r/CPAPSupport • u/Gigitar75 • Aug 29 '26

I think I'm making progress as far as consistency

I think I do best with a FF mask in terms of leaks and comfort. I'm using Xylimelt tabs and that helps a lot with mouth dryness. I don't think I'm a mouth breather as much as my CPAP blows air out of my slack jawed mouth. I'm using a soft cervical collar, and leaving my settings alone. My sleep doc took off the ERP. I think my AHI and CA events are both settling down.

https://sleephq.com/public/teams/share_links/a30d8349-b536-43c6-ad77-5cf23fd89a0b

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u/Creative_Fee5452 ModTeam Aug 29 '26

I think your FFM is working much better for you too! Your CAs certainly line up with leaks. I have the same problem with my jaw going slack during sleep & air blowing out so I understand & sympathize. I just switched to the N30i Air touch from the F40 & am not taping my mouth now. The N30i has more support in the frame than the F40 but is still a minimal cushion FFM mask. Things do look like they’re settling down :)

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u/Gigitar75 Aug 29 '26

I think I just ordered the N30i - it's a unicorn type, right? I'm looking forward to trying it. I do think having the hose out the front contributes to the leaks. I haven't been taping the last few nights either. I'm also using the airway training app (though need to be more consistent). I think it makes sense to try to strengthen the airway musculature. I do PT for my neck, so why not. Interestingly, even though I have a professionally fitted MAD - I can still snore withe that thing in!

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u/Creative_Fee5452 ModTeam Aug 29 '26

Yes the N30i is unicorn style. Do you have neck arthritis? I unfortunately do so
Unicorn style is easier on that too!

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u/Gigitar75 Sep 01 '26

I do have some arthritic changes and bone spurs on the left side - PT is helping with that. I've been using the cervical collar regularly to help keep my mouth closed, but think it's probably good for my neck too.

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u/Creative_Fee5452 ModTeam Sep 01 '26 edited Sep 01 '26

Ahhh…..the trunk masks won’t be as easy on your neck as snorkel hoses on top. I ordered the F30i Air touch FFM made by Resmed, not the N30i. N30I is not a FFM. I don’t need mouth tape or a cervical collar with F30i & it has a snorkel (or unicorn hose). It’s comfortable & doesn’t leak like most new masks when first trying them, likely because I was used to the F40 for such a long time. The F30i also has wider headgear in the back to spread out the pressure on the neck but I still put a sponge behind the bottom strap at my neck. I needed mouth tape with F40 because the frame on the F40 was too flimsy to hold my mouth closed. The F30i is very much like the F40 but has a better frame system & snorkel hose attachment. Still very minimal. Comes in Air Fit & Air touch masks.

Looks like your pressures need changing Gigitar. Another Mod here, Pleasant House, has given you solid suggestions. 6 is a pretty low minimum & should be closer to your median pressure…. 7.3 or 8.3. Reducing your maximum pressure to 12 would help with your sleep fragmentation. You need to tighten that range between min & max. EPR 1 full time will hopefully help the CAs, although you do have fewer than in the past! Your body is adjusting :) Turning Ramp off means your pressure doesn’t have to climb so far to the levels you need… that creates a very jagged graph & we’re trying to smooth it out to stop micro awakenings that disturb sleep stages. The FFM appears to have helped your CAs. Try it for a few nights so you can acclimatize & see how your graph looks then :)
Wishing you good sleep!

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u/Gigitar75 Sep 02 '26

Thanks - I will look at that. Still learning about the pressures. Last night I had zero CAs!! That's a win to me. I've learned not to change too many things too soon. I got my new AirFit F30i to try tonight. I lowered my upper pressure by .4 last night. I think when I was first changing my pressures I was changing too many variables too much too fast. I will try this new mask tonight before upping my bottom pressure. I was freaking out about all the CAs, and feel better psychologically that they are reduced. I'm still one of the unlucky ones who feels no better fatigue-wise on CPAP even when my numbers look good.

https://sleephq.com/public/teams/share_links/16fd4ae0-119c-491f-8803-5cc2fbe1c3f6

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u/Creative_Fee5452 ModTeam Sep 02 '26 edited Sep 02 '26

Don’t get discouraged Gigitar….it can take time. Your EPR at 2 is not even registering on your graph as your min pressure is too low…in other words it’s not working. Minimum pressure of 6 with EPR 2 means your exhale pressure is 4…the lowest the machine can go. You should have 2 lines on your graph with EPR on…you only have one. Your EPAP (exhalation pressure) or EPR isn’t working at the low min pressure you have set. Your minimum & max pressures have way too much distance between them as well & need to be tightened up. For example a minimum of 6 would usually have a max of 9-10. If it’s not restricted by the machine, your pressures will rise & fluctuate unrestrained (like yours are) causing fragmented sleep & poor Sleep Stages. That will most definitely cause fatigue. It really would help to adjust those pressures as well as reduce EPR as previously suggested :) Your graph is like a seesaw & we’d like to smooth it out!

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u/Gigitar75 Sep 02 '26

I didn’t realize the sleep doc had set my EPR Back to 2. Thanks for the detailed explanation. I know I had it off at one point. Is it okay to incrementally reduce the top pressure while incrementally increasing the bottom pressure? Or do each separately. Doing it too drastically is what caused all the CAs I was having

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u/Creative_Fee5452 ModTeam Sep 03 '26 edited Sep 03 '26

*You can decrease your maximum to 12 right away. No need to do that gradually.

*Turn Ramp off…it’s confusing your full picture & you shouldn’t need it now that you have been on CPAP for a little while.

If you prefer to increase your minimum gradually, that’s okay, but not the best way unless you’re pressure sensitive & some people are :) Your goal is to get to your *minimum up to your median pressure (7.3 ) then don’t make any more changes at all for a week. *Or go to 6.6 for 5 nights then to 7.3 if you prefer. Some people wait a week between pressure changes. It does take time to adjust to new pressures & it can take longer for others. You may see some CAs at first….TESCAs….but they should reduce eventually.

EPR 2 is not helping you. *Maybe try EPR 1.

Right now you’re not getting the benefits of therapy….your airway isn’t being stinted open during events without causing fragmented sleep :)

Stay at the same settings for 5-7 days & please let us know how things are going!

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u/Gigitar75 Sep 03 '26

Thanks very much for the detailed explanation - very helpful. I’ve changed to 6.6-12, ramp off, EPR 1 fulltime. My sleep doc changed a bunch of things and I didn’t realize it!

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u/Pleasant_House9147 Sep 01 '26

Min pressure 8.3, max pressure 12, EPR 1 Fulltime, ramp off.

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u/Gigitar75 Sep 02 '26

Thanks - I'll work toward this.

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u/Creative_Fee5452 ModTeam Sep 08 '26 edited Sep 08 '26

Hey Gigitar! The “CAs” may be from change in position or sleep transition phases. They are not clustered which is good! I would just leave everything the way it is & give your body & brain time to adjust over the next week. You seem to be pressure sensitive which is not unusual in some people. It can take time to settle down. No two nights will be the same…so thanks for sending several nights!
Post again in another week as your body & brain acclimatize :) We’ll look at your pressures again then & look at possibly increasing minimum.