Please help me out. I dont know what else to try

[Scottiep3369]

Please help me out here. When In started CPAP therapy om 8/8/24 I was so optimistic that treatment would help. My DR set my machine at 6-10 pressures with the EPR 2. Since then I have tried higher pressure, higher and lower EPR and EPR off, I got a cervical collar, wear a breathe right strip, use saline nasal spray to clear my nose before bed and my sleep still sucks. I feel terrible. I have the Resmed 10 with the F40 mask which I hate. My DME suggested the F&P Evora full so I got that. I hate that all I have is 2 hybrid masks. I am going to try the Evora tonight. What else can I change? My dr is kind of useless and said we will discuss at my 3 month compliance visit. I included screen shots of my OSCAR data through my time on therapy. Please help me out and thank you so much

[G. Szabo]

I got a cervical collar, wear a breathe right strip, use saline nasal spray to clear my nose before bed and my sleep still sucks. I feel terrible. I have the Resmed 10 with the F40 mask which I hate. My DME suggested the F&P Evora full so I got that. I hate that all I have is 2 hybrid masks. I am going to try the Evora tonight. What else can I change?

Keep doing these exercises because they are beneficial. Unfortunately, mask selection is a time-consuming process. I tried over a dozen masks before I settled on the current one, but I am still looking for a better one. 
As for your settings, you have also tried different things, but your pressure chart is like a mountain range. You want to reduce the pressure changes to have a better sleep.  You are also hitting your max pressure ceiling. Therefore, you should increase your pressure and keep the gap between the minimum and maximum narrow. Your CAs are diminishing with time, which is good.  

Suggestions: 
Turn ramp off 
EPR=1 full time
Pressure min/max= 8.4/10

[DaveL]

I hope that my experience might help.

I have an F&P Evora Full full face mask. I was having real trouble with leakage.

My reaction is to do up straps tightly to make the leaks stop. That didn't work well for me.

Last night I checked my headgear. I had leakage. one strap was longer than another. I let it out to make it longer. That allowed the mask to balloon out. When I started the machine the mask seal actually popped as it filled with air.. It provided a better seal.

I hope this helps. It seemed counterintuitive to me.

I like the Evora Full. Its the only full face mask I've worn all night. Most I can't wear because I'm claustrophobic.

My other mask choice is a nasal mask. It's a ResMed N20i. I use the fit gauge that came in the box with it to determine medium is the right size. Then I use a Knightsbridge Dual Band cap over the ResMed. That's because I'm a mouthbreather.

[alemon]

Your pressures are too low. Note the night you had no EPR, your AHI events were much better? That's because your effective pressure was 2 CM higher than what you currently have. You were still maxing out at 9, though, which means the machine wanted you to have an even higher pressure. The issue, though, is your flow limits went fairly high that night due to the difficulty exhaling - which probably also was disrupting your sleep, but in a different way.

I'm not one of the amazing experts here, but I'd bump your max pressures by at least 3cm, maybe more. 

What I would try: 
1. Uncap your max pressure, set it to 15. It's being far too constrained by your max. Stick with that for a couple days, see where your machine hits the 95%. My guess is your EPAP is gonna be minimum 9cm, if not more. I'd also push up your minimum pressure to at least 7. Keep your EPR at 2~3 for flow limits. You do have some centrals, but first goal ought be to minimize obstructives, within reason.
2. Once you have a few days of data, see how you're feeling, and set straight-CPAP, with EPR 2~3 at your 95%. Wild pressure swings can wake folks up and severely disrupt sleep.

[FLcracker]

I'm not even close to an advise giver, but there are several very qualified and helpful folks on here willing to help. Don't give up! We are using the same machine you are, and all the settings above are nearly the same, hers is set at 7-14, no ramp, 1 on humidity, and she has been using nasal pillows since trying and hating a few different face masks. Her first ever AHI readings when we first started were in the 60's and even low 70's. These days she regularly pulls 1's-2's, and even the celebrated occasional zero! She's had mouth leak problems, but she has pretty much solved them with her own personal bed-pillow arrangements. Finally, we learned to not hurry the unit to adjust to changes made. Give each change at least a few days to show up on your charts.
Best Wishes, FLc