Startling awake, need help

Hi. I've been on CPAP for about 5 weeks, using the nasal pillows. It took at least a week for me to even be able to fall asleep with the mask on, and after an hour or two I would take it off in frustration, so I could get some "real" sleep. Anyway, once I was able to start falling asleep with the mask, I then would startle awake, every time I drifted off to sleep. This happens over and over again, no matter if I'm on my left side, right side, or on my back. It's disturbing and upsetting. I then end up removing my mask so I can get some sleep. I'm averaging 1 to 2 hours usage a night, although most of that is not asleep. I'm either totally awake and trying to fall asleep, or I'm in the "startling awake" pattern. I get up for work very early, and I'm a nurse, so my job is already tiring. I'm chronically sleep deprived at this point, and quite frustrating. I also feel guilty that I've been unable to get through one night wearing the mask. I've changed the settings, changed pillows, tried sleeping pills, and Afrin. My current settings are 8.4 minimum and 9.4 maximum. I turned the ramp feature off as I felt air-starved with lower pressure. When I go higher than 8.4, I feel discomfort in my chest. My max AHI I've had on the machine is 13. I'm 5'6" and 135lb. My original sleep study only showed an AHI of 5. Before CPAP I was chronically tired and having frequent migraines, so my sleep doc though trying CPAP might help. I feel like it's making things worse at this point, so not sure what to try next. I won't be able to have a follow up appointment with my doc for another 2 weeks. Any help would be greatly appreciated!

First, what make and model of a machine are you using? Do you know what your breakdown of central and obstructive apnea events that make up your total AHI?

If you have a PC or Mac with an SD card reader, you may want to consider downloading SleepyHead. It will give you a better picture of what is happening during the night, and possibly some clues as to why you are waking up.

I have the ResMed, AirSense10, Autoset for Her. Looks like the majority of events are obstructive, but a few central. I haven't downloaded the SleepyHead app yet, but I can try that.

Thank you I will try those settings tonight!

Just an update - I still only wore the mask for a little under two hours, but had only .6 apnea events with the new settings you suggested. But, I did have a sort of breakthrough with figuring out what is waking me up. I'm getting a lot of air in my stomach, and when that air wants to come back up (like a mini-belch), that wakes me up, or partially wakes me up. So not all the startling is apnea related. I may turn down the minimum pressure to in the 7.4 range tonight and see if I get less air in my stomach. I think I turned the max up to 9.8 or 10. Not sure if that is contributing to the air stomach or not. My goal is to try 4 hours tonight, no matter what. I don't have to work tmrw, so less pressure to get good sleep.

try lowering the max to a bit lower than your 95% pressure. Then ease it lower to minimize your aerophagia. Lowering your min will have little impact because the algorithm will increase pressure to eliminate events.

Ok, thank you, I can try that tonight. I'm so new to this, what do you mean by "a bit lower than your 95% pressure"?

Ok thank you. I did pretty well last night and kept it on 4.5 hrs, with NO apnea events. Still some air in my stomach but better. I think I'm at 7.2 and 8.4 for settings. I will download the sleepyhead this weekend. I haven't had a chance to do much else this week due to work being busy.