Newbie trying to figure this all out. Any help would be appreciated

[Mk1West]

So short intro.
I've been trying to figure out my daytime fatigue for almost 5 years now. Finally found a new doctor that was helpful.
Had an at-home sleep study done which said I had sleep apnea and would benefit from a CPAP. I guess I should have asked more questions about what the test showed, but was just happy to have a solution.
Didn't want to go through insurance, so I purchased my ResMed AirSet 10 myself and I've kind of been on my own since then. My order came with an email that said the pressure setting was set to 4 cm - 20 cm and was set by Lytanisha???
I just thought someone who knew my prescription set it to those numbers and that was what I was supposed to use.

1st night went semi-okay, but it felt hard to breathe out.
2nd night my F30 nose part must have been weird because it hurt my nose a lot and was leaking so I ripped it off
3rd night went horrible and woke up with it at what seemed like full air and leaking like crazy and I was annoyed so I ripped it off and went back to bed
4th night I was very particular about making sure the mask was fitting right and it felt good going to bed, but then 2 hours in I woke up to it going full steam again and I couldn't even breathe a full breath out with how much air it was putting out.
I sat there for a few minutes with the mask on trying my best to breathe normally and let it chill out back to 4 cm, but it just kept going at 17.9 cm until I ripped it off.

So here I am now. I've found the info on this forum very helpful. I've put an sd card into the machine and installed oscar so I can look over the data and maybe post some reports.
I set my pressure to 7 cm - 15 cm to use for tonight to see what that does and maybe I'll call my doctor on Monday to see if he has a suggestion.
I've also ordered a ResMed F20 mask because I didn't realize the F30 didn't go over the top of your nose and I think I'd rather have that.
My only question right now is, why the heck would I wake up with the pressure at 17.9 cm and it wouldn't stop? Shouldn't it have lowered back down after I was awake? There was no way I was going to go back to bed with it at 17.9cm.

Any thoughts would be amazing. Thank you.

[Julie]

Post Oscar results so we can get hints.

[Mk1West]

Last night went pretty ok. I think I must have woke up because of the leaking and took it off because It went okay for 4 hours.
Looks like I definitely have some leaks going on that I'll need to work on. Hoping the F20 mask will be a better fit.
Still, confused by the pressures? Why do they go up when I'm not having an event?
Should I try some different pressure setting because I was still having events at 15 cm?

[LSAT]

You can see that the machine was trying to go higher but it couldn't because to have it capped at 15. Increase your Max pressure to 20.

[Pugsy]

Look at your flow limitation graph....flow limitations are also a driving force for the pressure increases.
Flow limitations are the early warning signs that the airway is trying to collapse. The machine increases the pressure in an effort to prevent the FLs from growing up to be OAs or hyponeas..and looks like it is doing a good job of preventing.
Snores are also a driving force for the same reason.

It's more than just OAs or hyponeas that can cause pressure increases.

What you see is just the machine doing its job.

Here's an example of what a FL graph looks like without all the warning signs. Compare yours to mine.

[Mk1West]

Thank you for the responses. The flow limit thing makes a lot of sense.
I'll put it back to 20 cm. I think I just got scared from waking up with it at 18 one night, but obviously, I was just fine with it at 15 for that long. Maybe if I fix my leaks it won't wake me up.
If I wake up with it at 20 cm, shouldn't it drop the pressure after a while or should I just stop/start treatment to go back to bed?

[Pugsy]

If I wake up with it at 20 cm, shouldn't it drop the pressure after a while or should I just stop/start treatment to go back to bed?

It will eventually drop the pressure when you wake up but it's going to take 5 minutes or more because it doesn't do anything quickly.
It's going to be a very long 5 minutes so I would suggest just turning the machine off briefly and restarting back at the lower pressure.

You might think about adding a little EPR and see if that helps reduce the FLs. Often it does.
Also when you are fitting your mask make sure you fit it at the higher pressure. A seal at the starting lower pressure won't hold well at the pressures in the mid teens. Use the mask fit check thing available on your machine to fit your mask at the beginning of the night.

https://www.respshop.com/manuals/ResMed ... %20her.pdf

[Mk1West]

Thank you. I didn't even realize that wasn't on. That should help me a lot.

[Miss Emerita]

I'd like to second the suggestion that you turn on EPR. You might start with 2, aiming to go to 3. I bet you'll like the way it feels; it allows you to exhale at a lower pressure.

The reason it may help with those flow limitations is that it gives you an extra boost as you inhale. Flow limitations are inhalation problems, with some kind of airway restriction that causes you to work harder to breathe in. If you zoom in on your flow rate, flow-limited breathing will not show a nice smooth curve but will show a dent, peak, or flattening.

If your flow limitations are well treated via EPR, your pressures may settle down. If they don't, you may want to consider capping your maximum again, but that's down the road.

One other thing. There's some clustering in your events and in your flow limitations. Do you know whether you tend to tuck your chin down toward your chest? Do you use several pillows, or a high pillow? Do you sleep on your back a lot? Depending on the answers, we can give you some ideas about things to try.

[Mk1West]

Thank you. I thought the EPR stuff was automatic, but I got it set now, I'm really optimistic to try that out.

I do have 2 pillows. I've never found it that comfortable, but my wife always put 2, so I used 2. I will definitely get rid of one if you think it'll help.
I'm not sure about the tucking of the chin, but I probably do. I'll have my wife check when she comes to bed because she goes to sleep after me.
I typically sleep on my back or stomach, but I think since this week of CPAP it's most likely been all back.

[palerider]

Why do they go up when I'm not having an event?

Flow limitations and snoring don't count as "events" but they make pressure go up.

Yes, put the max at 20.

[jimbud]

I started to have flow limit issues about three weeks ago. I upped my minimum 1cm and put EPR on 1. Problem solved.
Sometimes just a small change can make the difference. Once again, YMMV.

You may have to experiment some, but it does work more often than not.

JPB

[Miss Emerita]

Thank you. I thought the EPR stuff was automatic, but I got it set now, I'm really optimistic to try that out.

I do have 2 pillows. I've never found it that comfortable, but my wife always put 2, so I used 2. I will definitely get rid of one if you think it'll help.
I'm not sure about the tucking of the chin, but I probably do. I'll have my wife check when she comes to bed because she goes to sleep after me.
I typically sleep on my back or stomach, but I think since this week of CPAP it's most likely been all back.

Yes, try one pillow. Any chance you can sleep more on your sides? And if your wife sees that you tuck your chin, you might try a soft cervical collar, as an experiment.

[Mk1West]

Got the leaks down a good bit. Still waiting to try the new mask when it shows up because it was hurting my nose wearing it this tight.
I definitely liked the EPR and it seems I didn't wake up when the pressure was at 20 cm, so I think I'm moving in the right direction.
I was more comfortable with the 1 pillow, but I forgot to ask my wife to check on me tucking my chin.
I like laying on my side to fall asleep, but it's always been an issue that I'll roll to my back right after falling asleep and that's when my snoring would always be the worst in the past and my wife would yell at me to roll on my side.

[zonker]

Got the leaks down a good bit. Still waiting to try the new mask when it shows up because it was hurting my nose wearing it this tight.

no mask should be worn tight.

when the new mask comes, do a search on youtube for mask fitting videos. use the name of whatever mask in the search parameters.

good luck!