Seems to me that the increased minimum pressure hasn't actually done anything for you:Wonderbrah wrote: 1.) The best AHI I've had is with pressure set to 9-20
2.) To be honest, sleep quality feels the same to me between 9-20, 15-20 or anywhere in-between. I can't specifically peg a different between pressure settings. In terms of comfort 15 is no less comfortable than 9, starting out. I don't remember any awakening in regards to last night except the fourth one. I wouldn't say it's unusual for me to wake up in the middle of the night, regardless of pressure. When I take melatonin I think I'm more likely to sleep throughout the night but last night I did not. I'm trying to cut that habit because it makes me drowsy in the AM. I don't have a hard time getting back to sleep regardless of pressure either.
So subjective quality of sleep has not changed regardless of pressure but I think the objective sleep considering the data has.
- Increasing the min pressure has not improved the objective AHI data, and indeed the AHI seems to have gone up with the pressure increase.
- Increasing the minimum pressure has not improved the subjective quality of your sleep.
Here's what I would recommend:
1) Go back to using the 9-20 pressure range and stick with 9-20 for at least one to two weeks---regardless of the AHI data. It takes time for our bodies to adjust to CPAP and you may still be in that adjustment period. You can always reevaluate whether you need more pressure at the end of the 1-2 week period. And keep in mind that if your OAI + HI is well below 5.0 on almost every night, then increasing the pressure is not likely to do much in terms of making you feel a lot better.
2) Consider taking the melatonin earlier in the evening rather than right at bedtime. When my sleep doc had me experimenting with taking melatonin to try to stabilize my delayed sleep problem as well as help with my "too many spontaneous arousals" problem, he told me to take it 5-6 hours before my desired bedtime. Taking it earlier in the evening may help with the problem of melatonin leaving you too drowsy in the AM.
3) Consider taking less melatonin. Many people think that megadoses of melatonin are the best way to address sleep problems; they are wrong. If you are taking 3mg or more of melatonin, you need to cut the dose way back. Try to take no more than 1-1.5mg of melatonin each evening.
4) Try keeping a very simple journal with the following data:
- How well you feel immediately on waking. Keep it simple and use a 0-5 scale where 0=Awful and 5=Wonderful.
- How well you feel during the day. Keep it simple and use a 0-5 scale where 0=Awful and 5=Wonderful.
- How you feel at bedtime. Are you more physically exhausted and less sleepy? Or are you more sleepy and appropriately tired?