[Treatment] 10 Months In and Still Waking Up After 4 to 5 Hours

[Burnsy]

Hey all,

I've been using my CPAP machine for approximately 10 months now and almost every night I wake up somewhere between the 4 and 5 hour mark. Then I am unable to fall back to sleep with it on. I'm getting extremely frustrated at this point. I've played with the settings a bit. My maximum pressure used to be 12 but I noticed I was getting CA events. I tried lowering it to a max of 9 and I've noticed less CA and mainly RERA.. so maybe it's not high enough now?

I've attached screenshots from a couple nights ago waking up after 4 hours.

Here are my device settings:

Mode: APAP
Pressure Min: 5.00 cmH2O
Pressure Max: 9.00 cmH2O
Antibacterial Filter: No
Climate Control: Manual
EPR: Full Time
EPR Level: 3 cmH2O
Humidifier Status: On
Humidity Level: 1
Mask: Pillows
Patient View: Advanced
Ramp: Auto
Ramp Pressure: 4 cmH2O
Response: Standard
Smart Start: On
Temperature: 29 ºC
Temperature Enable: On

Any help would be greatly appreciated as I'm ready to throw in the towel.

[jcp519]

You definitely need to up the max pressure. Your pressure is hitting max a lot during the night and its causing flow limitations when it does. If you're getting CA events when the pressure is high, you can try to lower EPR a little bit too.

Maybe try putting the max up to 12 again and see what happens.

[staceyburke]

The resmed increases pressure when it finds flow limits. We treat flow limits with EPR. 

I would do 3 things

Set EPR to full time set to 3
Set your min to 8
Max set to 12.

[Burnsy]

Hi, I tried raising the max pressure back up to 12. I still woke up around the 4 to 5 hour mark. Previous nights I only managed 1 to 2 hours. It looks like the flow limitations decreased and no CA events so far, only OA and hypopnea. I've added attachments of the new info. This would have been my original settings and I'm curious why after 10 months I can't make it past 4 to 5 hours. 

I tried lowering the ERP one night to 2 and slept awful. I only managed an hour before I ended up taking the mask off. If you think this may help, I will try again.