Consistently Waking Up After ~3 Hours on CPAP

[sammyg7241]

Hey Everyone,

I've been on CPAP now for about two months, and I am consistently waking up after 3-4 hours of using my CPAP. I wake up feeling really uncomfortable, and almost like it is hard to breathe and I almost always end up taking my mask off and falling back asleep.

I am using a ResMed AirSense 10 Autoset with the built in humidifier and heated hose. I haven't changed my pressure settings since starting CPAP, and my machine is set to 4-20cmH2O. I've also changed the auto-ramp time to the max of 45min. I have already messed around with the temperature and humidity level to get it at a comfortable level and enabled pressure relief.

Also tried a few different masks including a F&P Simplus full face mask, a ResMed AirFit F30i, ResMed AirFit P30i, and a Philips DreamWear Nasal. Also tried a cushion from an N30i with the P30i frame (I think they're the same frame, my DME provider sent the cushions to me with the P30i to try). I think the DreamWear mask is my favorite so far, but it doesn't seem to solve my issue.

 Looking at my OSCAR data, my AHI is always below a 3, with an average of about 1.5 and I have minimal to no mask leaks. I can feel a difference on the nights I do use my CPAP, but I can't seem to stay asleep all night while on CPAP.

   
   
   

Any advice or suggestions are greatly appreciated.

[Muggzy]

As a person who also suffers from consistently waking up after three hours (see attachment), I wish I had some good advice for you but I haven't been able to resolve that particular issue. 

One thing I have been able to do is train myself to put the mask back on before I go back to sleep so that all of my sleep time is therapy time, and that has been a strong net positive for me so I would encourage you to try making that a habit if it all possible. 

Hopefully someone more knowledgeable will chime in with some advice for how to achieve the best comfort so you can get a full night's rest.

Best of luck to you!

[PeaceLoveAndPizza]

A few things that stand out…

1. Your pressure is too low. When flow limitations kick in the pressure starts a wild swing up and down, which look to be triggering arousals. We’ll address this below.

2. Ramp is not your friend. Only use it if you cannot sleep without it. During ramp you get no therapy and we have no real view into what is going on.

3. Your respiration rate and tidal volume are on the low side, which is likely from pressure being too low.

Increase the pressure will help with a number of things. It will keep you much more comfortable and you will get full value out of the pressure support. You are one of the lucky ones who can get a good AHI, but have a poor nights sleep.

Try the following:

Pressure min 7
Pressure max 12
EPR 3 full-time
No ramp

That should help and once you get a few nights on it post a chart. We can further tweak from there.

[redpackman]

I am confident that what I write will be considered heresy.

I am writing this in late July 2024 and have been a CPap user every night since March 22,2016. Since that time I have used the Philips Dreamstation 1 and found it very useful and helpful. I cannot fall asleep without a Cpap machine.  Since I had so many hours on my original Philips Dreamstation invluding having it  fixed twice once for the heating circuit for the humidifier and once for the recall that has now become infamous. After that "fix" and the Dreamstation 1 I rented while the first one was recall-repaired I've remained on the DreamStation 1.

With that much use I decided to get a new machine and was recommended the Respironics 10 this spring. The settings were *identical* to the Dreamstation 1 and verified as such my my sleep therapist professional. I still used the same mask (the minimalist Philips Respironics nasal pillow). The hose was different on the Respironics 10 and seemed  very overly "stiff" to me compared to the Dreamstation 1. If I moved my head often the mask would leak. I did not like the "new" hose!!  Yet in the trial period that was a small issue. In the three weeks I tried out this machine most nights I was waking permantently after 3 or 4 hours. The best I can describe it, I felt the machine was in "hurricane" mode even though my upper setting was 15. I NEVER sensed that with the DreamStation.  I returned the ResMed 10 and went back to my faithful DreamStation 1   and have bene sleeping 7 to 8 hours a night ever since.

I know, I know, heresy, but it has been my experience.

[twomashi]

> I returned the ResMed 10

Was it ResMed or Respironics that you returned? You mentioned both, as well as the dreamstation.