Recommendations wanted to improve my sleep quality

After two months of CPAP, I am still feeling a bit foggy when I wake up after 7-7.5 hours of sleep. My AHI have been consistently well below 5...averaging 1 to 3 most of the time. Last night I started slowly bumping my minimum pressure from 10 to 10.2 cmH2O (hoping to increase 0.2 cm once a week due to my vertigo...increasing from 10 to 12 in one night triggered my vertigo). For about the first 6 weeks, my pressure range was 10 to 16. A couple of weeks ago, my sleep tech increased the range to 12 to 18 which instantly triggered my vertigo including dizziness and headaches. Since then, I have lowered my maximum pressure to 17...my maximum pressure over 30 days was just under 17. It is noted that my dormant vertigo (BPPV) was also triggered when I first started CPAP therapy.

For the past week or 10 days, I have been rotating my three nasal masks (Eson2 to Dreamwear cushion to Wisp) every few days when skin irritations occurs.

Three recent SH charts are attached below. I would appreciate any comments or suggestions to improve my sleep quality. Thanks in advance.

March 27 was Eson2; March 29 was Dreamwear; April 1 was Wisp if my memory is correct.

DavidY wrote:After two months of CPAP, I am still feeling a bit foggy when I wake up after 7-7.5 hours of sleep. My AHI have been consistently well below 5...averaging 1 to 3 most of the time. Last night I started slowly bumping my minimum pressure from 10 to 10.2 cmH2O (hoping to increase 0.2 cm once a week due to my vertigo...increasing from 10 to 12 in one night triggered my vertigo). For about the first 6 weeks, my pressure range was 10 to 16. A couple of weeks ago, my sleep tech increased the range to 12 to 18 which instantly triggered my vertigo including dizziness and headaches. Since then, I have lowered my maximum pressure to 17...my maximum pressure over 30 days was just under 17.

For the past week or 10 days, I have been rotating my three nasal masks (Eson2 to Dreamwear cushion to Wisp) every few days when skin irritations occurs.

Three recent SH charts are attached below. I would appreciate any comments or suggestions to improve my sleep quality. Thanks in advance.

March 27 was Eson2; March 29 was Dreamwear; April 1 was Wisp if my memory is correct.

It took most of a year on CPAP before I started to really feel good. It took a while to undo the effects of years of bad sleep. I'm not sure you really need to make much in the way of changes.

I like the idea of getting to a min of 12 as well. Maybe try increasing by 0.2 every other day and see if that works without triggering vertigo?

It seems to me that averaging 7 or 7.5 hours of machine usage per night after 2 months is pretty good. A lot of people do not tolerate therapy as well as you do. Also, a lot of people wake up foggy and take a while to get going in the morning. It seems more important to consider whether during the day you are nodding off or have other symptoms of sleep deprivation.

So your question was how to improve sleep quality....but you didn't tell us what about your sleep quality you felt might need improving.
Is it just the fact that you wake up feeling a big "foggy after 7 - 7 1/2 hours of sleep"?
Are you thinking that a few tweaks with your settings will get rid of the foggy feeling or is there something else going on?

I need some more information that I may have already asked you in another thread but no time to go digging in past threads.

Do you wake often during the night? If so, any idea why?
Do you take any medications? If so, what?
Any other physical or mental health issues that might impact sleep quality or sleep architecture?

Personally given the history with the BPPV....I would be extremely cautious with the minimum pressure increases unless there was an urgent need for those increases and I just don't see it (urgent need to up that minimum) on these reports.
Maybe the flow limitations...but I don't know that the FLs are causing the foggy feeling...they certainly aren't urgently needing addressing by any means.

I have BPPV myself...and have had it for years and sometimes pretty severe. I wouldn't wish it on my worst enemy (well...maybe on a couple ) but I would be extremely careful with the pressure increases. The answer to your foggy feeling complaint may not even be "more pressure". It might be something else. I do understand the desire to try something though...just be careful because the foggy feeling monster may not be the worst monster you get to battle.

I have gout, hypertension and am quite a bit overweight. My hypertension seems better lately with CPAP therapy. Lost 15 pounds so far...low sodium (hard to do) and more balanced diet and more consistent exercise.

In the first 6 or 7 weeks of CPAP, I was waking up several times most nights. In the last week or two, I have been sleeping through most nights.If I do wake up, I don't remember it.

Pre-CPAP, other than snoring and the above mentioned hypertension and being overweight, I didn't have the obvious symptoms of sleep apnea IMO. Had averaged 5-6 hours of sleep. No naps during the day. During long drives, I would have to take short breaks every few hours.

I would like to tweak my APAP settings to optimize my sleep....would like my sleep to be more restful...I don't have that rested feeling each morning...that's my key goal.

Dave