[CPAP] Waking Up - Newbie Help

[lowlyradar]

Hi everyone. I was diagnosed with OSA earlier this year (~38 AHI) and have started CPAP therapy. I've used the machine somewhat inconsistently for about 2 months, and struggle with waking up a lot throughout the night, and having a headache + fatigue the following day. I use nasal pillows after not liking the Resmed N20 mask. 

I've tinkered with settings a little bit, but I don't have a great sense of how it all works. I turned off Ramp and EPR after seeing that those may compromise sleep quality. 

Today is my first day in OSCAR. This is my data from last night. For context, my Oura ring shows that I woke up 7 times between midnight and ~5AM. Can anyone help me with takeaways from this data? Appreciate it! 

   

[Crimson Nape]

Hi lowlyradar!  -  
2 things come to mind.  The first seems to be your sleeping position may be causing some of your apneas.  Please try sleeping on your side and avoid sleeping on your back.  Also, try to position your pillow to avoid tucking your chin in.  This can be another source of airway restriction.

The second possible cause of your arousals is pressure changes and its range.  The sleeping position can affect much of the pressure change, but if you want to try and tighten up this range (currently 5.6cm), I would set your minimum to 8.0cm and your maximum to 10.0cm.  This will reduce the range to only 2cm, making it more tolerable.  Try these settings for a night and see if your sleep improves, and how you feel the next morning.

Please keep us updated.
- Red

[CPAPfriend]

hey lowlyradar,

from a distant view, there's still definitely disturbed breathing present. It's possible the machine's pressure is currently set too low. Posting some zoomed-in screenshots of some of the events will add colour to your thread. One needs to always zoom in on CAs to determine if they're truly CAs or just post-arousal CAs, too.

[R750R]

Hey lowlyradar! It might help to try sleeping on your side if you haven’t already; it can really change things up. And don’t be afraid to play around with the pressure settings a bit.

[lowlyradar]

Hi folks, thanks for the feedback and advice. Sorry for the delayed response! My notes are below, and I've attached another night of data, with one zoomed in shot of a couple CAs.

Pressure: I updated my pressure to 8.0cm - 10.0cm as suggested.
Sleeping position: I always sleep on either my side or my stomach. I definitely do tend to curl up and tuck my chin in. I tried to be cognizant of that, but I'm not sure how successful I was.

I did not sleep well with these adjustments. I was aware of waking up at least 9 separate times, and was very tired the following day. I tried again the next night but ended up removing the mask in order to fall asleep, and have slept without it since (not ideal, I know). I think it felt challenging to breathe, like I wasn't getting enough air.

Questions: what is it from the graphs that gives clues about the chin tuck? And what should I try next?

Thanks!

       

[Deborah K.]

You had a tiny bit of positional apnea on your first chart and none on today's. You don't need to give it another thought.

Your pressure settings need to be changed. Set your range from 9 to 13. This is because your Median pressure is more than 9, and you are bumping way too much against the 10 you have set.

You also need to use EPR full time, set at 3. This will make your breathing more comfortable and, more importantly, help lower your flow limits. They need to be as low as you can get them.