Newbie to CPAP

[Justabulletaway]

Hello all. I have had my CPAP machine for about 3 weeks now. Seems like I am getting better rest but not what I expected. I am having some nights with under 5 AHI but a few over.
I downloaded Sleepyhead to look at the data. Looks like I am snoring a lot?
I feel like my pressure is low for some reason. On the night in the first screenshot, I woke up gasping. Seemed like I didn't have enough air.
The second screenshot is a good night.

Any input would be greatly appreciated.

[palerider]

I feel like my pressure is low for some reason. On the night in the first screenshot, I woke up gasping. Seemed like I didn't have enough air.
The second screenshot is a good night.

Any input would be greatly appreciated.

probably because your pressure is too low, unfortunately, you're on a non-auto machine so you have to set the pressure high enough to deal with things like whatever was happening towards the end of the first night.

try raising the pressure 1 cm at a time and let it average out for a few days, till you get to where you're not having those bad sessions.

[Pugsy]

The snores and RERAs point to sub optimal therapy pressure. Those both are warning signs of the airway trying to collapse but not quite getting to the point to meet criteria to earn an OA or hyponea flag.
Snores and RERAs and FLs (which your machine doesn't even flag in cpap mode and I suspect there would be some FLs to go along with those snores and RERAs) aren't part of the AHI but are still important in evaluating therapy effectiveness.

The "bad" night...with the one time frame with a dense cluster of mainly hyponeas with a few OAs thrown it...the airway went ahead and collapsed enough to earn the apnea event flags....maybe you were on your back at that time or maybe that was a period of REM sleep or maybe a combination of both REM and sleeping on your back where it is common for our OSA to be worse and need more pressure during that time than you need at other times.

Your pressure isn't quite holding the airway open well enough to prevent it from trying to start to collapse and sometimes it doesn't even prevent the collapse which earns the hyponea or OA flag.

All this points to sub optimal therapy and you need a little more pressure.
It is enough to impact sleep quality and likely plays a part in not feeling as good as you hoped.
Other things might also play a part...like you might need more hours of sleep.

Do you take any medications? If so, what? Sometimes meds play a bigger part in how we feel or sleep than we realize because of side effects.

Oh...do you wake often during the night? If so any idea why? Waking often will mess with how we feel no matter how good the report might look.

Sometimes we look at these reports and say you look good on paper and you need to give it time or dig around for other reasons for not feeling the good numbers.
In your situation there is something showing on your reports that points to your therapy not being optimal and it is easily remedied by using more pressure....so while I can't guarantee that more pressure will make you feel better....it's something that needs to be done to give you the best chance because the snores and RERAs are screaming "fix me" in your situation. Most of the time I end up telling someone that nothing is just standing out screaming "fix me"....but in your situation...there's definitely something that needs fixing and it may or may not help with how you feel but it is sure worth trying to see if it helps or not because it sure won't hurt.

Probably won't need much more....usually 1 cm will deal with just the snores and RERAs....I don't know yet about that ugly cluster of hyponeas/OAs. I would look at those separately if they happen often. Sometimes a little pressure will do the trick and sometimes it takes a lot more and we would need to have a different discussion about those clusters if they persist on more than a random rare basis.

Do you feel comfortable making the change yourself (it's not hard to do) or would you rather run all this by your medical team?

[Justabulletaway]

Thanks for the speedy replies.

I think on that "bad" night I may have been on my back. I remember waking up gasping for air, almost in a panic state and probably was on my back.
I usually wake up a couple of times to make a bathroom trip. I don't take any prescription meds at all. I do have leg cramps from time to time. Woke up a couple of times this week with a bad charley horse.

I am due back to see the Dr on 10-6. I have no problem changing the setting myself. I have already looked up the procedure for my machine.
Just wanted some opinions before I went playing with my setting.
Pretty sure the Dr. or DME wouldn't care. My wife has used both for years and they never do anything to tune her therapy.

[palerider]

Thanks for the speedy replies.

I think on that "bad" night I may have been on my back. I remember waking up gasping for air, almost in a panic state and probably was on my back.
I usually wake up a couple of times to make a bathroom trip. I don't take any prescription meds at all. I do have leg cramps from time to time. Woke up a couple of times this week with a bad charley horse.

I am due back to see the Dr on 10-6. I have no problem changing the setting myself. I have already looked up the procedure for my machine.
Just wanted some opinions before I went playing with my setting.
Pretty sure the Dr. or DME wouldn't care. My wife has used both for years and they never do anything to tune her therapy.

get the clinician manual for your machine, so you know what all the various settings mean. there's a link to get it via email at the top of apneaboard.com...

[Justabulletaway]

I bumped up the pressure to 9 for last night. Got my lowest AHI yet of 0.24
Still seeing some snoring going on but will give it a week or two to see how things hold up.

[Pugsy]

Remember the snoring could be related to sleeping position. If you are sleeping on your back for a good part of the night you might try staying on your side more. If that's not an option for some reason and you are still seeing more snores than you like (even with that nice low AHI) a little more pressure would likely help reduce the snores to cover any sleeping position.

There might be some REM stage sleep components going on but normally when it's just REM sleep making the OSA worse we see the snore clustering more in segmented groupings of around maybe 30 minutes and not so much like you are showing. So I suspect supine sleeping might be more of a culprit in this situation than REM but it wouldn't be impossible for REM sleep to also be a factor.

A few snores here or there probably isn't that big of a deal as long as you are sleeping well and feeling decent during the day.

[palerider]

I bumped up the pressure to 9 for last night. Got my lowest AHI yet of 0.24
Still seeing some snoring going on but will give it a week or two to see how things hold up.

that's great, hopefully the 'bad' nights will improve too.