New to CPAP, need help choosing right pressure.

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Tue Apr 12, 2022 7:08 pm

I guess it makes sense depending how I feel than what the machine says. I just don't know if I'm on the wrong pressure or if I have to wait for my body to catch up and eventually I'll feel better. I've read other people's experiences, some saying they felt amazing just after one night and others saying it took months.
I still feel the same, really. I sleep, I wake up once a night and I wake up feeling awful as usual. I haven't noticed any change since I started using CPAP. Even with all the pressure changes I've gone through I haven't noticed one positive change.

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Pugsy
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Re: New to CPAP, need help choosing right pressure.

Post by Pugsy » Tue Apr 12, 2022 7:31 pm

How many hours of sleep are you averaging?
Exactly what symptoms are you having that you wish you didn't?
Feeling horrible isn't very helpful.

Maybe there's something else going on besides OSA that is a contributing factor to your not feeling as good as you want to feel or expect to feel.
Mask: Bleep no headgear mask.. https://bleepsleep.com/
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I may have to RISE but I refuse to SHINE.

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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Tue Apr 12, 2022 8:30 pm

I've been getting around 7 hours recently.
I feel sleepy all the time, it never goes away. I have lots of brain fog. Paying attention is really hard. Forgetfulness. Irritability. Muscle fatigue. I can't grow muscle either. I never feel rested at all when I wake up. I feel exactly the same when I wake up as I do when I go to sleep, just a little less sleepy.
I can't imagine anything other than sleep apnea.

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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Tue May 24, 2022 10:13 am

It's been awhile since I've last said anything, but that's because I didn't know what else to do. Recently though, I decided to self titrate using whatever knowledge I could find on Reddit and other forums. This whole time I've just been using random pressures, which is totally wrong.
So I slept with 4-20cm for a few nights.

The first night the median was 7.82.
95% was 11.80
99.5% was 13.07
AHI - 5.43
EPR - 3
Clear Airway - 0.52
Obstructive - 4.91


The second night
Median - 8.44
95% - 12.38
99.5% - 14.02
AHI - 5.26
EPR - 3
Clear Airway - 0.46
Obstructive - 4.80
Large Leak - 0.01%

On the third night I decided to set the pressure from 11-13cm, based on the results from before. I don't know if I did it right, but I did see somewhat better results.
Median - 11.26
95% - 12.54
99.5% - 12.82
AHI - 1.57
EPR - 3
Obstructive - 1.34
Clear Airway - 0.22

Are these pressures I'm currently using good enough or should I raise/lower them? And is it recommended I use EPR?
I can post screenshots from OSCAR since I have access to a computer now.

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zonker
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Re: New to CPAP, need help choosing right pressure.

Post by zonker » Tue May 24, 2022 11:22 am

kidchameleon wrote:
Tue May 24, 2022 10:13 am

I can post screenshots from OSCAR since I have access to a computer now.
yes, please do. the experts can get a broader feel for what's happening if they see the charts. also, when you post charts, include how you slept and how you feel when you wake up.

good luck!
why folks don't like it when asked to clarify their statements?
We can't take this journey for you, but there is a forum full of people here who will gladly take it with you.-jnk

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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Tue May 24, 2022 11:37 pm

https://imgur.com/a/kclVtSY
Okay, I screenshot a few days of Oscar data. I still wake up the same, I don't feel any different from not using a CPAP. I'm ALWAYS sleepy, that never changes. I always wake up a few times a night, not to use the restroom or cause I can't breathe. I just open my eyes, check the time and go right back to sleep. I haven't had that refreshed, amazing feeling people get from using CPAP, but I really hope to someday. I can very easily fall sleep though, no problem there.

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Miss Emerita
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Re: New to CPAP, need help choosing right pressure.

Post by Miss Emerita » Wed May 25, 2022 11:07 am

It's just fine to use EPR. It's a good comfort feature, and it may be helping you with flow limitations.

Because of the EPR, your pressure when you exhale is 3 less than your pressure when you inhale. Your exhalation pressure is what helps with obstructive apnea events.

So in your place, I would start raising the minimum while keeping the EPR. You can set the maximum to 20; the machine won't go there unless your airway needs it.

Try going up by 1 and stay there for a few days. If all is well, go up another 1. Rinse and repeat until you consistently have an obstructive apnea index of around 2 or less. If it gets uncomfortable, reduce the increments to something less than 1. You can make them as small as .2.

I notice that you don't have regular times at which you go to bed and get up. It's standard sleep advice to make those times as regular as possible, including weekends. Is that something you could work on?
Oscar software is available at https://www.sleepfiles.com/OSCAR/

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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Wed May 25, 2022 8:13 pm

Alright, I'll raise the minimum by 1 and the max to 20.
The obstructive apnea index is the blue bar on the left, right? Not the AHI?
It's difficult for me to have a consistent sleep schedule, especially since my work schedule always changes. But most of that difficulty comes from me personally. I just go to sleep whenever I want. I really do need to change that though, I'll try to keep it consistent.

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Miss Emerita
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Re: New to CPAP, need help choosing right pressure.

