Anything to be improved?

[Mazus]

Hi, i've been using a CPAP machine for a while now, and I'm wondering if there's any improvements to be made, since I'm still feeling kind of tired, despite an AHI of around 2-3ish. I'm also wondering if the tiredness is just a matter of my body getting used to a proper night's sleep after all this time(have likely had sleep apnea since childhood, I'm 23), and maybe it's just going to take time.

Anyway, here's the info from last night, if anybody knows what's going on. Oh, and the machine seems to hit the actual maximum of 20 after I raised the maximum up to that as per Pugsy's suggestion earlier in another thread.This seems a little off, considering that supposedly the machine only goes as high as it deems necessary, and my original pressure from the sleep study is an 11-12. Also, I mentioned the flow limitations I've been having in that thread, and I figured I'd start using Flonase to help with my congestion, which helps me be more comfortable(doesn't bother me during the day, but with the mask on it somehow gets WAY worse, and I was told that may be causing the flow limitations on the machine), but the graph still looks kind of active. Also, I switched from an Airfit F20 to an Airfit F30i, which is far more comfortable for me.

11-12 gave me an AHI of around 3-5 down from 26-30 during the sleep study(strangely, once I got the machine at home that same pressure from the study led to a higher AHI consistently, of around 8-10, over the first week). 20 is pretty far of a leap, just short of double the prescribed pressure.So I'm wondering out of several options that I know of:

1. Is it somehow fine in this state hitting exactly 20 at points?(kind of seems unlikely since the machine appears as if it would go higher if it had the actual capacity, but it can't, which leads to my second question)
2. Do I actually need more pressure than this, which I kind of doubt?(some sort of BIPAP machine that offers 25 or something?)
3. Maybe there's something critically wrong with my setup making it go up to 20 when it should actually be somewhat lower, a little closer to the 11-12 from the study, and still be just as effective as the study without needing to basically double the pressure? It's been doing this for a while.
4. I've heard of people having like postural issues that cause obstructive/hypopnea events/oddities on the flow limitation graph and then needing a neck brace thing, and I'm wondering if that's it? Sounds like a long shot though.
5. Any other suggestions?

Lastly, the pressure seems to be causing my costochondritis(ribcage/sternum joint pain) to get worse in the mornings(may or may not be coincidence/unrelated) and it also winds up being hard to inhale without the machine for a few moments after I take off the mask in the morning. What do I do about these?

[Miss Emerita]

Hello, Mazus. To some extent, the pressure increases are driven by the flow limitations, so I'd be curious to see how things went if you were to increase EPR to 3. This might help to reduce the FLs. I would also recommend increasing your minimum, perhaps to 15 for now, with the thought that it may need to be raised further down the road.

The FLs and snores wax and wane. Could they be correlated with changes in sleep position, do you think? E.g., you rolling onto your back or tucking your chin down toward your chest?

Is 6 hours a typical night for you? Any chance you could experiment with 8? Some of us do a lot better with more sleep, even though others don't need it.

And do you know what's causing the large leaks (the greyed-shaded areas)?

I've had costochondritis, and it's easy for me to imagine that the effort of breathing with high-ish pressures exacerbates the condition. I'm sure you've gotten tips from your doctor; mine suggested icing for 10 minutes three times per day, plus ibuprofen around the clock, both until the flare-up subsided. That worked quite well for me.

Small thing: next time you post a chart, you can leave off the tidal volume and mask pressure. That might make the chart a little easier to read, at least for these aging eyes.

[Mazus]

Oh, I'll definitely try increasing EPR to 3. Also boosting the minimum up to 15. I'm kind of wondering if the costochondritis is somehow worsened by solely the effort required to exhale(and the EPR might also help with that?), since inhaling is perfectly easy. For side vs back sleeping, I don't actually know, I both fall asleep and wake up on my side, but I could be doing whatever between those two periods, and I'm also not exactly sure what I would do to stop myself from rolling onto my back, short of that tennis ball attached to the shirt trick. That would probably wind up interrupting my sleep, defeating the point. However, with the chin tucking thing, I suppose one of those neck brace things would fix that? It seems EXTREMELY uncomfortable though, at least for my tastes. If there's an alternate way around that, I'd definitely want to know.

And no, I typically sleep around 8-9 hours, Today I just wound up sleeping a total of 6(less, since the machine still counts the time you were awake it seems) for unknown reasons. Woke up and couldn't get back to sleep. And for the leaks, I don't precisely know what caused them, but it was probably me moving in my sleep and bumping the nasal cushion part of my F30i mask off of my nose a little.(The F20 I had was ultimately worse though, as it would constantly blow air into my eyes, even if it moved a tiny bit)

Oh, and the chart thing was because I wanted to have the machine settings included in the screenshot, and didn't know how I'd squeeze it in there without including those other things. I guess next time I'll just list them in the text or some other method, my apologies.

[Dog Slobber]

Oh, and the chart thing was because I wanted to have the machine settings included in the screenshot, and didn't know how I'd squeeze it in there without including those other things. I guess next time I'll just list them in the text or some other method, my apologies.

Keeping the machine settings is good.

What you can do is click on the border between two graphs and drag it to increase individual graph size.

This way you get Machine settings, and Pressure, Event Flags, FL. Leak Rate are larger and easier to read.