Constantly waking up in the middle of the night

[totesOates]

I was diagnosed with mild OSA(5.6 events per hour) last year and have been pretty consistent with using my CPAP. At first, it was impossible for me to use the CPAP when the mask pressure defaulted at 6 cmH2O but I was able to finally tolerate the difficulty of exhaling when I changed the pressure to 4 cmH2O. I've been pretty good about using the CPAP now for almost 11 months. I used to be able to average 8+ hours however the past 2 - 3 months I've been waking up in the middle of the night for no apparent reason so I decided to track what's going on by using OSCAR. I've tracked the times that I've woken up and there doesn't seem to be a pattern to follow but I was wondering if there's something I'm missing or not noticing.

I've been keeping track of the times I'm waking up for the past 10 days but will provide that last three days due to attachment limits and below is the times that I've woken up. It's kinda interesting that it always occurs twice and around the same time every night. 
1/6/2023 - 1:40am and 3:40AM
1/7/2023 - 1:40am and 4:00AM
1/8/2023 - 2:19am and 4:20AM

I'm thinking about going back to my sleep doctor because I haven't really felt any different or better since I've started but wanted to get more thoughts about this before going in.

[OpalRose]

Welcome to Apnea Board!

It doesn't appear you need that much pressure to control your apnea, so what I'm recommending is mostly for comfort.

First, you are using a wide open setting with a minimum of 4cm.  This would cause most of us to feel air starved.

Second, you're on the right track using EPR, but in your case you are not receiving any benefit from EPR.  The algorithm cannot subtract EPR 3 from a minimum pressure of 4 as the machine can go no lower than 4.  

In order to benefit from EPR 3, your minimum pressure should be set to 7cm.
(7cm minimum minus 3cm EPR equal an exhale pressure of 4.)  You may want to cap the max pressure at 12, although I don't see it even reaching that point.  

The times you list as wake ups line up with leaks.  Looks like some mask movement.  How does your mask fit?  
http://www.apneaboard.com/wiki/index.php...ask_Primer

Please try these changes and repost.  I believe you will notice a difference in your comfort and breathing.