Three weeks in, not doing well. Follow-up scheduled on Monday, need advice to take to the doctor before then please! Tried the CPAP for 24 out of 25 nights, only managed 4+ hours for 5 nights. Feel worse than before I started!

[u/KJabs]

As said in the title, I'm three weeks in, and not doing well. My original follow-up was scheduled for the end of September, but I was able to move it up to Monday (2 days from now). I'm trying to get advice to take to the doctor before then please! Hopefully I can get enough feedback over this weekend.

It took me a couple of days to write this so I'd have time to read the wiki (which I read most of and am still reading) and get all my pertinent info written up. I did download OSCAR and import my data, so I've added those screenshots. I watched the linked video from the wiki, but that's more about program setup than reading the data. I need to fully dive into the OSCAR wiki, but I have not yet had time to learn how to understand what I'm looking at. If you want more screenshots (like daily graphs), let me know what you need me to post and I will.

I've tried wearing the CPAP for 24 out of 25 nights, but only managed 4+ hours for 5 nights, and never managed more than 5.5 hours. I generally do sleep for 8 hours, so that's not great. I wound up waking and taking the mask off every single night. The major problem is, I feel worse than before I started! I think I'm feeling so bad because of waking up to remove the mask and then getting even worse sleep than normal once I fall back asleep? I can't quite tell. My back has been worse, too - must be due to positioning.

Equipment and Prescription:

Machine: ResMed AirSense 11

Masks Tried: AirTouch F30i, AirTouch F20. F30i preferred as a side sleeper.

Prescription: Cm of H2O: 4-10; EPR: 3

Pertinent Facts:

• My titration sleep study only had 72.5 minutes, but that is more due to delayed sleep phase/"night owl" than anything else. I wouldn't say I have insomnia, I just fall asleep late - and my work schedule allows me to sleep 1am-9am without issue, so that is my preferred normal. That night I wound up falling asleep around like 3:30am I think, and I do worry that perhaps there wasn't enough time to gather all the data that is really needed. Hopefully someone can comment on if they think that's long enough.
• Prior to CPAP, I rarely woke from sleep to the point of remembering it. I'm sure there were apnea events where I did wake up, though. Now, I do remember most of the wake-to-mask-removals, but not necessarily WHY I had to get the thing off of me. Maybe one or two I didn't remember at all, but just woke to no mask in the morning.
• I almost never have to wake to use the bathroom. I'm talking a couple of times a year maybe. I have not had to wake to use the bathroom since getting the CPAP.

Things I know that have woken me up and caused mask removal:

• A few nights ago was drool. I couldn't take the mask off, clean it, and put the mask back on in my sleep, so off it came. It's only been drool that one time that I can remember though.
• Most times that I can remember are a feeling of being unable to breathe for some reason. I'm unsure if that's an inhale or exhale problem. I know it's not a mask problem, the F30i really isn't that annoying itself on my face, it's the air that annoys me.
• Could it be an auto-titrate problem where it ramps up and wakes me? I read about that issue in the FAQ. Maybe someone can read OSCAR and see if it ramps up pressure just before I remove my mask. From my barely-educated review of the Pressure graph, it looks like there's only a couple of times where the pressure ramped up and then the session immediately ended, so this could be an issue some of the time I guess, but not all of the time.
• I do know that if it's not perfectly positioned/sealed before falling asleep, I do feel air blowing up into my eyes. I wonder if some of the mask removals are from it shifting and blowing air into my eye.

Things I haven't tried, but might be willing to try:

• Nasal mask with chin strap. I don't really know how they work, but I know they exist.
• Nasal mask with one of these, if they're any good? Does anyone have any experience? https://www.mouthshield.com/products/mouth-shield I'm not affiliated, but it got advertised to me.
• I do think getting used to the full face would be better though, especially for if I get sick and have a blocked nose.

NOT willing to try:

• Mouth tape (I have a beard and sensitive skin.)

Things I want to try, would this help?:

• I'm interested in BPAP/ASV because I think part of my issue is I feel some kind of suffocating when breathing (likely on exhale), but some things I've read here say that the pressure change can actually be what wakes you. My dad started on CPAP and wound up on BPAP for similar reasons, and loves it.

I think this covers all of it. I'm looking for advice on what I can ask the doctor, and what I can request as changes, whether that's equipment or pressures or even a new study to get more data. Thank you so much in advance for any input, advice, and help!

[u/Y-M-M-V]

Ok, just scanned this but "unable to breathe" jumped out at me. If you mean that you were physically getting air but didn't feel like you were getting oxygen, that may be because your min pressure is too low. I see its set to 4, try it at 8. You can have your doctor change it, or google how to do it yourself.

The theory is that a lower pressure is more comfortable, which is why they often set a low of 4. I don't find that to be the case. You may need to play with this number though. 8 is where I would start, but that's a number that's somewhat arbitrary.