I really need help figuring out my settings. Please help!!

[madamsleepsalot]

Alright. I really need help. I feel as terrible now as I did when I started CPAP. 

So here is relavent data:
I was sleeping 14-16 hours a day before getting diagnosed (young female). At diagnosis my AHI was 7.4. It was determined then I would go CPAP level 6. I started it and immediatley slept with the mask all night. No trouble. I felt a tad better but not great. I went through several months of mask changes, chin straps, and mouth tape to finally get a full face mask that worked for me. 

After posting on this forum someone suggested I change my settings to Auto 6-10 with EPR of 3. I did and felt a lot better but after a few weeks started feeling bad again. (around July) I started waking up a lot with my stomach hurting, and like I couldn't breathe. I contacted my dr who said that might be that the pressure was too high and that she would pull my data and see. Well she did and she said my average night I was sitting a 9.9 pressure and that actually indicated that I need to go UP in pressure. And to change the machine settings to "for her".

So about 8 weeks ago I changed 6-12. EPR 3

I feel terrible. I am taking the mask off in the middle of the night and not remembering. When I wake up enough I have to turn the machine off and back on the feel like I'm not being strangled by the pressure. My stomach still hurts here and there. 

I almost feel like I'm having trouble breathing out. The last time I contacted my sleep Dr she said if this setting change didn't fix it, that I would have to come in for an all night and all day study to rule out narcolepsy and diagnosis as idopathic hyper insomnia and be put on medication. Which I am slightly opposed to. 

Anyways, please tell me what more images I can post to help figure this out.

[staceyburke]

The settings you show are really the exact same settings for both nights.  Let me try to explain.

Min 6 EPR 2
Min 6 EPR 3

Min is the inhale pressure, the exhale pressure is Min - EPR.  BUT the lowest any cpap machine can possible go is 4.
6-2=4  but 6 - 3 is less than what the machine can do so it is also 4....   Both of these settings give you inhale 6 Exhale 4.

We use EPR (exhale Pressure Relief) for 2 reasons.  The first it makes the exhale lower so you are not pushing air out of your lungs was as much pressure. (again, 4 is the lowest your cpap can go)  The second reason is to reduce Flow Limits.

Flow Limits are apnea just like the Obstructive and Hypopnea are.  Flow limits are not as big an event but they do a couple of things that cause problems.  The pap machine raises pressure when it finds Flow Limits and it does that to stop them from becoming larger Obstructive or Hypopnea.  Flow limits also stop you from getting into deep sleep and will sometimes wake you up.

We use EPR to help limit Flow limits.  To use EPR your min (inhale) must be high enough to subtract the EPR.

So I would try the settings like this.  Min 8 and EPR 3.   That will give you an inhale pressure of 8 and exhale of 5.

This will actually make your pressures LOWER than what you are experiencing because the Flow Limits are making the machine go to higher pressures.  Compare the Flow Limits chart and your pressures chart.  You can see when the flow limits go up so do your pressures...

[Brazen]

Your story is so similar to mine.
Lack of improvement... yup.
Sleep 14-16hrs/day... yup.
Diagnosis AHI... mine was 7.7.
Stomach pains... yup. That's gas pain from air going into stomach (aka: aerophagia).
Taking mask off during the night... yup.
Suggestion of an idiopathic hypersomnia (I'm assuming you meant that, not INSOMNIA) diagnosis... yup.
(By the way... I started down that route until doc said it would mean two weeks cold turkey off ALL current medications, I realized he was making an unsafe recommendation, and I fired him)

Try Stacey's settings suggestions for at least a week+.
Similar settings were moderately helpful for me (struggling with too much leak right now to fully gauge).

Take an honest look at sleep hygiene and life factors affecting sleep.
Yes, you have mild sleep apnea, have a need for cpap, but it's unlikely to be the golden cow that fully resolves your fatigue.
It's one tool. 
Unfortunately, it's an incredibly frustrating tool.

Do your best to adjust and optimize cpap so you can at least control the sleep apnea and rule it out as the cause for your fatigue.
Advocate for yourself until you find docs willing to dig for other contributing factors. 



I hope it's helpful to read of a similar struggle and not too much about me. 
My point was meant to be that you're not in this boat alone, not everyone adjusts to cpap life easily nor does it make everyone feel better.
Keep pushing through the struggle.
The less your body has to fight for each breath, the more you have to fight other battles.