[Pressure] TiredButNotCranky's CPAP journey

[TiredButNotCranky]

Hello, guys.  
A newbie here, I have a few questions that I hope you guys can help me with.
1)Any tips on getting rid of aerophagia while maintain the treatment effectiveness?
Which factors I should change ?
-According to OSCAR, my best setting is from 12 Apr. 2024.
-I rarely feel great with my CPAP treatment. I had a terrible sleep with that "Best Settings"  . Kept waking up because my tummy was bloating really bad and to reduce the max pressure about 2 -3 times.

-On the next couple of days, I experimented with settings and found that my sleep just got worsen overtime (migraine every morning that I had to ice my head and neck for hours and took 3 hour-long nap to recover from tiredness).

-In short:
 Best Setting (according to OSCAR) min 4 / max 10 / tolerable max 8.4   *Waking up 2-3 times
 the next day  min 4     / max 8.2  *slept OK but migraine upon awake (CA 1.4, OA 0.84, OA 0, H 0.42, RE 0.14, AHI 2.66)
 then              min 8.6 / max 8.6   *slept OK but migraine upon awake, AHI getting worse (CA 4.12, OA 1.56, OA 0, H 0.46, RE 0, AHI 6.14)
       
2) Is OSCAR's analysis of Best Setting is correct? Based on my usage history, which is the Best Setting in your opinion?
From 2020 - 2024, never found the right settings for my treatment.
   
-Background: age 40 , Female, always low-normal BMI (currently BMI 17.6 )
A bit of rant here: 4 sleep doctors with completely different diagnosis...the struggle is real.
1st doc just threw me the CPAP description and done.
2nd doc said it is just my depression and allergies that made me tired, and I don't need a CPAP.
3rd doc said I need to get a CPAP or a MAD and myofunctional therapy and they changed an arm and a leg for those and rarely have case of bite change from the MAD (and cant' guarantee that it won't happen to me).
4th doc said I need to get back on CPAP and sleep 9 hours a night, because she suspects that I have other underlying sleep issues like narcolepsy. Or if I don't like my CPAP , I should try MAD.

Thank you for your replies in advance.
Hope you all stay happy, not cranky.

[Phaleronic]

You should raise your min pressure from 4cm to 7cm since you have EPR set at 2.   You could raise it to 3 once you bump pressure as it will lower exhalation pressure for you.  Your hitting your 8cm max pressure ceiling too during the night.]

'If adjusting pressure on your CPAP device or switching you to a nasal mask does not ease your aerophagia, talk to your doctor about alternate options to treat your obstructive sleep apnea. They may suggest a bi-level positive airway pressure (BiPAP) device instead, as this type of device offers lower pressure during exhalation.''

[staceyburke]

Your pressures are rising because of flow limits.  Resmed senses flow limits and raises pressure to stop them from becoming H or O events.  To lower flow limits you need to do 2 things, change your min and use EPR.

Min 7
EPR Full time
EPR 3

leave the max where it is.

[TiredButNotCranky]

Your pressures are rising because of flow limits.  Resmed senses flow limits and raises pressure to stop them from becoming H or O events.  To lower flow limits you need to do 2 things, change your min and use EPR.

Min 7
EPR Full time
EPR 3

leave the max where it is.

Thank you so much for all of your input.
I didn’t know Min 4 and EPR 3 are the reason why I feel a bit suffocated at the beginning of each night.?

Tried the new setting last night, woke up with dry mouth and aerophagia. On the bright side, I could slept the whole night without waking.


Should I try mouth-tapping with the new setting?

Thank you for all of your suggestions in advance??

[staceyburke]

Min at 4 is the inhale pressure and it just is not enough air for an adult. Many people are using min 4 because it is an auto adjusting machine BUT the pressure goes up to stop apnea but goes back to the min on inhale. For me I need at least 9 or I am taking my mask off at night gasping for air. 

Min of 7 is not real high and again EPR 3 (7-3) gives you the lowest pressure again of 4. 

Post another night of Oscar graphs so we can take a look

[TiredButNotCranky]

   
Here is the screenshot from last night setting.
Intended to attach in my update from this morning but ran into time crunch so could not do it.

Anyways, any suggestions will be highly appreciated.

Thank you so much, guys.

[staceyburke]

I would move your min to8. You still have to many flow limits.