Any ideas on what is keeping me waking up?

[KaesarMTY]

This is my 12th day on treatment.

Im on a Resmed S10 autos with Resmed F30i mask... I started using this mask on day 4.

Any additional info I can tell is that I had to use 0.125mg of alprazolam (xanax) to be able to sleep... but yet I got awake about 2 hours from start sleeping... and so on

[PeaceLoveAndPizza]

My two pence is your pressure is too low. Try this…

Mode APAP
Min pressure 7
Max pressure 11
EPR 3 full-time
No ramp

That should help you settle into a range that is comfortable and we can help adjust things from there.

[staceyburke]

Your min of 4 is to low for adults, that low of a setting is normally for children.   Try a min of 7 and see how that does for your sleep.

[Crimson Nape]

Your saw-toothed pressure graph may be the problem. All the pressure swings are causing arousals. To test this theory, turn off the Ramp, and set your pressure to 8 cm, both min and max. Leave your EPR set to 3 - Full-time.
- Red

[SarcasticDave94]

All the above should be a help.

[Rickyricardo]

One notable item is that alprazolam is an anxiolytic benzodiazepine meaning it is for anxiety (along with Valium and Ativan) and it is not a hypnotic, which is a type of benzodiazepine specifically for sleeping (triazolam is).

And Xanax has a very long half life of 11+ hours while triazolam is only about 2 hours. Even though the Xanax is a half dose it still has too long a residual effect, but regardless it's not indicated for insomnia.

If a physician prescribed it for sleeping they should know it's not a sleeping pill and try you on 0.25 mg triazolam, or even half of one, instead. If you're taking it off label, Xanax is of no help at all for this purpose. Even if your brain is wide awake with worry, e.g. anxious, alprazolam is not going to help you fall asleep. Triazolam is designed for this. (So is temazepam [Restoril] but it has a half-life 4X as long as triazolam). And "Z-drugs" are double the half-life. In case the doctor suggests Ambien.

That's on top of pressure that is far too low. And ramping is of no help. Try the settings in response #2. You can see from the graph that the only time you are at such a low pressure of 4 is when you start and restart the use of the APAP at which point it rockets up to 6-8 cm. You average 7+ so you may as well start at 7. The upper limit could be 10,11,12,15 which you'll never get to no matter where it is set.

[KaesarMTY]

Thank you all for your reply

As an update, I did 2 or 3 things last night, I think they helped me find out what let me sleep longer

I tested about 8cm pressure as both lower and upper limit with with no ramp, but I found out I need ramp to get to sleeping... I also felt that 8cm is too much for start, that's why when I woke up changed to values between 5.8 and 8.6.

Then I found out that automatic ramp get pressure up before I'm really sleeping, so I switched autoramp to 45 min ramp.
That change allowed me get back to sleep easier, and that helped me had a second half sleep more free from interruptions I guess.

Maybe I will switch to a min of 6 or 6.2 to keep avoiding "saw-toothed" air pressure changes, and ask next week to the med specialist about comments on the prescription I got to get help with sleeping.

[Deborah K.]

Using ramp set at 4 for a long time, you are still waking up constantly. Then, each time you return to bed, you start your long ramp again, which is robbing you of therapy. If you need ramp, set it to 10 minutes and move the ramp pressure up to 6. Then set your pressure range to 7 to 11. This way, your pressure won't be jumping around, as it still is, and you'll probably sleep better.

So, ramp set at 6 for 10 minutes.
      pressure set at 7 to 11.