Need Help with Sleeping more than 4 hours using BiPap

Hi All, I have had my BiPAP for over a year and it's not been easy. However, I definitely can tell when I have a good night's sleep. My biggest problem is not being to sleep more than 5 hours with the BiPAP (I'm wide awake and can't fall back asleep for at least another couple of hours, or sometimes I pull off the mask when "semi-conscious"), and most of the the time it's only around 4 hours. Obviously this is causing issues with compliance so I'm finally turning to you guys for help.

I'm not sure where to start, so I'm going to throw a few things at the wall here and I hope maybe people will have some ideas of what I can check first:

1. I'm working under the assumption that my settings are effective (I haven't found any article discussing what is "good" for all the variables that SleepyHead tracks--I'm just going off of how I feel). The below is a capture of my stats from SleepyHead:


2. I sometimes wake up with my nose being itchy. I generally have the humidifier around level 4-5, and I don't notice any condensation.

3. It's hard for me to go to sleep unless I hit the ramp button, I'm wondering if my settings are too high because I do feel the higher pressure wakes me. I note the original titration was done when I was about 20 lbs. heavier (I was 210 lb., now down to 190 lbs.).

4. Mask fit can be improved, but I don't feel there are any significant leaks. Besides, I currently have a large full-face but I am switching to a medium.

5. I'm exercising regularly and eating pretty healthy (hence loss of weight). I'm avoiding coffee/tea anytime after 6 pm (and generally I don't even drink coffee/tea). Most of the time no liquor either.

My thought is to maybe adjust the pressure settings first? Any suggestions would be welcomed.

Basic Machine Info

Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P
PAP Mode: Auto Bi-Level (Variable PS)
Min EPAP 10.5 Max IPAP 15.5 PS 0.5-1.5 (cmH2O)

Detailed Machine Settings

PAP ModePAP Device Mode Auto Bi-Level (Variable PS)
Min EPAPLower Expiratory Pressure 10.50 cmH2O
Max EPAPHigher Expiratory Pressure 15.50 cmH2O
Min IPAPLower Inspiratory Pressure 11.00 cmH2O
Max IPAPHigher Inspiratory Pressure 15.50 cmH2O
PS MinPressure Support Minimum 0.50 cmH2O
PS MaxPressure Support Maximum 1.50 cmH2O
Flex LevelPRS1 pressure relief setting. x3
Flex ModePRS1 pressure relief mode. Bi-Flex
Headed TubingHeated Tubing Connected No
Humid. Lvl.PRS1 Humidification level x5
Humidifier StatusPRS1 humidifier connected? Connected
Ramp PressureStarting Ramp Pressure 4.00 cmH2O
Ramp TimeRamp Delay Period 30.00 Minutes

Your stats look really good. Before thinking about changing the pressures, you might think about two things.
1) Try reducing the length of the ramp time down from 30 minutes to something shorter and see it that helps. The target is to get to a place in which ramp is turned off completely. This may be difficult but might be worth the effort.

2) When you wake up in the middle of the night, get up and go to another room and do something non-stimulating like read or listen to soft music (not hard rock for example ) The issue is sleep hygiene and retraining your brain from "Its OK to be in bed and awake" to "I'm in bed so I'm going to sleep."

After trying the first two for a while to see if there is improvement, then a small adjustment to the pressures might be in order.
3) You might try reducing the difference between your EPAP and IPAP pressures. For some, the change in pressure is the triggering think that causes sleep disturbances. The upper value does seem to be needed so increasing the EPAP just a little my reduce the swing. Lowering the IPAP a little may cause more events (obstructive and/or hypopneas,) but might not increase your overall RDI too much.