New to taking ownership of CPAP and need some guidance.

[morg]

Age: 38
I have been on this CPAP journey for a year now. Initially when I received my CPAP I hated it, it's uncomfortable and I couldn't adjust my breathing to the pressure among other things such as; which mask and position to sleep in. Beyond that I just assumed after my sleep study I would get another reasonable option or at least some help getting the CPAP setup. Long story short, I didn't. So I quit using it leading up to my sleep study. Then at my sleep study I was told I needed a third kind of machine by the nurse that monitored me during the study. Then I couldn't get in to see my doctor for the results until 6 months later and during that time I didn't bother using the machine as I believed I needed not a CPAP, not a BiPAP, but a third type... Come to find out that's for people with high C02 levels which is not something I have. My doctor told me if I can't use the CPAP, then I need INSPIRE. For me this just wasn't an option so I am back at attempting to use my CPAP since about the 22nd of this month. The difference for me now is that I don't have an option and I've just been feeling terrible mentally and physically. So, i'm owning this. I have done a lot of reading here and on some other sites and I would like some help making it happen.

I am using the Resmed 3B luna G3 CPAP machine. I have settled on the Resmed F20 (medium for now but, just requested a large to try from insurance) after trying N20, and the F & P Evora Full face masks. I sleep mostly on back to start and then usually go to my sides, however I'm definitely spending longer on my back with the mask on. I also sleep with a mouth guard for bruxism that is prescribed by my dentist. I eventually open my mouth and typically drool. Right now I do end up taking the mask off after not being able to fall asleep for ~2 hours. I also have to get up to use the bathroom at least once a night. I have put the mask back on after that and I want to make that a habit, although i'm hoping it's just becuase of OSA and will eventually stop. I am a shallow breather and so initially I was feeling like I was fighting against the air pressure to exhale. Then I turned up the "reslex" on the machine to 3 and the pressure down to min5 and max20, however it didn't change much. Then as I was reading on here that my pressure has to be at min7 for the reslex to activate. So last night I adjusted it to min7 reslex 3 and it was too little pressure and I could actually feel my throat close and not be forced to reopen (reslex was working!). My mask was also making a sound and kind of "bouncing" which i'm not sure if that's a feature or not but, it kept me awake. It was late last night after my attempt and so I slept the rest of the night without my mask. Today I went ahead and adjusted the pressure to min8 and max18 reslex 3 because I read that if i'm getting air in my stomach it could be too high of a max pressure. Then I took a nap and it went much better than last night, however I still was able to stop breathing and not be forced to inhale and my mask did the bouncing thing although much less frequently.

My numbers for my nap were:
Used time: 37 mins
Avg. Treat P: 8.0 cmH20
P95: 9.5 cmH20
AHI: 3.2
CAI: 0.0
Avg. Leak: 0.4 L/min
95% Leak: 1.0 L/min

Obviously I know this is a short amount of time, however my other 4 days (2 hours each) AHI's were:

24th: 13.3
25th: 23
26th: 8.3
27th: 3.5

My question is for my pressure do I just up the min pressure a little at a time and keep the max pressure the same for now? Should I adjust the reslex or just the min pressure? I feel really positive knowing that I got it to where I can exhale all the way without fighting it, now I just want to know how to make it where I can do that and am forced to inhale again. I am open to any and all advice as I do have severe sleep apnea.

[Okie bipap]

It takes some of us quite a while to get used to sleeping with that alien thing on our face. When you only use the machine for a short period, the AHI tends to show a higher number than if you would have used it longer. Some people have found it helpful to wear the mask and machine while watching a movie or something else on TV. This will often help your mind get used to breathing with the mask and machine. I wouldn't recommend making any changes to the pressure settings until you can sleep for a longer period with the machine. Once you start sleeping with the machine, we can make a more informed estimate of your pressure needs. Incidentally, your machine is not a Resmed machine.