A month into CPAP for mild apnea

Max pressure last night was 10.88 cm.
95% pressure was 9.14 cm. You need to understand the definition of a 95% number. It's where you were at OR BELOW for 95% of the night. It is NOT an overall average and it is NOT where you spent 95% of the night. The OR BELOW part of the definition is real important but people either forget it or don't understand it.

It might be higher if the large leaks didn't happen...don't know. Some nights people have higher pressure needs than other nights even if everything else was perfect....like no leaks and 8 hours of minimally interrupted sleep.
The amount of large leak you had last night puts a damper on the evaluation process.
The leaks themselves could have played a part in the unwanted wake ups.

When you get much below 8cm pressure, you're having events, and the pressure spikes up... I think if you work on getting your minimum up above 8, you'll see more benefit.

I just had another crappy night of sleep. And I’ve been tossing and turning for the last hour or more. Maybe I’m putting too much pressure on myself to see how the charts turn out. I fell asleep at 1:30, woke up at 5 with no mask on. Machine says I slept for 2 hours with the mask on. I am beyond frustrated right now. How the heck will I ever get better? I went from sleeping 7 hours with the Cpap, to just a few in the last two nights. I think I’m putting too much pressure on myself to show some updated charts....


Or maybe my coffee intake has been bad? Last two days I have come home from work and had a coffee around 6pm, then eventually going to bed at 1am. I’m not sure how I’m going to be today

You've been advised to raise your pressure, but seem to not want to do it for some reason, then things don't work. Until you give the advice a fair trial, you're just playing games with therapy and not optimizing what you can.

Julie wrote: ↑

Tue Jun 12, 2018 5:52 am

You've been advised to raise your pressure, but seem to not want to do it for some reason, then things don't work. Until you give the advice a fair trial, you're just playing games with therapy and not optimizing what you can.

Thanks for the response Julie.

How would not raising pressures make me wake up, or throw my mask off without any recollection of it? That is such a frustrating thing to wake up with no mask on after falling asleep with it on.

I’m trying to get this right though. I wouldn’t be posting on this forum asking for advice if I wasn’t trying. I avoided taking it up to 20 because I was afraid I wouldn’t be able to breathe properly at that setting. It’s not exactly a relaxed exhale at this point with air blowing right at my mouth.


I think once I woke up, negative thoughts started creeping in. “Go back to sleep, get some new data.” “Why am I not sleeping?” “Why do I have to sleep with a CPAP to feel rested?” “Maybe if I lose 30 pounds, I won’t need this machine anymore” and random thoughts about life. Usually I wake up, put my mask back on, and fall back asleep. Last night was hell though. One is for sure though, I need to stop going to sleep so late. I average 6.5 hrs of sleep a night.

WillMakeIt wrote: ↑

Tue Jun 12, 2018 7:41 am

I think once I woke up, negative thoughts started creeping in. “Go back to sleep, get some new data.” “Why am I not sleeping?” “Why do I have to sleep with a CPAP to feel rested?” “Maybe if I lose 30 pounds, I won’t need this machine anymore” and random thoughts about life. Usually I wake up, put my mask back on, and fall back asleep. Last night was hell though. One is for sure though, I need to stop going to sleep so late. I average 6.5 hrs of sleep a night.

The mind is a powerful thing but sometimes it doesn't do us any favors when it kicks into over drive in the middle of the night.

You are putting undo stress on yourself with all this worrying. Giving yourself a good case of insomnia.

I am not so sure that more pressure is the answer to your problem. Your sleep is worse now instead of better. Just because the machine wanted to go higher doesn't mean that we have to let it go higher if the going higher is creating more problems than it is fixing.
Trying to kill those flow limitations might be causing more problems than the flow limitations are causing.

I think I would back up and regroup and go back to what I was doing before and get back into a better sleeping routine and then maybe make some changes if I felt I needed to and make small changes instead of big ones.

Hi again,

Well last night was a little more successful, sleeping over 6 hours without waking up (that I could remember, anyways). The mask stayed on all night, but I had a couple large leaks. Max was set at 15 but the max it hit was almost 13.

I read a tip on another forum that lowering the humidity might make me keep my mask on all night, so I set it to a 2 and tube temperature to 75 degrees. What do you folks think about that? Anyways, here is my most recent chart. Thank you!

