[Pressure] Looking for treatment/pressure advice - want to stay asleep!

[amgpeter63]

Hello, I'm seeking some advice. I started treatment in May of this year. I had high blood pressure and other symptoms of sleep apnea since about January of 2023. Since starting treatment, I've seen results fluctuate. Some weeks I feel great with no symptoms, others I feel pretty poorly. I'm hoping you can decipher this data to see if you think any changes need to be made. I have an appointment with a sleep doctor but it was scheduled for 10 months after starting treatment (Feb 2025).

My starting pressure was 5/15cmH2O. In September I started waking up 3-5x per night and lowered the max pressure to 9.8cmH2O (per advice of my doctor). I'm at 6/15cmH2O as of last night, which is the attached image (12/19/24). I still can't stay asleep through the night and it's driving me crazy! 

Here are some additional details:

About me
Age: Late 20s
Height/Weight: 6'3", 208
Active: Weights 3-4x per week, cardio 1-2x
Diet: I eat healthily for the most part, minimal processed foods. 1 coffee per day at 10am. I drink lots of water
Alcohol: yes (usually weekends only - this is something I am struggling to reduce)
Nicotine: Not in the past 2 months, but previous light usage
I have been sleeping 8-9 hours a night. I stop screen usage 1h - 30min before bed and wear blue light glasses in the evening

Symptoms
Wake up 3-4x per night, always at least once to pee
Mild headaches later in the day/evening
Low libido - one of the more concerning symptoms
Apple watch sleep tracker shows 0-25 min of deep sleep, .5-1.5 hours of REM
Blood pressure has been between 130/70 and 140/70 in the mornings. I take 10 mg Lisinopril daily

Device
Machine/Mask: AirSense11 AutoSet, AirFit F30i
Mode: Autoset
Autoset Response: Standard
Ramp Time: Off
EPR: Full time, 3

I appreciate any advice and all comments! Thanks in advance

[SarcasticDave94]

Welcome to Apnea Board,

Pretty good stats. One thing I'll suggest, due to your use of EPR 3 full time, which is fine, you'll want to increase the min pressure to 7, so up 1.

EPR in use reduces that min pressure when you exhale, but physically it cannot reduce below 4. The math is this:

Min pressure 5 EPR 1 can work immediately
Min 6 EPR 2 works fully
Min 7 EPR 3 works fully