Can't fall asleep, should I adjust pressures, etc.?

[PJP71]

Hello everyone. I am hoping to gets some advice and/or suggestions before I give up and try a custom Mandibular advancement device.

I was diagnosed with OSA and given a prescription of 6-14cm using a Resmed Airsense 10.  I am a bit of a mouth breather so I started with a Resmed F20.  Couldn't stand so much on my face so I tried Phillips Dreamwear Nasal and now Bleep Eclipse and mouth taping.  The Bleep eclipse seems a lot easier to deal with but I have thus far been unable to fall asleep using CPAP.  I have experimented with EPR but realize that might defeat the purpose.  I feel the difficulty I am having may be the feeling of being force-fed air at a different breathing rate which is startling and disrupts me being able to doze off.  After much research, I was wondering if changing the settings might help? Maybe removing the ramp and EPR and maybe lower the pressure settings to where I am able to tolerate it and finally fall asleep.  I know many of you may have dealt with similar issues and would appreciate any advice or suggestions.  Please let me know if I need to give more information that might be helpful.  

Thanks in advance!
Paul

[Rickyricardo]

Nobody should use ramping. I don't get why you want to starve yourself from a therapeutic pressure for half an hour which is what ramping is. It's less than the minimum pressure required over a prolonged period of time. Change it to 0 and set EPR to 3.

That said, the starting pressure is too low at 6 because EPR won't even fully work at 6. Set pressure to at least 7.

The APAP is not setting your breathing rate, you are. It provides pressure when you breathe but it is not a ventilator setting a pace for respiration.

You should post your OSCAR charts with your concern. Then we can see what pressure the device is calling for. Maybe 14 is also too low.

[PJP71]

Hmmm. I thought the purpose of the ramp was to ease you into the elevated pressure? I'm still learning so trying to figure everything out. I guess what I was saying about the breathing rate was different is it seemed that when I feel like I am beginning to doze off and my breathing begins to slow, the rate does not follow the slow down...if that makes any sense.  As far as uploading data,  would I have real data without being able to fall asleep as of yet?  Thanks for the reply and suggestions.  I will give them a try.

[Nightynite]

PJP71, Try laying down for a bit and read a book or listen to some music. You may just need to relax and let your breathing slow before you put on your mask. That may help you synchronize with the machine a little easier.

[PJP71]

How long would you suggest?  I think I have only put it on maybe 15 minutes ahead of time max.

[Nightynite]

I would post up a correctly formatted chart for advice , that’s the fastest way to getting dialed in.

[PJP71]

Hopefully I will actually be able to fall asleep to create real data.

[Nightynite]

Put it on 7 min. 7 max. EPR 3. No ramp. That’s low and should at least let you get to sleep and get some mask time in. If you feel air starved, bump those numbers up to 8. Getting to the point of keeping the mask on is the goal here. Adjustments later after you post up a chart or two. Get comfortable and able to keep the mask on is step 1.

[PlayerTwo]

What I would start off with is for a few hours at a time while your playing video games or watching a movie or something wear the mask. For the first week what was going on with my situation was my lungs were getting stronger because they havent been fully used in years while sleeping.

Second thing is dont use ramp you should be able to sleep without it. I also tried this and what would happen is I would just wake up in 20-40 minutes once the ramp was over and if your pressure settings are too strong what can happen is it might be waking you up by pushing too much air into your face and blowing off your face. Its like blowing up a baloon or plungering your face and the air escapes out your mask. Which can also be a problem if you just have a leaky mask.

What you need to share to be accurate is that screen that shows your stats over at least a week.

The goal is to get under 5 ahi with the lowest amount of pressure and smallest amount of difference of inhalation pressure. (exhalation can be dramatically smaller ie what a bilevel machine does like mine for more comfort also what epr does to make yours a fake bilevel to a small extent)

So yeah try getting used to the machine awake for like a week for a few hours then switching to trying to sleep even if you cant after like a hour of trying just go to sleep normally.

Setting your settings at EPR at 3 will automatically give you sorta a range for easier exhale you should notice it. Then I would start at a static pressure of 10 for a few nights see what your ahi is and if your ahi is under 5 but you still arent sleeping well you can start notching down the pressure more or if its over 5 you can start setting your range.

I would suggest looking up Uncle Nikos (CPAP Reviews) videos the one I would look at is
"CPAP Pressure! Too Low, Too High, Just Right. How To Adjust Your CPAP Pressure Levels" on youtube

Dont feel bad the support for this stuff isnt officially really out there unless you got money in your hand forking it over to somebody that could just give you quick advice.

Just stick with it and if you have more questions come back here.

[PJP71]

Wow lots of great advice guys! I'll try all your suggestions. They really make sense so hopefully I will have success here soon. Thanks!