[CPAP] New CPAP User waking up frequently, any ideas?

[withanx]

Hi Apnea Board!

I'm a new CPAP user, just completed night #2 with my new Airsense 10. I was diagnosed with mild apnea (AHI 5.1 RDI 15.1) when getting evaluated for a septoplasty so decided to try CPAP as I have woken up groggy and been an occasional snorer for as long as I can remember (though never had trouble sleeping through the night).

Night #1 was a bit of a wash, couldn't sleep and pulled the mask off after about 4 hours trying to get to sleep.

Night #2 (last night) was progress! Slept for several bouts but still was up a lot of the night. I had trouble falling asleep after waking up to the full pressure so I kept hitting the machine to start/stop and do the ramp again.

Currently have machine set to 6.4-15 APAP (prescription was 5-15, thanks to this board for the info on how to do that) and EPR of 3 (ramp-only).

Any suggestions welcome - really hoping I can get used to this / adjust things so I can sleep through the night! I've attached OSCAR data from last night.

[Sleepster]

The pressure is rising because the machine raises the pressure when it detects the need to do so. This has nothing to do with the ramp.

I think you just need time to adapt. You have to get used to the hose and the mask and the pressure. The good news is that we humans are particularly good at adapting to new circumstances. We just have to be patient and let nature take its course.

[withanx]

Thanks for the encouragement! I understand that the pressure needs to go up, just wondering if there's any tips/tricks to stay asleep longer than an hour or two at a time I guess. Hard to have patience especially when I can feel the higher quality sleep happening! I'll give it a few more days

[Deborah K.]

Don't be discouraged.      Most new pap users have a very noticeable adjustment period.  It will keep getting better night by night.

[clownbell]

Patience and perseverance are key.

[Gideon]

I'd like you to try a higher EPR to better manage your Hypopnoea.

Set min pressure to 7 to take full advantage of the EPR
Set EPR =3 and Fulltime

Be aware that this may increase your central apnea. If that happens we will react appropriately.

[withanx]

Thanks so much for the kind words and the suggestion!

Gideon, I think I may have already done what you suggested. I've actually set EPR higher the last two nights (titrating to 1 then 2 last night) just for comfort reasons and that has already reduced the hypopneas significantly. Attaching screenshots of last 2 nights plus a zoom in on one of the the CA 'episodes' which have persisted. I have been reading about UARS and it seems that might be the case for me - AHI of 5.1 but RDI of 15.1 on my sleep study, narrow jaw, skinny 35yo male, etc.

Last night (aug 15) the most restful sleep was from ~1a to ~4:30a where I slept on my right side like I normally do (deviated septum on right nostril). Then at 4:30am I rolled over to my left side and slept much worse - quite visible from the CA episodes I think!

So not sure what to do next.

[DackJaniels]

It is normal , you're changing your sleep routine , it will take some time but so worth it

[Sleepster]

So not sure what to do next.

Just be patient as you adapt. Some people can't tolerate a CPAP machine and stick it in their closet. Others sleep like a baby the first night. The rest of us are somewhere in between.

It's great that you are able to tolerate the machine. It means that with practice you will adapt. I know this is hard to believe but soon you'll be so used to the CPAP machine that you won't even know it's there.

[withanx]

Thanks again for all the encouragement! I'm happy to report I've mostly slept through the last two nights with only one or two wakeups and feel like my sleep quality is at least back to pre-CPAP baseline So I'm optimistic! Plus I switched to a one size smaller nose pillow and feels much more comfortable.

I'm still seeing a couple hypopneas and a bunch of Clear Airway (CA) events each night and a high-ish AHI of around 9 (see attached). My subjective sleep quality is probably like 7 out of 10. I've kept settings at 7.0 min and 3 EPR as Gideon suggested. I've read on other forum posts that this sometimes is "normal" and will go away in time but also that sometimes it helps to reduce EPR to combat these? Any thoughts appreciated!