Looking For Advice

Hello,

Been using CPAP for about 12 years. Ended up getting a new Philips Respironics System One right before we moved to a new town. They did not do a new sleep study before I got the new machine. For the past year and half I am continually tired even after sleeping 7, 8 or 9 hours. Constantly yawning through out the day like I haven't really slept. In the past year and half I have gained about 30lbs. While sleeping I do grind my teeth and my wife says I have the crazy leg syndrome at times.

So I've grown tired of this and now am on a quest to see if I can get my life back. I know the easy answer is go get another sleep study. Well insurance doesn't want to pay for that to happen.

It seems I have a bad mask leak problem. Since I do grind my teeth and I do wear a night guard I am wondering if that is where a lot of the leak is coming from. My former high pressure was at 12. I have bumped it up to 15.5 to see what if any difference I might feel. I am sleeping a little better I do believe.

What mask are you using?

Do the leaks wake you up?

The time over red line % statistic is inaccurate. SleepyHead defaults to the ResMed red line leak number and it's a lot lower than the Respironics red line leak number. You are having some brief large leak episodes but no where near 44% of the night being in large leak.
Respironics never tells us an exact red line number where large leak territory starts because it can vary so much between the type of mask used and the pressures that are used.

You can either turn off the red line statistic or change the ResMed 24 L/min red line threshold to something more suitable for your machine.
Go to Preferences/CPAP tab and on the right you will see the red line threshold stuff. You can either remove the check mark for "show time over red line" or change the 24 to something more suitable like maybe 60 L/min (it's probably actually even higher but 60 would be a nice conservative number).
Go by the Events graph for real large leak evaluation because those LL (large leak) flags are from the machine itself.

If the leaks don't wake you up...I don't know that I would worry a whole lot about those very brief large leaks and it appears you barely made it into large leak territory. Respironics machines will actually do a fairly decent job of compensating for those big leaks until you go over 100 L/min total leak (that top leak line on the graph).
Now if they wake you then they need to be fixed because anything that wakes us up is unwanted.

Now about your results....From the snores and the obstructive stuff going on...I think that a little more minimum pressure is probably what is needed.
Unsure how much but probably something around 9 or 10...maybe a little more.
I would suggest that you slowly increase that minimum by 1.0 cm (for 3 or 4 nights at a time) and see where things start getting cleaned up a bit.
You might not need as much as my gut tells me you are going to need and going up slowly is an easier adjustment anyway.
I suspect something around 10 would do a good job cleaning up all that obstructive stuff and you will likely feel a little better too.
Have more maximum helps but sometimes we just have to use more minimum also because these machines work best by preventing the airway from ever collapsing in the first place instead of trying to fix something after the fact.....more baseline minimum pressure works wonders sometimes.

OAs, hyponeas, RERAs, FLs and snores all point to the pressure not being optimal and you aren't maxing out at 15 except for a very brief time so now is the time to add more minimum.
Start slow with a 1.0 cm increase or even less if it's too uncomfortable and use the new minimum a few nights to get used to it and to also get a feel for the trend on the reports. Or jump to 9 cm minimum if you are comfortable with it and see what happens.

It may be more comfortable moving to 9 for a few nights to get use to the higher starting pressure. If those were my charts and using the statistics table on the left hand side. If the 'med' median pressure is a typical number. I would think you are going to finish up with a minimum pressure of 11-12 Which is a bit under the shown 12.3 to have a good OA/H

It is suggested to set the minimum a bit less than the median number and the maximum 1-2cm above the 95%, as a rough guide. I read on the forums that the respironics generally work better with a tighter gap between min and max, because they are slower to respond.

the mask I am using is Fisher & Paykel FlexiFit 405 Nasal Mask. sometimes it does wake me up. I tend to sleep on my side most of the night.

i will make the small adjustments and see if it helps out over the next few nights.

DJFaninTN wrote: ...and my wife says I have the crazy leg syndrome at times.

If "at times" is often and/or severe enough to disrupt sleep you may need to look at that later. Right now I'm agreeing with the others and expecting you see better sleep with your settings as per prior discussion.