Sierra

Is the pain due to irritation of the nose by the mask?

Have you looked at your CPAP data with OSCAR to see what is actually happening when you are going to sleep? Your are correct that the CPAP will not report an apnea of less than 10 seconds, or any apnea during the pressure ramp period. But with OSCAR you can zoom in and manually look for apnea events whether they are flagged or not. You may even be able to tell what type of events they are even when they are not flagged by the CPAP. I do not suffer from this issue but I went back over my recent nights to see if I could find a time when I had an apnea event early during the going to sleep period of the night. Here is a screenshot of one night when I had an early event.

I have an AirSense 10 and use the Ramp set on Auto. It detects when I go sleep and then ramps pressure up from the ramp hold pressure (9cm) to my treatment pressure (11 cm). You can see where the green vertical cursor is that the pressure starts to increase. Shortly after it reaches 11 cm I get an obstructive event which lasted long enough to be flagged. And very shortly after that there is a second event which occurs but is not flagged. This gives a sense of what you can look at with OSCAR. The free software requires a PC or Mac and a SD card reader.

As far as measures to control it, I would look to see what type of event it is, and if it is obstructive then you may want to consider a higher ramp start pressure and/or higher minimum pressure on your machine. The idea would be to get the pressure up as quickly as possible to prevent the airway from obstructing and causing you to wake up.

I still have an AirSense 10 in Canada and see it displaying full bars on the display. However, I do not use it. I have never bothered to use the MyAir app as I find it too limited to be useful. Instead I use SleepyHead, which is now OSCAR to monitor my sleep results. It is much more detailed and helpful.

You can get an idea of how serious they are by zooming in on them and comparing the minute to minute air flow rate to OA, CA, and H events. I have very few RE events flagged but I found this one. It seems to me when looking at the air flow disruption it is quite minor compared to an OA or CA event. Each flagged OA and CA event is a minimum of 10 seconds with no air flow. From what I see of RERA events, they are more of a small flow reduction, not a total interruption of flow.

I was thinking more that you may be able to go back to look at those nights when you had RERA events flagged and see what may be different about your settings that makes them show up on the event bar.

Another thought would be that OSCAR may have had a brain fart and needs a jump start. You could try turning off the flag switch for RERA events (RE) to red and then shutting OSCAR down, starting it back up again, and then try again to switch it to green (on).... The Bill Gates Microsoft standard solution!

I looked back at some of your older screen shots and I can see the RERA flags on them... See this thread: https://myapnea.org/forum/flow-limit-and-ahi-s/1#comment-62193

Seems strange, but I recall the RERA event flags can be hard to see as they are a light yellow. Another way to look at them may be to click on the Events tab beside the details tab and below the date. This should list the type of events and if you click on they it should list each event and the times.

About the only way to see what a pressure change will do is to try it...

I suspect you may have the flags for RERA events turned off. Left click on the box under the Flow Limit. title at the bottom of the screen, that says CSR. It should display what flags are turned on (green) or turned off (red). Click on the switch to turn the "RE" event flags on. It looks like the first event that started to raise pressure was a hypopnea event. But then the pressure stayed up. Perhaps RERA events were keeping the pressure up. If your minimum pressure was set higher, that initial hypopnea even may have been avoided. It also looks like you are having significant flow limitations. That also may be driving the pressure up.

1. The top bar on the Daily screen shows the events. The RERA ones should be represented as a yellow one. That will let you determine at what time and pressure the event happened.
2. The AutoSet feature adjusts the pressure within limits that you or the sleep tech sets. The max pressure setting is to limit how high the machine will increase pressure. The minimum pressure limits how low it can go. Generally it is best to get the pressure up quickly and not let it go too low during the night.
3. Display the Daily screen full screen, and press the F12 key. It will be saved in a location which will display briefly in the bottom right corner of the screen. Use File Explorer to find this file. Left click on it and drag it into a message here. It is best to start a new full width window for the post by using the orange Write a Reply button.

I very seldom suffer from RERA events. My thoughts are that RERA events occur when the pressure setting is too low, not too high. When the minimum pressure is set low these RERA events can occur before the pressure increases automatically enough to stop them. It would be worthwhile to take note when they occur and what the pressure is at when they happen. With the maximum pressure reduced to 15 cm you also will want to watch how much of the night you are at this maximum pressure and what events are occurring when the pressure is at max. If you post a daily screenshot I can comment on what I see.