New-ish CPAP user needing help with settings

[tylerg419]

Hello all, long winded, but I'll try to keep it short.
I was diagnosed with a AHI of 13 December 2023. I have gone through a few masks, but ended up with the P30i, as it is the most comfortable. I've had A LOT of ups and downs trying to get comfortable and have settled on both mouth taping and chin straps. I've been able to stay under 5 AHI, but have been trying to play with the pressures for the past several months to no avail. I get super lucky if I get under 2. If I ramp up the pressure close to 2 of my 95% I usually get terrible aerophagia. I've also tried epr, which sometimes helps, but sometimes increases my centrals even more than the high pressure does. Can anyone give me suggestions as to what settings I should be trying first. My biggest problem is I will change the settings, not like the outcome, then change it again without giving myself time to adapt? Thanks again!

[Old Steve]

I think some of your apneas are Positional Apneas (clusters) caused by chin tucking or your sleeping position.  Get a thinner pillow, try sleeping on your side if you now sleep on your back, if neither works try a soft cervical collar.  I would also suggest that you should your raise your minimum pressure to around 10cm and a maximum of pressure 14cm, do it gradually if you want, 2cm at a time is fine.  I would also try setting your EPR at 2 to start and then perhaps 3 when you get to 10cm.  The "Central Apneas" are most likely just a Clear Airway, where you just stop breathing after an arousal, pretty normal.   

[Nightynite]

I would be searching only for comfort at this point, 2 events is considered treated and no matter what you do you will never end up with zero events nightly.

[HalfAsleep]

I'm not a settings maven, but superficial take is that they are not at the most sleep-relaxing for you.

To echo @OldSteve, Your goal should be to minimize a kink in your neck, which will give you positional apnea. Use a pillow of a height that avoids the kink: taller for side, flatter for back sleeping.

Would you mind filling out your avatar info exactly? Exact machine, exact mask, exact settings. It's confusing when it conflicts with the Oscars, and it helps fellow posters not to have to dig into your Oscars if they have non-settings contributions.

[Deborah K.]

You only had one CA.  Having a few more will not harm you in the least.  Turn your EPR up to 3.  It will make your breathing more comfortable and lower your flow limits, both good things.

Also, if you are mouth-taping you do not also need a chin strap.