By the way, I have lately been experiencing a shortness or breath and sometimes it feels like theres something in my throat. Maybe it's just anxiety. Maybe it has something to do with the CPAP? Maybe allergies? Any ideas?

Humidity preferences are highly individualized so what works well for one person may not work so great for another.
This is something you will need to just experiment with yourself to see what works out best for you.
There's no way I could use the setting of 2 (I need the max) but for others that setting of 2 is a lot. We are all happy with what we choose even though the settings might be world's apart.

For some people too much humidity causes congestion...for others too little humidity causes congestion. There is no right or wrong but instead there is just what happens to work well for the individual.
So if congestion is causing sleep issues or discomfort then playing with the humidity to see what your nose likes or doesn't like might be worth trying.

It did hit 13...(look at the max pressure on the left.

As to humidity... experiment, like Pugsy says... it's very individualized, more so than shoe sizes.. "Someone said I should try a size 10, what about that?" etc.

palerider wrote: ↑

Wed Jun 13, 2018 12:16 pm

"Someone said I should try a size 10, what about that?" etc.

I could put both my feet in one size 10 shoe at the same time. Might not be able to walk so good though.

There is so much to this cpap therapy that is so highly individualized and comes with a huge YMMV sticker...but humans tend to recommend what works well for them as the gospel accord to Paul and they don't realize that it might not work well for the next person for any number of reasons.

I know a husband and wife both on cpap...one prefers no humidity added at all and the other is like me...would snort water if they could.
Same house, same bedroom, same ambient humidity, same machine even, etc...but each prefers one extreme and that's what makes them happy.

Thanks again for the comments and opinions, you folks are awesome.

So obviously I'm still fresh with analyzing charts, but how does my flow limitation look now? Also, should I raise pressure even more? Also, why the sudden spike in pressure at ~3:40am?

My guess for the pressure spikes is probably REM stage sleep related. Maybe your OSA is worse in REM.
Might also be supine sleeping related. Those are the 2 main reasons we see increases in pressure like that...something changed to cause the OSA to worsen and need more pressure to hold the airway open.

I suspect REM because the pressure increases you see all loosely correlate when we would expect REM stage sleep to be happening in the sleep cycles. Heck, maybe it's a combination of being on your back and REM.

It's very common for pressure needs to change, substantially even, during REM when compare to what is needed in the non REM sleep.
Same thing about supine vs side or stomach sleeping. Something changed to cause the machine to want to go higher.

I don't know that I would change the pressure anymore...if you think that maybe you are sleeping a little better and feeling decent.
The FL graph is still a bit active but not horribly active and I don't know that killing more FLs will impact how you feel that much.

I once did an experiment where I decided to increase my minimum in an effort to see if it changed anything in terms of AHI, my sleep quality or how I felt. Now mind you I was doing quite well with what I was using but I wanted to see if more pressure did anything.
I was using 10 minimum and 20 maximum. I started increasing the minimum 0.5 cm per week until I reached 13 cm minimum.
So took me about 6 weeks total. Nothing ever really changed...the AHI was running between 1 to 2 the whole time and never changed ...my sleep quality was unchanged and how I felt during the day was unchanged. I spent a week at each new setting to give the body time to adjust and I could eliminate any fluke nights from my evaluation.

So IMHO...on paper I don't see the need for more minimum if you are sleeping good and feeling decent.
I don't know how much of a factor those little bits of FLs are in terms of your sleep.
I don't go just by the graphs or the numbers....I go by how I sleep and how I feel.

People plop the reports out and say "what do you think" without ever telling me how they feel and how they feel is much more important than the numbers.

At some point you might elect to do an experiment like I did and just see if anything changes. Sort of answer any lingering questions that might be in your mind about "what if I used more pressure".
Don't be afraid of more minimum...it won't hurt you. The worst thing that might happen...aerophagia and if it happens you know that you probably shouldn't go there.

Pugsy wrote: ↑

Wed Jun 13, 2018 12:27 pm

palerider wrote: ↑

Wed Jun 13, 2018 12:16 pm

"Someone said I should try a size 10, what about that?" etc.

I could put both my feet in one size 10 shoe at the same time. Might not be able to walk so good though.

Think of the savings you'd get on buying shoes!!! a pair would last twice as long