I have changed the settings. Still having some difficulties but I know things can take time. 

Here are the last two nights.

   
   

[Sleeprider]

The use of EPR resulted in no flow limitation and a good therapy. The problem is, you only use the CPAP for less than 2-hours per night. What is preventing you from using CPAP for 7 or 8 hours? You're never going to feel the benefits of the therapy with this minimal amount of time. I presume you are removing the mask and sleeping without it.

[markrule]

Yes I seem to take it off in my sleep. Sometimes I notice and it’s because it wakes me up and I feel breathless or gasping. I’m trying to work out if there is a setting that might be causing this or whether I need to continue to try to power through.

[Sleeprider]

Markrule, mask removal becomes a behavior that is difficult to break, and arises from resistance to using the therapy and perhaps resentment of the therapy. It is self-reinforcing because you perceive a reward (no mask) every time you do it. It takes discipline and behavior modification. You may be able to device some means of making it more difficult to remove the mask, but the important thing is to change your lane and attitude towards therapy. It really helps to have a positive attitude, and always replace the mask as soon as you realize you have removed it. Your settings are fine, and your therapy is good, you're just rejecting it. As unhelpful as it may be, the problem is mostly in your head, and it is in your control to change. If you don't make an effort to change this, you will soon quit therapy. Here are a few links dealing with the problem.

https://connect.mayoclinic.org/blog/livi...pnea/?pg=2
https://www.health.harvard.edu/blog/i-ca...0072920672
https://link.springer.com/article/10.100...016-0051-2
https://www.uptodate.com/contents/assess...pnea/print

[markrule]

Thanks sleeprider. That is actually good to hear as I think that my brain defaults to thinking that the machine is not properly set up so I then take it off. I will persist with a positive mindset.