EPR (off) creates mask hissing noise!!!!

[Jwicks1995]

-been on cpap for 5 weeks.
There may be a lot of missed info pls advise if needed. 

So I have been having problems with getting to very point of where i seem to fall asleep, and then waking up - feeling wide awake. From this moment on i will have this butterfly anxiety feeling in my stomach and find it difficult to get to sleep as i feel wide awake. Last night i did not sleep till 6am. (never happened prior to cpap)  This is a regular occurance. Many threads have stated that epr can cause this? So i turned my epr from 2 to 1. I then immediately noticed that there was increase air coming out of the small vent holes at the point where the tube connects to the mask. This is a feint hissing noise. And it is noticeable whereas before it was silent and this is frustrating. 

I will upload sleepyhead data shortly as i do not have access to sd card reader at current state in time but just need some advice as im not feeling good about this issue. 

The rare nights i feel good are nights that i manage to fall asleep quickly. Without the inital wakeup as i mentioned before. I will get around .8 ahi in these. Most nights i get around 1.5-2 and i wakeup frequently feeling wide awake.based on my stats from what i remember, the majority of my events are open airway events. 

Sorry for the lack of specific data. Will check and update when i have access to sleepyhead.

Issues: epr (off) noise/hiss.
Usual epr @ 2 - no noise. Many noticeable wakeups feeling wide awake. Clear airway apeas.

[CB91710]

Both EPR and pressure being too high seem to contribute to CA events.
For some reason, my wife's AS10 seemed to ramp up much more quickly than mine to 16-18, often resulting in high leakage and a moderate mix of CA, in addition to many OA/Hyp because it seemed that her machine "liked" to "idle" down near the minimum.

I pulled her max pressure down to a couple of CM above her 95%, and brought her min pressure up to 7 with EPR at 2.

Her charts showed a significant improvement almost immediately and has been maintaining well.

For me, reducing EPR from 3 to 1 cut my CA events in half.

[robysue]

I answered on your other thread, but my answer is appropriate here as well.

It sounds to me like what you are noticing is normal sleep transition centrals that would not ordinarily be scored on a sleep test.  You probably never noticed them before you started CPAP simply because you were not paying much attention to your breathing before your adventures in CPAP land started.

The thing is: You now know that you have trouble breathing at night, and even if you don't think you are focusing more on your breathing as you are trying to get to sleep, you most likely are focusing on it much more than you used to.  With time, you won't wake up so much because you just noticed a normal sleep transition central apnea; with time you'll finish the transition to sleep and while the machine may very well score a CA (or two) during your transition, as long as the number of CAs remains low, they are nothing to worry about or lose sleep over.

On the other thread you wrote:

With some research i found that reducing the epr may causes a difference so im going to see if that makes a different tonight. A problem with this is that simply reducing the epr from 2 to 1 causes the vent holes that connect the tube to the mask to leak air at a higher rate than before which creates a feint but noticeable hissing sound. Is this normal? I want to try reducing epr but find this sound irritating.

Reducing EPR or turning EPR OFF means that more air is being blown through the mask (to keep the pressure at a higher rate). And more air blowing through the mask means more air blowing out of the ventilation holes (higher pressures have higher intentional leak rates). And more air blowing out of the ventilation holes means there's a higher probability of sound being created by the exhaust flow, and that exhaust flow may very well sound like "hissing", particularly if it's hitting your mattress, your bed covers, your arms, or your pillow.

Since you describe the noise from the lower EPR as "irritating" I'd strongly recommend NOT reducing EPR from 2 to 1.  If the CAs you are noticing are just sleep transition ones, they may continue even with EPR turned OFF because they are a normal breathing pattern for many people, even people who have no sleep apnea problems.

[trish6hundred]

Hi Jwicks1995,
WELCOME! to the forum.!
Good luck to you with CPAP therapy, hang in there for more responses to your post.