[Treatment] Seeking help for poor sleep with cpap

[vHungry]

Hello, everyone! I recently got a new Resmed AirSense 11 after being fed up with my iBreeze from Resvent.I am using an N30i mask and a heated tube. My minimum pressure is 7.4, and my maximum pressure is 10.4. My climate control is set to auto.

I don't feel well-rested despite using the cpap (I have been using cpap for a bit more than 2 years. Please take a look at my recent data. I attached data from the last 3 days.

I would appreciate some advice. Many thanks in advance!

Edit: Additionally, since switching to my AS11, I have found it hard to keep my mouth closed when sleeping. Mouth taping helps, but I sometimes take it off in the middle of the night. I wake up with a dry mouth often.

[G. Szabo]

I suggest setting the minimum pressure to 9 and the maximum to 12.
EPR=3, full time.
You should also adjust your mask or switch to a different one to mitigate leaks.
Try to sleep on your side.

[vHungry]

I suggest setting the minimum pressure to 9 and the maximum to 12.
EPR=3, full time.
You should also adjust your mask or switch to a different one to mitigate leaks.
Try to sleep on your side.

May I ask why you specifically suggest 9 as the min and 12 as the max, and why an EPR of 3?

Thank you!

[staceyburke]

Take a look at your pressure graph, it looks like a mountain range.  WHY is the pressure raising?  The Resmed increases pressure when it finds Flow Limits.  Flow Limits are apnea just like O and H events.  They are less than 10 Seconds ( in my signature you can see how they are rated).  It raises to STOP Flow Limits from becoming O or H events.

The more pressure swings, the more leaks and arousals.  We counter FL by using EPR and that is why he suggested EPR Full Time set to 3.

[G. Szabo]

May I ask why you specifically suggest 9 as the min and 12 as the max, and why an EPR of 3?

Thank you!

I can reiterate the above message of Staceyburke.
The minimum pressure of 9 is based on your flow curves. The instrument needed to increase the pressure dramatically and multiple times in your current setting. Min P 9 eliminates some of the frequent adjustments and you will have a pecefull night.
A maximum of 12 is needed because, on one of your curves, you are hitting your current maximum setting; hence, it is not high enough.
Because of the higher pressure setting, you might have issues with the pressure. The high EPR will help you exhale more easily and reduce leaks, too.        

[vHungry]

Hello everyone. I slept with a min of 9 and max of 12 with an EPR of 2 (I didn't want my pressure to go under 7) for 2 days and have some data. What do you think now? I don't feel like my stats changed much and I don't feel much or any of a difference.

Please advise.

Thank you!

[SarcasticDave94]

The occasional leaks didn't change much, except they don't go as high. They may be the basis for not getting to the well rested state.

The spikey leak look is the mask, and if there's any wider rather flat looking leaks, that's typical for mouth leaks. There's examples of both within these charts.

If you want to try EPR 3 without going below 7, pressure 10-13 EPR 3.

[vHungry]

The occasional leaks didn't change much, except they don't go as high. They may be the basis for not getting to the well rested state.

The spikey leak look is the mask, and if there's any wider rather flat looking leaks, that's typical for mouth leaks. There's examples of both within these charts.

If you want to try EPR 3 without going below 7, pressure 10-13 EPR 3.

What is interesting to me is that I mouth-taped last night, and I am pretty sure I kept it on the whole night. It's weird how there would still be longer leaks. I use an N30i and have tried sleeping on my side the last few days, so maybe that is causing more leaks?

Do my pressure curves look any better?

Thanks!

[G. Szabo]

I don't feel like my stats changed much and I don't feel much or any of a difference.

Your stats improved. And you are expected to be better when you follow the above suggestions of SarcasticDave94.

[vHungry]

Hey everyone. Been sleeping a few more days with these new pressure settings. I noticed that if I sleep on my back, the leaks go down by a lot, and I surprisingly feel a lot better than when I sleep on my side.

I am still noticing a lot of weird events. Any advice on these?

I uploaded a full screenshot of the night followed by some cut and paste events I found (some marked, and some not) with labels for each event at the bottom (hopefully it isn't too confusing)

Is event 1 really an OA? It is for 21 seconds, isn't that really bad?

What are those short flatlines like events 2-6?

These are just a few events, but it seems like it is common to have a short flatline like events 2-6 that every 10-15 minutes