New diagnosis and new to CPAP

[obstructiveindividual]

Awesome - that's really encouraging to hear

Honestly I'd go straight to blasting 20cm H2O if it was gonna get me some good Zs -_-

Is 0.6 still a good increase per bump or should I be going a bit finer at this point?

Thanks for all the guidance!

[PeaceLoveAndPizza]

Your choice. I personally like smaller increments as you are fine-tuning, but use what feel right.

[obstructiveindividual]

Well based on the last couple of weeks, it seems my threshold to start swallowing air is around 9.5 - 10cmH2O. Typical as it sounds like it's just below the window to potentially settle those arousals haha

I have had some contact from my sleep tech who is understandably not particularly impressed with me taking things into my own hands
They have asked me to go back to my original 4-12 range APAP with EPR maintained at 3

Wanting to keep everyone happy so will try this tonight, but going forwards wonder whether moving the APAP up to 9-12 might be my max tolerated pressure whilst allowing some treatment range whilst I'm unconscious

If there are still signs of RERAs at that point then should I be starting to think about BiPAP? Or can cross that bridge when we get there I guess

Thanks for the ongoing help

[PeaceLoveAndPizza]

Your therapy, so do what you have to do. You are not keeping everyone happy as you will be back to where you were when you started, so you will not be happy.

A bi-level is always a good idea. Now is a good time to start that discussion with the sleep tech.

[obstructiveindividual]

Haha. That is true. Although I need them on side if I do end up needing/ ?wanting a BiPAP machine!

As a compromise I moved back to APAP but kept the minimum pressure higher (full range 8.6 - 12cmH2O)

Although nil aerophagia at the baseline of 8.6 before sleeping, multiple episodes waking overnight with both leaks and with burping

It seems:
1. I am sensitive to pressure changes overnight
2. My current threshold for aerophagia is 9-10cmH2O regardless of fixed vs APAP

It also looks in general last night my graph is far more "spikey" so am guessing at 8.6-12 I am getting even more RERAs?


Grateful for thoughts on the above and what if anything I should be discussing with my sleep therapist of at this point
Am also happy to accept "it might take time" etc if that is reasonable to do at this point. Am happy to let my body adjust etc. but equally do not want to be wasting time and sleep if these settings/this approach just isn't correct

Thanks as always

[obstructiveindividual]

Thought I should provide an update

My sleep tech offered me a pillows mask to try instead - ResMed N30i

Have attached my latest OSCAR, am currently building pressure up again from the 4cm H2O they wanted to go back to

It appears my pressure requirement is much lower with the pillows

At the moment plan on increasing pressures again tonight unless anyone thinks EPR would be better at this point?

Thanks

[obstructiveindividual]

Hi all

In addition to above
Have been gradually increasing my baseline pressure with the nasal pillows

Just hoping for some feedback on whether it is improving things or not OSCAR-wise and whether it still looks worth continuing to increase

Haven't had any changes in symptoms really to give me a good impression if I am doing sensible things!

Thanks again

[obstructiveindividual]

Have now made it up to baseline pressure of 7cm H2O with APAP on
Unfortunately as I keep chasing my 95% value, it keeps rising!
Also graph remains spikey and I remain tired
I now seem to have developed this odd wave like pattern in some of my breathing - please see attached
Is this to be expected? Something to be concerned by?

Thanks

[obstructiveindividual]

Bumping for advice

Have increased baseline pressures as well as starting mouth taping

Still feeling unrefreshed in morning and tired during the day

In terms of my OSCAR data my AHI has been consistently good

The only thing I can see is flow spikes and associated leak spikes. This lead me to the threads:
RE: Leak Spikes and A Break in Flow by @blu15
Please Review My Data (Oximeter Info Included) — Still Tired Despite "Good" Treatment by @avhenry

Am wondering whether this could be UARS?

Am a little lost now as my AHI score is good, my flow limit seems ok

Is it worth me increasing my baseline pressures again?

Is there anything else worth doing at this point?

Would very much appreciate some input

Thanks