[CPAP] CPAP works, but at the same time doesn't

[AUniqueUsername]

I've tried out CPAP therapy for about 2-3 months now after my diagnosis of sleep apnea (AHI: 5.6, RDI: 19), however I still feel just as awful as before (Heart palpitations, trouble staying asleep). Every so often I can sleep 5+ hours with the device, however usually I wake up 2-3 hours in, take it off, and fall back asleep (Perhaps the waking has become a habit, because I wake up early regardless if I'm on CPAP or not).

Settings I changed from default, and why:
EPR: 3 Full time | I found it difficult to exhale
Therapy Type: CPAP, 7 | Looking at my early reports, I suspected that the changing pressure from autoCPAP might've been waken me up, although in retrospect it could be coincidental
Humidity: OFF | Condensation in the mask, likely due to my room's low temperature at night [This is a change I made very recently]

The thing the confuses me is that my results look good. My AHI is consistently under 1, and none of the events that OSCAR has flagged coincide with me waking up. However, I can't keep the thing on because when I wake up I find it a little uncomfortable and just take it off. On the days I can keep it on after I wake up and then am able to successfully fall back asleep I still feel awful and sleep less than I should be (although still not less than I would without CPAP).

Things I am suspecting that is preventing CPAP therapy from working:
- I've noticed that the condensation in the mask, while not uncomfortable for me, can saturate parts of my mask and I believe may be preventing the mask from venting properly. Thus, I have turned off the humidifier, however even then I small amount of condensation forms on the mask from my breath. I am currently getting a hose cover and heated hose to see if this will help.
- I've simply formed a frequent waking habit, and I need to just keep my mask on until I can sleep through it. However I believe that there might be something more going on because I find the mask more than just a little uncomfortable when I wake up, sometimes I can't fall asleep again until I take it off. I don't find the mask uncomfortable when going to bed for the first time.

Things I am working on:
- I am getting a heated hose and hose cover in case that little bit of condensation is causing problems
- I am getting an oxygen monitor to see if despite breathing properly according to OSCAR I am still not getting the oxygen I need
- Getting a proper in lab sleep study, however my appointment is several months away
- Trying to force myself to keep the mask on when I wake up
- Begging for help here

Things I have tried, but am no longer doing:
- Nasal pillows | I tried to see if they were more comfortable (they were!) but the condensation issue is much worse, within minutes the plastic mesh for venting becomes completely saturated it becomes suffocating. This is actually what made me realize the condensation might be interfering with the mask's functionality.
- Putting my machine on the floor to combat rainout | I realized that the condensation in the mask is more so to do with my breath than the machine's humidity, as it occurs even with the humidifier off.


I can post more screenshots of the OSCAR data if requested, but as far as I can tell it's just me keeping the mask on in 1.5-4 hour sessions with no events and then me taking it off and then going to sleep or putting it on again and sleeping 1-2 hours more. The sleep study is from Lofta, so it's a at home kit.

Any help would be greatly appreciated. I should hopefully be able to provide information quickly if asked, I have lots of time considering I had to put college on hiatus because of my increasingly poor sleep.

[G. Szabo]

I suggest you turn your instrument in AUTOSET mode in the clinical menu. In the current setting, there is no exhalation relief.  

The "I Am getting a heated hose and hose cover " is a good idea. In the meantime, you might want to turn the humidifier on, using some low settings. But do not put water in the chamber to heat up the inhaled air and combat condensation. 
  

[Sleeprider]

Do you find it interesting that your breathing levels our and becomes smooth once ramp has ended. Turn off ramp.

[AUniqueUsername]

Alright, I'll take both of your guys' advice in conjunction.
Humidity: OFF -> 2
Therapy type: CPAP -> AutoSet
Ramp -> OFF

When I turn off the ramp it sets the minimum pressure to 7, which is a little uncomfortable since I'm used to 4.8. Should I change it?

[G. Szabo]

[quote pid='511034' dateline='1713407633']
When I turn off the ramp it sets the minimum pressure to 7, which is a little uncomfortable since I'm used to 4.8. Should I change it?
[/quote]

You have an EPR 3 setting, which will help you to exhale. Follow the recommendation of Sleeprider.

[AUniqueUsername]

Okay, thank you very much for clarifying. How long should I wait before posting an update? I'm assuming it should take a bit of time to adjust to any changes and seeing any results.

[Phaleronic]

Give it a few nights, see how you feel, and post update daily chart.

[Deborah K.]

I suggest that you post another Oscar tomorrow. That way you can get any help needed sooner.

[OpalRose]

Just a little clarification on why the suggestion to turn the ramp setting to off.  

Take some time to study your graphs.  Looking over the 4/17 chart, note the jagged Flow Rate, leaks and Unclassified Apnea, all happening during ramp!

I think we can definitely say that Ramp is not your friend!

   

Your minimum pressure should be no less than 7cm when using EPR 3.

I too would rather see you use the Auto Mode, with a pressure range of 7 minimum and 12 maximum.  EPR 3.

Right now, comfort and sleeping well should be the goal, as your AHI is low.

See how these changes feel for a day or two and repost.

[AUniqueUsername]

Thanks for all the tips so far, here's an update
I've installed the heated hose and hose cover and there seems to be no more condensation issues
I've taken OpalRose's advice to set the maximum pressure to 12
Overall despite the higher starting pressure it seems to be more comfortable than before, which I guess I have you guys to thank for

Here's the data from last night. The days previous to yesterday it seems like I took the mask off without realizing it as there is little / no data
I don't actually remember falling asleep again after I put the mask back on

Also, looking at my OSCAR data as a whole, it seems like that night I slept more than average with CPAP on however it is similar in that most nights I where I have two blocks of time sleeping with CPAP and one block in the middle sleeping without it. Is this normal? Should I be doing anything to address it? I feel like's it's become a habit.