Post by Miss Emerita » Wed May 25, 2022 11:06 pm

Yes, the blue bar on the left.
Oscar software is available at https://www.sleepfiles.com/OSCAR/

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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Thu May 26, 2022 9:53 am

Alright, thanks for the help.
I was also wondering about something. Would getting another mask help? I'm using a Resmed Mirage FX at the moment and I'm a mouth breather. I use a soft cervical collar and a chin strap to keep my mouth closed, I think, but I still have dry mouth when I wake up. I used to use a Fisher and Paykel Simplus full face mask, but I still felt my mouth dry. Is there any other mask that could work well? I'm looking at an Airfit F20 starter pack being sold at a good price, is that a good mask? Or would an F30 be better? Or Phillips Dreamware?

Edit: So after writing this, I decided to try testing the Simplus again. This time I used the small size. I've used medium and large but never small. I thought maybe the small size wouldn't fit me. Surprisingly it works pretty well, from what little I've used it. No leaks whatsoever and it covers my mouth and nose. I didn't sleep, just laid down with it. I'll test it properly once I go to sleep later tonight. Hopefully this improves my sleep and gets me better results.

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Chris33022
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Re: New to CPAP, need help choosing right pressure.

Post by Chris33022 » Thu May 26, 2022 2:49 pm

kidchameleon wrote:
Thu May 26, 2022 9:53 am
I'm looking at an Airfit F20 starter pack being sold at a good price, is that a good mask? Or would an F30 be better? Or Phillips Dreamware?
I know everyone is different and I'm still new. I've only ever tried two full face masks (I prefer the nasal pillow mask P10 when I'm not congested). The only two full-face masks I've ever tried are the F20 and the F30. I infinitely prefer the F30. For me the F20 was a total nightmare. It's my understanding that the F30 is a newer, improved model.

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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Sun Jun 26, 2022 3:15 pm

I haven't posted on here in awhile, but l've been trying to self titrate since then, learning what I can from the Sleep Apnea subreddit and some other forums.
I started with a few days of using 4cm-20cm.
The first day I had these results
AHI - 5.83
Min - 4.00
Med - 7.82
95% - 11.80
99.5% - 13.07

Then the second day
AHI - 5.26
Min - 4.00
Med - 8.44
95% - 12.38
99.5% - 14.02

I got these after a week trying 4-20 again
Wednesday
AHI - 6.96
Med - 6.52
95% - 13.90
99% - 16.20

Thursday
AHI - 2.79
Med - 6.06
95% - 10.02
99% - 10.80

Friday
AHI - 8.30
Med - 8.68
95% - 14.90
99% - 16.86

Saturday
AHI - 5.54
Med - 7.70
95% - 11.62
99% - 12.92

My AHI was higher than usual, but later on I decided to turn off the humidity and it went low again. It makes me wonder if I should try 4-20cm again now that I turned it off. I also turned off EPR, since I remember doing so and getting lower AHI one time when I was experimenting.
With these results, I decided to set my pressure to 15 maximum and 10 minimum. I chose 15 since my maximum never went above it and 10 as my minimum because it's close to my 95%. I read median is the way to go, but I could never get a clear answer on what number to set my minimum to. Plus, my median was around 6 and that felt a little too low. Maybe I should try 4-20 again without humidity and EPR?
Yesterday and Today I got these results with 10-15cm.
https://imgur.com/a/ExGB0CI
My questions now are, should I continue with 10-15cm and continue raising that? Or should I start anew with 4-20cm now that I turned off my humidity and EPR? Or maybe I misread my numbers and should switch to that? I'm still not sure if my minimum should be based off median or 95%.

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Dog Slobber
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Re: New to CPAP, need help choosing right pressure.

Post by Dog Slobber » Sun Jun 26, 2022 3:30 pm

Lists of numbers as you provided in the first part of you post are rarely beneficial

kidchameleon wrote:
Sun Jun 26, 2022 3:15 pm
Or should I start anew with 4-20cm now that I turned off my humidity and EPR?
No don't be setting it to 4-20. 4 is absurd. Almost always the most important pressure is the minimum. You should be setting it to a reasonable value, leaving it for a bit then adjusting, typically up. Then you can see trends on your statistics page.

Randomly pushing buttons and turning knobs day at a time tells you nothing.

Increase you minimum to 11, leave it for a few days, then repeat as your AHI changes less than increase at reduced values.

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Miss Emerita
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Re: New to CPAP, need help choosing right pressure.

Post by Miss Emerita » Sun Jun 26, 2022 4:47 pm

Just to be clear, on the most recent chart you had EPR of 2.

Fo several days, try the settings recommended by DS (with your current EPR of 2) and then come back to this thread and post a chart. We can help you do a more methodical titration.
Oscar software is available at https://www.sleepfiles.com/OSCAR/

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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Sun Jun 26, 2022 4:58 pm

So 11 is fine based on my charts? And maximum stays the same, right? I need to be sure so I don't overthink things like I usually do and make changes.

Also, I'm pretty sure the charts I just posted had the EPR off. Did you mean June 25 and 26 or one I previously posted before that? I don't mind, I just wanted to be absolutely sure I do everything right.