Help with APAP therapy

Hello everyone! It's my first post here and I'm out of the ideas so I'm looking for guidence.


I was diagnosed with sleep apnea in mid January 2022 with 43/AHI. After one month of try-outs, I have chosen nasal mask (the least annoying one) with Resmed autoset 10 CPAP machine.

I have been using CPAP machine for almost 2 month. Unfortunately, I have noticed 0 positive aspects of therapy during the day, I'm still exhausted, fatigued, irritated and sleepy from the minute I wake up in the morning. The problem is (and im no expert), that I cannot get continuous amount of sleep.

Without the mask and machine I will wake up after 2-3h to pee, than I sleep for 4-5h till I wake up. With the mask and machine on, I will also wake up after 2-3h to make a toilet visit, than sleep for 2-3h more, wake up and cannot fall asleep with the mask on, so I will take it off and take last part of sleep for 1-2h.

I have no idea why im constantly waking up, and my Oscar data is not telling me much. I don't feel like there is any particular reason for me waking up during the treatment. My sleep doctor is also wondering what is the case. Is there any hope for a guy like me, or I'm doomed?
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Lately I was told that I may suffer from Positional Apnea and with problem of mouth breathing (as my mouth is dry even with Humidifier) so I've bought Cervical Soft Collar and Full Face Mask and still with no positive effects during the day. I'm trying tweaking with settings with my CPAP machine but nothing seems to be working and still no clue why I'm keeping waking up during the night.


If anyone got some tips I would be glad to hear them. Maybe some additional info about me:
32 male
5.11"
175 lbs
non smoker
non drinker
exercising every other day
eating healthy

CPAP Machine: ResMed 10 Autoset
F20 Full Face Mask

Attaching some Oscar data with typical night of mine.

Welcome! I don't know why you aren't able to fall asleep with your mask on toward the end of the night, and like you, I don't see anything in the Oscar chart to explain this. So let's consider how to make your night as restful as possible and hope that with some more time you'll be able to sleep better.

I recommend that you pretty severely limit fluid intake during the three hours before bed. It'd be nice if you didn't need a pee break.

It's possible the clusters reflect REM sleep, but could you also make sure your chin can't slip under your cervical collar? And is your pillow fairly low and firm?

Assuming your clusters aren't positional, you'd probably benefit from a higher minimum pressure, with no ramp. That way the machine might have a better chance of heading off OAs before they happen. As a start, do you think you could hack a minimum of 10 with no ramp? And a maximum of 20, in case the machine wants to go there? If you think 10 would be difficult, you could try 10 with EPR increased to 3, to help you exhale more easily.

A lot of sleep experts recommend that you get up if you can't fall back asleep after 20 minutes, and giving yourself some tough love might mean getting up instead of taking the mask off if you can't fall back asleep with it on. Difficult when you're craving sleep, I know, but it's an experiment to keep in mind.

When you post your next chart, could you include all of the left panel plus just these six graphs, all in one screenshot:

Events
Flow rate
Pressure
Leaks
Snores
Flow limitations.

You can scrunch the graphs by grabbing the gray bar that separates them and pushing up, and you can reorder the graphs by left-clicking on the graph label and pushing the graph up or down.

https://www.cpaptalk.com/viewtopic/t183 ... again.html

Please see the above link to thread about attachments.

The top and middle posted screen shots in your post aren't helpful and are taking up precious space in the forum attachment storage. The bottom image...that's what we like to see.

When you have time could you please remove the 2 images that aren't useful so space is freed up for the next person who wants to post an attachment. You never know....that might be you.

Thank you.

Your posted report isn't horribly horrible but there is a lot of up and down of your pressure line. Looks like a lot of snores as well. You omitted the Flow limitation graph on that bottom image but I suspect it also is more active at about the same time you are seeing the snores and pressure increases.
Snores and flow limitations are early warning signs that the airway is trying to collapse.

The clusters of OAs and snores makes me think that maybe this might be REM stage sleep related and the machine can't get to it fast enough to prevent what is going on. It's quite common for OSA to worsen in REM (and when supine sleeping) and for us to need more pressure to better prevent the collapse from even starting to happen.

I suggest giving the machine a better head start so that it can get to more optimal pressures fast enough to prevent those clusters from ever happening in the first place.
Maybe 9 cm minimum. You can leave the max where it's at since you don't seem to ever hit the max anyway.

Ramp...up to you if you need it but 10 minutes isn't horribly long...just be aware that when in ramp the machine can't respond at all nor does it record anything.

Let's see if the pressure line will stabilize a bit and see if it helps break up those clusters.
One change only.....minimum pressure to 9 cm.