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You are fast approaching pressures where you are maybe going to want to really utilize EPR.
I actually would concentrate on the minimum pressure increases for a little bit before trying reducing EPR.
Pick what is most comfortable for you. It you can't get comfortable you can't sleep and sleep is the primary goal right now. There's still ample room to increase the minimum before we have to resort to reducing EPR.

Using EPR essentially makes the machine function like a bilevel machine and it's going to offer more comfort in the pressures you seem to be needing.

Hey Weej:

Just about every time I make a change I try to make ONE change and then give it at least a couple of nights to see what results, if any, I get. That isolates variables, and keeps you from jumping to conclusions after one bad night. Don't know if this has been mentioned before. I would tinker with one thing at a time. Unless Pugsy says otherwise. She has a boatload of experience and I don't.

Weej, your OA occurs in clusters. As suggested by Pugsy, this could be REM stage, or it could be positional. One of the easiest ways to get to the bottom of this would be to use a smartphone app like SomnoPose (there may be others). If we an correlate the events to sleep position (or not), then we can have a more direct course of action to suggest.

Hi Sleeprider, thanks for your advice. will get the Sleep position monitor app and try it out.

this was last night's data. I think there are improvements, but i remember myself waking up a few times to adjust my mask for comfort and little leaks. Really need to see if there are any correlations between sleep position and the events for my case.

Your clusters are while the pressures are lower and before the machine can increase to prevent them. I would increase the minimum Epap to 12 with the EPR at 3 and try to prevent those. While REM and sleep position may be involved in your clusters, we can't control REM and you need to be able to sleep in any position that you are comfortable.
Your leaks look much better. Just that one at the end when you were probably waking up.

Weej, it looks pretty good for a new user with relatively high pressure. Your leaks are under control, and the clusters of OA and H are widely spread apart, so you're probably getting good sleep in-between. I'm still curious to see if there is a sleep position correlation to the clusters.

Good luck1

Hi all,

unfortunately I do not have an iphone, so I can't use the application mentioned for the sleep position monitoring.

But my new Respcare Hybrid mask came. Tried for 2 nights, and got awakened by leakage of air from nose pillow due to the high pressure. At lower pressure it fits nicely, but when the pressure increased, it tends to slide off my nostrils and resulting in some leakage. Will try again tonight with some adjustment to the straps. But one point to note was, this hybrid mask kind of suits a side sleeper like me.

Cheers

Hi all,

Just an update
I have been using the hybrid mask for about 10 days. First 5 days was not so good, my AHI fluctuates between 28 - 10. Then i decided to use double pillow (so I am resting on an inclined angle, raising my chest and head higher), and my AHI dropped to range between 1.6-2.8

I would consider this as an improvement? I do feel better in the day as the day time sleepiness is greatly reduced. I do not wake up in the middle of the night to use the toilet since last week.

But when I woke up for a short while during my sleep, I find my neck and some body muscles aching, so i have to adjust my body a little and feel relaxed, and I fell asleep again immediately.

May I know if there are any unhealthy side effects on sleeping at inclined angle while undergoing CPAP therapy?

thanks!

Weej wrote: May I know if there are any unhealthy side effects on sleeping at inclined angle while undergoing CPAP therapy?

None that I know of. Some use small wedges to help with their reflux. The only complaint I read is that it was uncomfortable to their lower back.
Elevating the head some can actually help by decreasing the pressure that the abdominal organs can put on the diaphragm when lying flat. A couple of pillows is no problem as long as you are comfortable.

I have been sleeping with my head raised for several years, now due to lower back problems. I even did my sleep studies that way. Since I normally sleep in that position, they tested me that way. With treatment my AHI has gone from 49 down to where it normally stays under 2. I think you will find wedge pillows more comfortable than using two regular pillows. I bought some from Bed Bath and Beyond several years ago and use them when we travel. At home, I use an adjustable bed similar to a hospital bed.

Weej wrote:Hi all,

Just an update
I have been using the hybrid mask for about 10 days. First 5 days was not so good, my AHI fluctuates between 28 - 10. Then i decided to use double pillow (so I am resting on an inclined angle, raising my chest and head higher), and my AHI dropped to range between 1.6-2.8

I would consider this as an improvement? I do feel better in the day as the day time sleepiness is greatly reduced. I do not wake up in the middle of the night to use the toilet since last week.

But when I woke up for a short while during my sleep, I find my neck and some body muscles aching, so i have to adjust my body a little and feel relaxed, and I fell asleep again immediately.

May I know if there are any unhealthy side effects on sleeping at inclined angle while undergoing CPAP therapy?

thanks!

You're basically confirming my suspicion of positional apnea. Using an inclined sleep position is one approach to dealing with this. Anything that keeps you off your back is probably going to be worth investigating. You need CPAP plus some kind of aid to avoid sleeping supine.

Should I go for another detailed sleep study?

My AHI has been slowly climbing up for the past 3 days, now at 5.4, and last night I was awakened twice by the large outburst of air probably due to the increment of pressure. I did not change any settings, or my sleeping position. But I think something has gone wrong after 1.5 hours of sleep, probably when entering REM, as mentioned by Pugsy and Sleeprider.

Should I go for another sleep study to find out what exactly is happening during this period?

Have not re-read everything here, but are you not using Sleepyhead to see what's happening, and if not, why not? It will quickly give you coverage of most factors you need to know about, and therefore point you to what might need tweaking.

Weej wrote:Should I go for another detailed sleep study?

My AHI has been slowly climbing up for the past 3 days, now at 5.4, and last night I was awakened twice by the large outburst of air probably due to the increment of pressure. I did not change any settings, or my sleeping position. But I think something has gone wrong after 1.5 hours of sleep, probably when entering REM, as mentioned by Pugsy and Sleeprider.

Should I go for another sleep study to find out what exactly is happening during this period?

I don't think a sleep study is needed just yet. On the screenshot you posted earlier it looks like your minimum needs to be increased to help prevent the Obstructive clusters which very well could be during REM or back sleeping. If you have a higher minimum closer to your median pressure it might prevent the clusters. I would start with an increase to 12 but it will probably need more.
Since you are sleeping inclined one other thing you might consider is a soft cervical collar if your head falls down and blocks your airway.

Hi all,

Here's my data from last night..


Is this considered as effective treatment?