[CPAP] New to APNEA, struggling to get full nights sleeps, appreciate review and advice.

[new2paphopeful]

Hello all,
 
I hope everyone is good.

I am new to CPAP.

I was diagnosed via sleep study with severe apnea (AHI of approx. 60).

Started using Resmed Airsense 10 11 days ago.

Using an N30i mask with nasal pillows.

The settings on machine are:
Mode: Autoset
Max Pressure: 14
Min Pressure: 5 (3 nights ago I increased from 4 to 5)
Mask: Nasal
Response: Standard
Ramp Time: Auto
Start Pressure: 5
EPR: on
EPR type : Full time
EPR level: 3
Climate Control: Auto
Tube Temp: Auto

According to airsense therapy is working – happy face for mask seal, high score on the app, AHI of less than 1.

However I am struggling to sleep for a full night with CPAP on. Initially I thought I needed to get used to mask etc.

Now I am getting a sensation of congested nose and also sometimes feel like it is difficult for me to exhale.

Last night I took mask off subconsciously before waking and putting back on.

The charts below are from last nights Oscar.

My questions are:
1.      Is therapy working for me?
2.      Are there any improvements in settings which might help with congestion and exhale problems?
3.      Is there anything of note in the Oscar graphs?
4.      Should I persist with the nasal mask of would I be better off with a full face?

Thank you for reading this and for all of the help and support offered by this forum.

[Canuck 2]

Welcome to Apnea board, looks like you are doing very well on your machine. Seeing you are new to the board and are on a learning curve. I'm not sure you have heard of rain out in your hose's, that occurs when condensation forms and works its way to the mask and it can give a little discomfort. Your mask hose should have no water droplets and if this occurs you might have to turn down humidity. When I feel congested all I do is open my mouth and let the air free flow for 10 seconds or so a few times and that will clear that feeling of congestion usually.

[staceyburke]

Yes you are being treated and it is working.  But I think you would be more comfortable if you move the Min to 7 and EPR to 3.  It should work better and make breathing easier.  If it does not work well for you make the EPR 2 the next night.

The leak rate (mask) looks good, I would stay with this one for awhile.

[SarcasticDave94]

Welcome to Apnea Board. I agree with staceybuke, go with pressure of Min 7 and EPR 3. See if it helps add comfort. Try it and post with an OSCAR chart, and state if your comfort is better. BTW: We're not adjusting for better chart numbers, as they are great. We are attempting to add to your comfort.

[Cpapian]

Have you heard of a nasal rinse.  Originally it was the neti pot, but in recent years there have been some redesigns.  The neilmd, something like that, is a good one and readily available.   You could try that before bedtime.   It would help with your stuffy nose.

[OpalRose]

Agree with stacyburke, move your min. pressure to 7cm and set the EPR to 3.  This will give you an exhale pressure of 4. This will help you with exhalation, and the higher Min. pressure of 7 will keep you from feeling "air starved."

Your charts look excellent and suggest the therapy is working, except for the lack of sleep.  Five hours is not enough sleep to function well during the day.  I don't see anything in your graphs that would cause you to wake up, so you need to look at other reasons.  Do you have any other health issues that keep you from sleeping?
I know myself, I wake a couple times a night due to pain.  Some meds are known to affect sleep too.

As far as congestion, Cpapian's suggestion is one that I also use.  I use a rinse whenever I feel congested, also use a saline nasal spray nightly.