Dont know what else to do

I am asking for an opinion. I have been on a CPAP, for about 10 years, give or take, been seeing a sleep dr even longer. It started with parasomnias, night terrors. I always sleep walked even when I was younger. Initially dr prescribed clonazepam, seemed to help, never making it 100% better. After a while the doc said he thinks its all from sleep apnea. Over the years I had numerous sleep studies. Changes were made to my machines, I think I had four different machines along the way. They had me on pressures ranging from 8 to 25 using Bipap, cpap, auto. My AHI never gets below average of 15. If it does its rare. The AHI just seems to be all over the place. Do I feel rested? I guess. I long for a good nights sleep. I can rarely sleep for more that 6 or 7 hours total, and for whatever reason I am usually up at the same time every night. I was able to loose 40 lbs in the last year hoping that would help. Im 6 ft and I am 225 now. Im off the clonazepam now because dr said its not good to stay on that. Ive not had the night terrors, parasomnias, or sleep walking for a while now, but sleep itself is not quality. I can say this, I dont handle high pressures of my PAP. I seem to do better with low pressures. Right now my CPAP is set for a pressure of 10. The dr I go to is one of the best I am told. Im ready to chuck my machine in the trash. Im going to try to post some graphs from OSCAR. I try to read them but I cant interpret them. Any help or advice would be appreciated.

JM

Hi - hate to ask this, but would it be possible for you to post just a couple of graphs without the calendar or Navigation, allowing more info below it to show up?

And more specifically, why did you end up on plain Cpap vs Auto?

And have you seen an ENT for ideas re what might be causing such obstruction, though strongly suggest that for now you don't necessarily agree to immediate surgery (yet, anyhow) as ENT's just love lining up patients for it.

Currently, you are in straight CPAP mode at a pressure of 10. That is clearly not high enough to address your needs.

You've stated you "You dont handle high pressures of my PAP. You seem to do better with low pressures.". But you have't stated, why you don't handle high pressures. Can you not tolerate it? Do you suffer from Aerophagia? Do you start experiencing Centrals? When was the last time you tried pressure above 10? Is there any reason you aren't using Bilevel and Pressure Support.

Right now, you have a very good machine, but you are not taking advantage of any of its features that might address your intolerance or your apneas.

Without knowing some of the answers to the above, it's very difficult to suggest anything.

Are you willing to re-titrate and possibly try pressures over 10? If the answers is no, then there is really nothing to be done.

If you are then, I would suggest:

• Starting from fresh.
• Reseting the machine to default, we don't know what the Bilevel settings are.
• Putting it into Bilevel mode with a Pressure Support of 4.
• Cap the maximum EPAP, because you've indicated problems at higher levels.
• Start adjusting according to graphs and your tolerances.
• You will need to start posting graphs in a proper format.
• The above starting points might change depending on how you fill in some of the unknowns.

Please review this thread for formatting of your detailed report. You should be able to get all we need on one image.
viewtopic/t158560/How-to-post-images-for-review.html

Your pressure settings appear to be fixed cpap mode with 10 cm fixed and EPR at 3.

Do you have a bilevel report we could see?

RIght now...the 10 cm isn't doing the job...you need more pressure. Probably a lot more pressure.