New CPAP user... Still waking up during the night

[UARSandApneaguy87]

I'm a guy in my 20, based in England. Recently diagnosed with suspected UARS, bordering on sleep apnea. Basically my AHI was 2 per hour for my sleep study, but some hours it went really low (1.5) whereas other hours it was higher (5). I had long hypopneas (40/50 seconds on the study).

Got a Dreamstation CPAP Auto (APAP) from Phillips. So I've slept 3 nights so far with it. 

I have noticed some benefits. I feel way sharper mentally, but still feel tired because I keep waking up to pee. The need to pee several times a night is what caused me to seek out testing. I have ruled out other causes for this. Now this may sound disgusting, but I pee in a bottle because of the fact that I'd wake up so many times (6 or 7 on some nights). 

Since I began CPAP, I'm still waking up, either to pee or to adjust my pillow between my legs (when I switch from back sleeping to side sleeping, I have to change the pillow). I am definitely feeling cognitively better, and I can sleep with it on (second night I slept 9 ish hours, 3rd night 8ish) this waking up is annoying me. 

I've included my OSCAR software here for the first 3 nights, hopefully someone can give me an idea of whats going on?

Important details about the first 2 screenshots --- On the first 2 days, there are some points during the day where I turned on the machine but was just awake and on my phone. I highlighted them in red to not be counted in the sleep and to ignore it.

In the first screen shot, I went to bed around 5am and woke up at 10am, then back to bed for 1.5 hours. Woke up several times throughout night
In the second shot, I went to bed around 4am and woke up around 1.30pm. Again, woke up several times throughout night to adjust position and to pee

So even tho the 3rd night has a large leak rate, the other 2 didn't (I think??? Can't read the data) and i felt the same, needing to awake through the night. Also, I wear a large full face mask if that makes any difference. Could maybe try medium.

I've also attached a zoomed in picture of my flow rate from my second screenshot sleep when i was having a hypoponea from around 6am. It covers 2 minutes. 

I also noticed that my pressure raises to 12 at occasion, even though no FL or apnea is detected. I think it could be confusing when I'm awake for an event of some kind. Anyway, on the 2nd night my pressure was 9.5 for 95% of the night, and on the 3rd night, it was 8.2 for 95% of the night. I am thinking that I could increase the minimum from 7 (which is what it was for the 3rd night) up to 8, and change my mask from Large to Medium to see if that fixes leaks. But really, I'm just wanting to see if there's any data here that someone could analyse and give me advice and info?

[UARSandApneaguy87]

        And my zoom in + overview.

[staceyburke]

You are running “fully open “. 4 is the lowest your machine can go and 20 is the highest. The low of 4 makes it difficult for your machine to rev up to help you.  Most adults have to have a higher pressure or they feel air starved. 

 You have left the calendar showing so some information can not be seen. Turn it off by clicking on the small triangle in the date line. Because I can NOT see the information I don’t know if you have the EPR on. If you don’t turn it on and set it to 3. Set your min pressure to 7. That should help with your events.

[UARSandApneaguy87]

You are running “fully open “. 4 is the lowest your machine can go and 20 is the highest. The low of 4 makes it difficult for your machine to rev up to help you.  Most adults have to have a higher pressure or they feel air starved. 

 You have left the calendar showing so some information can not be seen. Turn it off by clicking on the small triangle in the date line. Because I can NOT see the information I don’t know if you have the EPR on. If you don’t turn it on and set it to 3. Set your min pressure to 7. That should help with your events.

My min pressure was 6 on the second night and 7 on the 3rd night. Still same issues.

[staceyburke]

All nights you posted show 4 except 1 was at 6 and that night you ha large leaks that effected your therapy. 

What is your EPR set at?  We use EPR to help with H. Like I said I would put it to 3.

[UARSandApneaguy87]

All nights you posted show 4 except 1 was at 6 and that night you ha large leaks that effected your therapy. 

What is your EPR set at?  We use EPR to help with H. Like I said I would put it to 3.

I think my screenshots are out of order. The first screenshot is the 3rd night. And I fiddled with pressures during the day which shouldn't be counted for sleep. Last night I set it to 7.

What is EPR? Do you mean Flex? That's what its called on the Phillips machine I think. I think mine is set to 2. Whats the purpose of the function?

[staceyburke]

EPR is exhale pressure relief and yes it is A flex on your machine. I was hoping you had it turned off and turning it on would help with the H. If you already have it on the only thing to do is to raise the min pressure. Whatever you have it set raise it by one and try to stop the high leaks or turning it up will not do any good.

[UARSandApneaguy87]

EPR is exhale pressure relief and yes it is A flex on your machine.  I was hoping you had it turned off and turning it on would help with the H. If you already have it on the only thing to do is to raise the min pressure. Whatever you have it set raise it by one and try to stop the high leaks or turning it up will not do any good.

From what I've read, Resmed EPR is bi-level in capability whereas Phillips Flex is just comfort based in function.

[staceyburke]

ResMed handles apnea better in most people. EPR does help H more than A flex however both are a comfort setting. Older Cpap machines only had one set pressure and never changed on inhale and exhale. Only bilevel had a min number and upper number. So the newer cpaps are in fact bilevels they just don’t have the range a bipap has. 

I have a bipap and it’s EPR goes from 1 to 25 with .2 increases. The machine you have has a max of 2 EPR

[staceyburke]

ResMed handles apnea better in most people. EPR does help H more than A flex however both are a comfort setting. Older Cpap machines only had one set pressure and never changed on inhale and exhale. Only bilevel had a min number and upper number. So the newer cpaps are in fact bilevels they just don’t have the range a bipap has. 

I have a bipap and it’s EPR goes from 1 to 25 with .2 increases. The machine you have has a max of 2 EPR