[Pressure] New to CPAP - obviously questions :-)

[mayuh]

Hmm. Not quite sure if IPAP 17.5 is enough. I tried and subjectively felt really bad when I woke up (AHI 7.5 at that time), so I decided to up the IPAP to 19 for the rest of my sleep (~3 hours - AHI went down to 5.3, so I'd say it has to be around 3 mathematically) and felt a lot better in the morning.
Could you provide some feedback on the attached graphs, to make sure it isn't only my gut feeling?

(if this forum alters the filenames: Full night, some detail in the IPAP17.5 phase with OAs, first half IPAP17.5, second half with IPAP19 - VS2 turned off)

Thanks,
Mario.

[Walla Walla]

I'm not a big fan of the variable pressure support. I think you'd be better off just setting both the minimum and maximum PS to 5cm. I think this would help better than increasing the maximum IPAP. Also I think your still getting some clusters from positional issues that Sleeprider mentioned before.

[mayuh]

So, a few more days more in my new adventure. I think I'm doing pretty well. Both with my machine adjustments and mentally dealing that I'm sleeping with a mask.

Very weird (actually amazing) for me is, that is pretty damn obvious when I had a few beers before sleep and you immedialy see it with an higher AHI - I guess that's not what the doctor ordered :-)

Do you see anything else, or have any more suggestions? Or should I just leave it alone for a few weeks?

Thanks,
Mario.

[Walla Walla]

I think bumping the EPAP to 12cm will put you pretty close to where you need to be.

[jaswilliams]

You are hitting the max pressure of 19 may be worth opening it to the max of 20

[mayuh]

Yes, I agree with both of you. I'm only unsure if the mask will start leaking again at 20. I'll give it a try... I thought I didn't need that high pressure, when my nose was not suffed as it is now (and for the last few days)

How do you longterm guys deal with a stuffy nose? Increase the pressure, or leave it alone? It seems my sinuses are affected and I tend to have headaches when bowing down. Stuff I didn't experience since I quit smoking...

[Sleeprider]

If you can tolerate nasal pillows without mouth leaks, they are the best at opening up your sinuses. Sinus passages are located in your face in exactly the places a CPAP mask puts pressure, and any inflammation or congestion just gets worse with a mask. Keep mask straps fairly loose. A tight fit is not always better. Flonase and nasal rinses may provide some relief.

[mayuh]

In the meantime I tried the dreamwear nasal mask. Though it’s very comfortable, it seems I can’t keep my mouth shut ;-) honestly I really like the ffm better and switched back to that.

My AHI is now around 2 (0.8 lowest - 3.2 max)

That being said, tonight I had a AHI of over 9. With a lot of OAs. No leaks, everything looks fine in sleepyhead.
As a new *pap User I tend to be worried a little. Not after one night of course, but if it continues... ;-)

With your collective experience, is it normal to have some sh**ty nights?

[jaswilliams]

We all have rubbish nights from time to time maybe you spent more time on your back, as I think your machine is not an auto it cannot increase pressure on its own when you require more pressure due to back sleeping. Post a typical daily graph from sleepyhead and we can see what’s going on but normally to reduce OA’s the epap needs to be higher

[mayuh]

Little update after 2 months of CPAP and 3 weeks  of the new pressures:

AHI is an average of 3.5 - not too bad from 86.2 measurement without CPAP in the lab :-)

I still have no real idea how to interpret the sleepy head graphs -- especially what is falsely flagged during REM sleep - I just don't get it :-)

I do rarely/never see 2 or 3 nights with similar events. Meaning that the pie chart in SleepyHead jumps around like crazy when scrolling through the days. Is this normal? One day FLs, the other day OAs, next day Hs again... Weird. Anyway I decided not to tweak anything without your help, except I upped the max IPAP to 20 as I now use the humidifier all the time.

Please find a few typical nights attached. Plus a 2 zooms that I would say are flase positives during REM sleep.

Any suggestions and comments are welcome!

Thanks! 
Mario.

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and the last 2