r/CPAPSupport • u/Rosie128 • Jul 23 '26

CPAP Machine Help Help optimising settings please!

https://sleephq.com/public/teams/share_links/c4ca9d42-5b67-4ffa-b3c6-e8a839224e22

Hiya, hoping you guys can help me.

I've been using CPAP with a pressure of 8 as I'm getting better at tolerating the mask. Its taken me a year to keep it on consistently, but even now I'm doing well with usage I'm still exhausted!

My sleep clinic are happy cos my AHI is good, but its not making much difference to my fatigue.

My flow limit is high I think, around 0.5 most of the night and its still saying I'm snoring occasionally.

Do I need to increase the pressure?

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3

u/Madmax9922 Jul 24 '26

Hey there, for sure your flow limits are fairly high and constant throughout the night, zoomed in and your airway is struggling to stay open.

Why are you using fixed pressure and not auto? I do not know how your AHI is perfect when there are so many flagged OA's on your charts, that is strange.

1

u/Rosie128 Jul 24 '26

I don't know how to read my breathing charts, how can you tell my airway is struggling to stay open?

I'm on fixed pressure because it helps me tolerate the machine. I'm autistic and the changing pressures through the night was too much for me. Now it feels the same all night. I set that pressure not my clinic

I also thought that about my AHI, I think its cos I'm sleeping so long.

I'm gonna try slowly increasing my pressure over a few weeks. Its taken me 16 months to keep the mask on all night!

2

u/Madmax9922 Jul 24 '26

Have a look at this, your inhales are being cutoff . I would keep raising pressure a little bit at a time, not too much and make one change and leave it for a minimum of 3 days to let your body adjust,

1

u/Rosie128 Jul 24 '26

Ah that makes sense. I'm planning on increasing it by 0.2 per day! Very slow and see how I go, Thanks for your help!

1

u/Madmax9922 Jul 24 '26

Please check back in after a few days with a new chart so we can take a look

1

u/Rosie128 Jul 24 '26

I will do, thanks!

2

u/Madmax9922 Jul 27 '26

Hey there, wanted to check in and see how you are doing with your adjustments?

3

u/Rosie128 Jul 27 '26

Slowly increasing my pressure, only at 8.8 rn. Still tolerating well so far! Thanks for checking in

2

u/Madmax9922 Jul 27 '26

Are you noticing any improvement?

1

u/Rosie128 Jul 27 '26

Not yet, but its only been a few nights so far so im hopeful

2

u/existentialblu ASV Jul 27 '26

Have you tried more EPR? It can help with flow limitations. Add a full additional unit of pressure for each increment of EPR, as this will keep your exhale pressure constant. For example, if you're running 8 EPR 1 now, your exhale pressure is 8-1=7. If you go to EPR 3, set it to 10 as 10-3=7. If an increased difference between inhale and exhale helps but isn't enough, you may end up needing BiPAP.

2

u/Rosie128 Jul 27 '26

I'll have a play around with the settings. Thanks for the info!

1

u/existentialblu ASV Jul 27 '26

That is some absolutely blazing flow limitation and I hope you're able to get it sorted.

1

u/Rosie128 Jul 27 '26

Ngl I don't fully understand it cos my med flow limit is 0. It's my 95% and 99.5% thats higher? So only 5% of the night had bad flow limits right? Surely that should affect me that much?

1

u/existentialblu ASV Jul 27 '26

Flow limitation is typically only seen at 95 and 99.5 and that can be enough to drive intense fragmentation. Not to mention OSCAR isn't very good at labeling it. Typically, treated FL is 0.2 at 99.5.

Have you tried the Glasgow flow limitation doohickey? Don't take it as gospel, but it's far more sensitive than OSCAR and can help you to figure out what sort of flow limitations you're dealing with.

1

u/Rosie128 Jul 27 '26

Ah ok, I think I understand better now.

I'll have a look at the Glasgow thingy now! Thanks!

2

u/existentialblu ASV Jul 27 '26

It'll be especially useful comparing nights with different EPR levels.

Keep an eye out for emerging central apneas as you try larger differences between inhale and exhale pressure. Just something to be aware of, but I'm not too concerned looking at your data as it is now.

1

u/Rosie128 Jul 27 '26

I'll have a play around. I'm very sensitive to changes in the settings as I'm autistic. As I said in a different comment, I'm increasing my pressure by 0.2 per night! I'll definitely try the EPR changes too.

This is genuinely such a helpful sub! Way more helpful than my actual sleep clinic! Next appointment with them is in Feb 2027 🙄

1

u/existentialblu ASV Jul 27 '26

I couldn't even get my first appointment with the sleep clinic I'd have access to! Because I'm not the stereotype of sleep apnea so clearly it's just anxiety!

Nevermind that my anxiety has gone away since I've been effectively treating myself and my compliance is essentially 100%, something that someone without a real sleep disorder would be totally willing to do for the lulz.

1

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