Newbie here! Staying positive, but I keep waking up right as I doze off

[Brysleeps]

UPDATED!
I didn't realize how much data was involved in all this, it's very cool. I now have OSCAR charts and metrics. I've posted the imgur links below.

Background info:
I'm 37 years old, male, 5'9, 170lbs. My snoring started out of no where about 5 years ago. I sleep with my mouth closed, breath through my nose. I snore SO loud and am very lethargic during the day after my morning coffee buzz wears off. My wife has to wear ear plugs while we sleep and she is still bothered by my snoring. So, I usually move to the couch. I really want to sleep in the same bed with my wife again and also want to get some good sleep so I can function better during the day. So, I did an at home sleep study using a WatchPAT device.
Here's the summary of results from my at home sleep study:
https://i.imgur.com/5p5y6ga.png

The at home sleep study indicates I have moderate sleep apnea. So, I do an overnight sleep study in a sleep lab. They started me on CPAP but after an hour they adjusted to BiPAP because they noticed I kept waking up due to struggling to exhale. Once the switches to BiPAP I was able to fall asleep and sleep pretty good, but it did confirm Obstructive Sleep Apnea.
Here's a summary and conclusion of my in-lab overnight sleep study:
https://i.imgur.com/ES3SuQl.png
https://i.imgur.com/1U7FO8O.png

My current situation:
I now have the AirCurve 10 with a AirFit N30i mask (I also have a DreamWisp that I like). They started me out with an IPAP of 9 and an EPAP of 5. I've tried this and found that I was waking up as soon as I doze off (I fall asleep very easily). Like, as soon as I would usually fall asleep and start snoring, I am being awaken by the fact that I am not inhaling air/breathing. It's very apparent to me, I can actually keep count of them. Also, I can hear it in the machine as well, almost like it's idling, waiting for me to take a breath.
I told my doctor this and they said they would change the pressure settings to IPAP of 15 and EPAP of 7. They dragged their feet, so I just adjusted the settings myself. I tried those settings and had the same results, being awakened by not breathing as soon as I doze off. I can only wear the mask for about 2hours until I need to take it off, so I can get some sleep.

Any suggestions or advice? Is it possible the BiPAP is causing more Central Sleep Apnea events? If you need any more charts or data, please let me know. Thank you all!
OSCAR Chart: https://i.imgur.com/eH9ncEn.png

[ChicagoGranny]

If you will post an OSCAR chart (or SleepHq.com for the less technically inclined) in this thread, some members will give you some informed advice. OSCAR instructions are pinned on the index page.

[zonker]

to elaborate on what granny has said, the forum needs details of how your particular sleep goes. oscar can provide the forum with that info. this is important because we all don't sleep the same and what might work for me probably won't work for you.

also, when you get a moment, please fill out your equipment profile. that way, your mask and machine will appear under each of your posts as mine does below.

and yes, machine and mask make a difference.

good luck!

[Brysleeps]

Thank you! I will fill out all my info and upload my studies and OSCAR data. Thanks again!

[zonker]

Thank you! I will fill out all my info and upload my studies and OSCAR data. Thanks again!

i see you have!

please post your oscar charts right here in this thread. see the stickies at the top of the forum for more info.

if you have any trouble, feel free to ask about it. we've all been there.

good luck!

[Brysleeps]

If you will post an OSCAR chart (or SleepHq.com for the less technically inclined) in this thread, some members will give you some informed advice. OSCAR instructions are pinned on the index page.

Thank you! I just reposted with all my info. I hope it's helpful. I really appreciated everyone's times and expertise.

[Brysleeps]

Thank you! I will fill out all my info and upload my studies and OSCAR data. Thanks again!

i see you have!

please post your oscar charts right here in this thread. see the stickies at the top of the forum for more info.

if you have any trouble, feel free to ask about it. we've all been there.

good luck!

I just updated my original post. I hope that's ok. If not, please let me know!

[Pugsy]

Is it possible the BiPAP is causing more Central Sleep Apnea events?

Highly possible...
With bilevel fixed mode...that's the 7 EPAP and 15 IPAP....equals PS (pressure support) of 8 and pretty much guarantees central apneas popping up.

How did you come up with that much PS??? It's actually not a good thing to be doing that much PS without a damn good reason...and plain old OSA isn't a good reason.

Have you done a trial in auto mode with a much more reasonable PS? That's what I would recommend.

[Brysleeps]

Is it possible the BiPAP is causing more Central Sleep Apnea events?

Highly possible...
With bilevel fixed mode...that's the 7 EPAP and 15 IPAP....equals PS (pressure support) of 8 and pretty much guarantees central apneas popping up.

How did you come up with that much PS??? It's actually not a good thing to be doing that much PS without a damn good reason...and plain old OSA isn't a good reason.

Have you done a trial in auto mode with a much more reasonable PS? That's what I would recommend.

Thank you for your input! Can you explain to me what PS is? Why 8? I assume it’s the difference between the numbers, but why is it significant?
It was originally set to 9 - 5 and I told them about my issue with waking up, so they changed the numbers to 15 -7.

How do I try auto-mode? And what is a more reasonable PS?

[Pugsy]

PS is pressure support or simply the difference between inhale and exhale.

