Trouble with higher pressure

[JeffV]

About a month ago, I was prescribed a pressure increase to 14-20 (APAP), after spending the previous six months at 9-15 and even lower for a month or so before that. I've spent the last month gradually increasing the pressure to acclimate to it, and a few days ago I finally hit 14. However, as the pressure has increased, my partner and I have been noticing more and more issues.

- Sleep quality overall degraded quite a bit - harder to get out of bed in the morning, more tired in the evening, overall energy down, etc.
- My headaches returned. Prior to getting on CPAP last year, I had frequent mild headaches. I went on magnesium at about the same time I went on CPAP and they went away.
- I was mouth-breathing a lot more. According to my partner, she was nudging me multiple times a night to get me to shut my mouth or roll over, and occasionally had to wake me up to get me to stop. I don't currently use a chinstrap or tape (and never have).
- Aerophagia, every once in awhile. No pain or anything, but the first time I woke up and burped for ten seconds straight caught my attention a bit.

Last night I decided to try a lower pressure and dropped my minimum to 11. (insert Spinal Tap reference) This morning I felt much better. Bounced right out of bed with my alarm, no headache today, and overall feeling noticeably pretty good. I realize that small sample size is small, but it's a pretty big coincidence. Any recommendations for what I should do from here?

[Julie]

Why was a higher pressure prescribed? Doesn't make a lot of sense from the sound of things.

[JeffV]

Short answer: I'm actually not 100% sure why.

Long answer: My initial sleep study was enough to diagnose OSA but I didn't sleep near well enough to be titrated. I was prescribed CPAP with pressure of 7. Based on my numbers and my input, he increased it to 9-12 a month or so later, and that's where I stayed for six months. Since my AHI was staying around 1 I refused to do a separate titration study for monetary reasons. (At some point during that period I took it upon myself to bump my max up to 15, since I was coming up to 12 fairly often.)

This year I had some unexpected medical bills and maxed out my insurance very early in the year, so I told the doc to go ahead and order the titration study. I had an appt with him for the results last month, where he told me that I needed a pressure of 14. I didn't get many more details past that. When I asked his nurse for a copy of the results, she told me all they had was the preliminary report and that she'd mail me the final report when it came in. Still haven't gotten it. I kinda forgot about it until I started having trouble, and I now have a call in to the hospital (where the sleep lab is) to get a copy myself.

[Julie]

Can you download Sleepyhead (see 1st 'Announcement' on pg) and post results using info given?

[JeffV]

I've got SH already, been using it from day 1. I'm at work right now so I don't have access to the info at the moment - any particular ones you want to see?

[Julie]

Well, you seem to know what you're doing and unless the MDs report says something unexpected, I suppose you could keep doing it.

[JeffV]

Well, you seem to know what you're doing and unless the MDs report says something unexpected, I suppose you could keep doing it.

I have the graphs, but always knowing what they mean and what to do about them is another matter entirely. I have done my homework and know quite a bit, but I definitely do NOT know everything. I've also gotten a bit lazy on looking at my graphs... I'll pull them up when I get home in a little bit and post some pics.