[CPAP] Need Help Finding Right Settings

[G. Szabo]

See the 
 Simple solution to prevent unconscious mask takeoff during night
post too.

[iwesterbeck]

Here is an update from last night. 

I am only including last night because I just got a Fisher & Paykel Eson 2, and I was able to keep the mask on for almost the whole night. This mask seems so much more stable than the Dreamwear nasal mask, with or without pillows. That mask seems to just come off on its own.

I also used mouth tape in combination with my chin strap. The mouth tape definitely seems to have made a difference.

There are a handful of moments at night where my nose felt itchy and I felt the need to remove the mask for a few seconds; this is probably where the major leaks occurred.

Still hoping to improve my AHI. I also felt some minor aerophagia in the middle of the night but not nearly as bad as it was with the other mask.

Looking forward to finally living a life with quality CPAP treatment!

[G. Szabo]

Still hoping to improve my AHI. I also felt some minor aerophagia in the middle of the night but not nearly as bad as it was with the other mask.

Indeed, you have made some progress.
It would be best to increase your minimum pressure from 9.6 to 10.6 and set EPR=2 so your exhalation pressure remains the same. Your data indicates the need for an even higher minimum pressure, which you might increase gradually based on the outcomes and feelings.  
As a result, your CAs might increase. However, there is an observation that some parts of the CAs disappear as you become customized with the treatment. 
I would also increase the humidity to 4.

[iwesterbeck]

Here are the last three nights of my treatment.

I thought the humidity at 4 was causing me more discomfort because I prefer colder air, especially in the current climate where I live, so I put it back down to 3.

The first night I tried this new mask, it was great and stayed on all night, and I hit my first 7+hr session with an AHI below 3. I now feel like I am struggling to replicate that for some reason.

I do find that I may be tightening my mask more than I did when I first got it, but I feel like if I don't, the odds of leak are higher. I am still experimenting with this.

I may consider the cardboard method, but I would absolutely prefer not to have to go to those extremes so I may save that as a last resort.

I am still slowly making my way to 10.6. One other thing worth noting is that when I was able to keep my mask on all night, the minimum pressure was 9.6, and as soon as I increased it I started having these issues. Maybe I need to try lowering it again?

Lots of questions to be answered still it seems.

[G. Szabo]

Indeed, your full-night data is promising. You can go ahead and set EPR = 3 because your CAs are not too high. It will also help you keep the mask on. Do not be frustrated. Finding the right mask or mask setting takes quite some time. I have experience with six different masks. I am about to order a newer product, which I believe is better.