Sierra

I agree that does not sound normal. Straps too tight or you need a mask with a larger fitting area for the straps and headgear.

I believe that is the one you use if you use supplemental oxygen. It has a fitting to connect the oxygen. This one is the standard ClimateLineAir heated hose. It is claimed to be suitable up to 25 cm pressure, so should be suitable for the BiLevel AirCurve machines.

You may want to consider downloading OSCAR software so you can view the detailed results. It requires a PC or Mac and a SD card reader. There may be some obvious issues that become apparent. If not, a consult with the clinic or doctor that set it up may be in order.

This is what SleepyHead says about Oximeters. Not sure if OSCAR has added more or not...

I use SleepyHead to monitor my apnea treatment. OSCAR has replaced SleepyHead, and at least for now is pretty much the same. It requires a PC or Mac, and a SD card reader to get the data to your computer. Assuming it is the same as SleepyHead it accepts Oximetry data if your meter is supported. That would allow you to see that data along with your sleep data. That said I have never used an Oximeter and have just assumed O2 would drop during apnea events, and have just focused on minimizing apnea events. How is your AHI? The goal is to be below 5 and ideally around 1 or less.`

I have had diabetes for 20 years or so. I try to focus on a balanced diet, and then treat the diabetes to manage that diet. I currently take metformin and use insulin. My objective is to try and achieve an A1C of right around 6.

The most common causes are having a cushion insert that is too small and goes too far into the nostrils. It is better to have one that is a bit bigger than smaller. The second cause as you have figured out is having the mask too tight. In my experience this is a getting used to a new mask issue. I use an over the counter 1% hydrocortisone creme in the mornings to help heal the irritation. That should only be used for a week or two though. If none of that works you may have to try a different style mask. As I mentioned above I have used the ResMed P10 and the F&P Brevida. For me the P10 worked better. My wife likes the Brevida.

Prior my diagnosis of diabetes I had issues of dozing off behind the wheel. In retrospect it was most likely due to high blood glucose. I did not get into the CPAP based on that issue, but I still have had issues with it from time to time on very long drives. The best software I know of for monitoring your sleep data from the CPAP is SleepyHead (also available as OSCAR). It is a free download, but requires a PC or Mac computer, and a SD card reader to transfer the data from your machine to your computer. SleepyHead is not being developed any further but still works fine. I use it. I will post an example of the kind of data it gives you at the bottom of this post. It can be helpful in determining the general quality of sleep and if there may be improvements in machine set up to improve sleep.

An A1C of 6.1 is probably considered just about ideal for a diabetic. It is supposed to be an average of the last 3 months. Does that reflect your current no treatment drugs situation? Does your BG spike high after a meal? That can cause sleepiness. I currently use metformin, plus rapid insulin (NovoRapid), and very slow acting insulin (Tresiba). It works well, but the rapid insulin has to be carefully matched to carb intake or you can get lows, which are not pleasant at all... Are there not walk in clinics in your new location that you could go to with copies of your old prescriptions to obtain new ones?

If you can't stay asleep at night you may be underestimating the impact of the coffee and other sources of caffeine taken later in the day. I have a brother that has serious sleep issues. He consumes coffee from morning to night, and says it doesn't affect him. Yet he is awake half the night...

Here is a SleepyHead daily report screenshot. If you have any questions, just ask...

Some thoughts:

1. The armodafinil and provigil may be preventing you from getting a restful sleep. My thoughts would be to focus on getting a restful sleep, rather than to take drugs to stay awake. How is your CPAP machine working? Are you getting 7-8 hours of uninterrupted sleep each night? Are you using software like SleepyHead to monitor your detailed sleep results?
2. I have had diabetes for nearly 20 years now, and high blood glucose can certainly make you feel tired, especially after a meal when BG tends to go up. How is your A1C? What drugs or insulin are you taking for the diabetes? Maintaining a reasonably constant BG level during the day and night is very helpful.
3. How are your sleeping habits? I find I cannot sleep well at all if I take any caffeine after about 2:00 each day. Here is a link to a website that I have found helpful in reviewing my sleep habits and making some changes. There have a number of tools to use to evaluate sleep.

SleepWell - It's No Dream

That sounds good. I would try that for a week or more to see what your readings average out at. Then try it with both CPAP pressure and ramp start pressure set to 7 cm for a week or more, to compare 7 cm with 8 cm.

What was your CPAP pressure at? 8 cm? And the ramp start pressure the same at 8 cm?