Too much (too high) PS can cause a person to inhale and exhale to a point where they wash out too much carbon dioxide in their breaths. Centrals are caused when a person's carbon dioxide levels aren't high enough to for the brain to know it needs to send the signal to breathe. So too much PS causes carbon dioxide wash out which in turn causes the brain to not know it should breathe and a central apnea happens because a person simply isn't breathing.

it was originally set to 9 - 5

That's 5 EPAP (exhale) and 9 IPAP (inhale) which makes PS at 4 which is a much more normal PS.

I don't understand your problem with 5/9 and PS of 4 but changing it to 7 EPAP and 15 IPAP ends up with PS of 8 and it is a prime recipe for central apnea production because of carbon dioxide wash out.
A better choice IMHO would have been maybe try that EPAP of 7 but keep PS of 4.

How do I try auto-mode? And what is a more reasonable PS?

You go here and request the provider/clinical manual for your machine
https://www.apneaboard.com/adjust-cpap- ... tup-manual
and you learn how to get into the clinical menu setup area and make changes to mode and other stuff.

As for a more reasonable PS....I don't ever suggest going with more than 5 PS unless special circumstances are present or a doctor is involved.

I use the AirCurve 10 VAuto....I use PS of 4 and I am in auto mode and not fixed mode.
My current settings are minimum EPAP at 5....PS at 4...maximum IPAP I just leave at the default of 25 but it never goes anywhere near the max. It works for me. So on inhale I get the minimum EPAP of 5 plus the PS of 4 which makes my inhale at 9 and then it can auto adjust as needed.

If nothing else...reduce your PS to 4...and to do that in fixed mode you would have EPAP at 7 and IPAP at 11.
Or try auto bilevel mode with minimum 7 Epap and PS of 4 (in auto mode you actually get a choice for PS instead of having to do the math) and see what happens.

I am sorry but I don't understand what the problem was with the original 5/9 settings except maybe they simply were sub optimal settings and not doing a good job holding the airway open.

But I do know that a PS of 8 is a really, really dumb idea for plain old OSA.

[mp6617]

Not sure if this is helpful but I have an AirSense 11 and I'm able to turn off the ramp time. It's still on auto but instead of waiting til I go to sleep it starts upping the air as I need it right away. I was having the same issue of waking up all the time when I quit breathing. I am starting to actually sleep with it now that I turned the ramp time off. Good luck.

[Brysleeps]

Thank you! I am learning so much. Please excuse any stupid questions.

I don't understand your problem with 5/9 and PS of 4 but changing it to 7 EPAP and 15 IPAP ends up with PS of 8 and it is a prime recipe for central apnea production because of carbon dioxide wash out.
A better choice IMHO would have been maybe try that EPAP of 7 but keep PS of 4.

My Problem is that when my setting were on 5/9, I was waking up as I dozed off, due to forgetting to breathe. My doctor suggested the increase to 15/7.

If nothing else...reduce your PS to 4...and to do that in fixed mode you would have EPAP at 7 and IPAP at 11.
Or try auto bilevel mode with minimum 7 Epap and PS of 4 (in auto mode you actually get a choice for PS instead of having to do the math) and see what happens.

This helped a lot! I was wondering how in the heck you got a PS of 4 from 5 - 25, but I see when I switch to Vauto mode, I can now choose my PS. Very cool, Thank you!

Thank you so much for your input! I will take the advice/suggestions!

[Brysleeps]

Not sure if this is helpful but I have an AirSense 11 and I'm able to turn off the ramp time. It's still on auto but instead of waiting til I go to sleep it starts upping the air as I need it right away. I was having the same issue of waking up all the time when I quit breathing. I am starting to actually sleep with it now that I turned the ramp time off. Good luck.

Thank you! I've turned off ramp mode.

[Pugsy]

I was wondering how in the heck you got a PS of 4 from 5 - 25

In fixed mode there is no separate PS setting to control. Instead you simply do the math and PS/Pressure support is simply the difference between EPAP and IPAP. So you regulate PS by changing EPAP and/or IPAP.

In Auto mode it gives us a separate choice for whatever PS we want to use.

End result is still the same...just a different way of getting there.

My Problem is that when my setting were on 5/9, I was waking up as I dozed off, due to forgetting to breathe. My doctor suggested the increase to 15/7.

How do you know you were forgetting to breathe? Maybe you were having OAs and they were causing the wake ups.
Forgetting to breathe is central apneas....airway is open but no air is moving because you aren't breathing.
Holding your breath...airway is open but no air is moving...that's a central apnea (Clear airway on OSCAR).

Now there is a thing called sleep onset central which can sometimes happen to some people when they transition from awake to asleep but we don't know for sure that is what is going on with you.

I don't have time to sort through all the potential stuff...lets see what happens tonight with more normal settings and go from there.

[Brysleeps]

End result is still the same...just a different way of getting there.

Gotcha, thank you for the clarification.

How do you know you were forgetting to breathe?

Well, I could be mistaking it for something else, but it happens every time i try to sleep with the mask on. I doze-off...then I gently wake up, noticing I'm not taking a breath. I notice the whir of the machine also seem to idle, then I take a breath and all is good until I begin to doze-off again. It seems as if I am holding my breath. This has happened every night for 5 nights. I try the mask for over an hour and can't fall asleep due to this.

I don't have time to sort through all the potential stuff...lets see what happens tonight with more normal settings and go from there.

Thank you so much for you time! I can't thank you enough. I will try tonight and report back!