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Changed Mask to Nasal Pillow - Big AHI Drop
#1
Changed Mask to Nasal Pillow - Big AHI Drop
Hi Everyone, I'm still very new to CPAP, was diagnosed with an AHI of 66 events per hour and SP02 levels dropping to 62%. I have a Resmed Airsense 10 and was using the default mask, size medium mostly without humidifier but recently purchased the humidifier. The best AHI I had during the use for that mask was 5 and the worse 20. I found the mask forced me to mouth breath as I struggled to nose breathe as it pinched my nose. Also had a terrible dry mouth. Was using no ramp, pressure 12-20, anything less that 12 and I felt like I was being suffocated.

2 days ago the P10 nasal pillow arrived and both nights so far had an AHI below 1. Far more comfortable (except for pinched nose). Looking at the pressure, it seems to be at 12.1 (ive not looked at OSCAR data yet) whereas using the facemask it would be around 18ish, or even more.

So, can anyone make sense of this, why might the nasal pillow be giving me drastically better results? What does it say about the problem i have? 

Also, I have been sleeping on my back (usually on my side without CPAP) because I dont have a pillow that's comfy for a mask, and also I am sleeping with an airline neck pillow, which I find really helps the positional apnea problem I have.

Anyone can offer some thoughts?

I will grab the OSCAR data and upload pics, but the first night both nights I didnt have much sleep (for other reasons, not SA) but I dont feel tired... Probably get a full 8 hours sleep tonight.

Note.. I will probably try turning down the pressure to 8 and see if my baseline drops, I assume using a lower pressure is better if the AHI remains low?
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#2
RE: Changed Mask to Nasal Pillow - Big AHI Drop
I'd think sleeping on your back makes your tongue flop back and block your airway rendering mouth delivered air in less quantity even with higher pressure, while a nasal airflow should push air behind your tongue more directly into your trachea. A better fitting mask, e.g. a larger cushion might have allowed better nasal airflow. But if the P10 works a lot better, great, use that.

I don't know how the P10 pinches your nose but it should have come with S M L three sizes of nasal pillows, maybe try the smaller size.

I didn't know they sold the Airsense 10 without a humidifier, e.g. the water tank. The HumidX is a disk humidifier for an AirMini travel CPAP machine. The Airsense 10 has a built in humidifier with a removable plastic tank with a metal bottom which allows heating the water.

Are you using an AirMini tube and humidifier disks with a CPAP with a built in humidifier?
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#3
RE: Changed Mask to Nasal Pillow - Big AHI Drop
It will be best if you post a couple of nights of Oscar charts. Use the exact protocol in Apneaboard’s wiki.
It’s very possible you have a leaky mask (or mouth), and the unit simply isn’t registering events. Thus the difference in AHI.
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#4
RE: Changed Mask to Nasal Pillow - Big AHI Drop
I'm not at all surprised that you get better AHIs with a pillows mask. The air is blown directly up your nose, where you need it, instead of over parts of your face. Also, pillows masks leak the least of the various types of masks.

I mostly sleep on my back due to back pain, and for me, it causes no problems at all. My AHIs are almost always 0.something, so back sleeping works fine for lots of us.
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution
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#5
RE: Changed Mask to Nasal Pillow - Big AHI Drop
Some FFM's push back on the chin as well, depending on the mask and how tight, can exacerbate flow limitations.  For me it was a slightly higher AHI (yours is worse) and a higher average pressure.
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#6
RE: Changed Mask to Nasal Pillow - Big AHI Drop
Hi have some screenshots of my OSCAR data (one day around 8.5 hours in total broke into 2 sessions), I hope the graph is in the right order, I changed as per the wiki page, but couldn't fit "snore" onto the same screen, so I did two screenshots.

Also, I have data from my O2 ring, not sure how to import into OSCAR yet, but posting a summary screenshot. Which I waaay better than what I saw without CPAP, it would spend hours in the 80% range and dip to 70%.. Average of 96% is mind blowing. I'm so glad about that.

I think I can try dropping the pressure a bit? I have it set 12-20 and seems to be flatlining at 12 mostly, peaking at around 13... Maybe change it 8-16 ?

Anyone have any opinions on my chart?


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#7
RE: Changed Mask to Nasal Pillow - Big AHI Drop
This is an example of me wearing the full face mask -- where I am forced to mouth breath because somehow the full face mask makes it difficult for me to nose breath (which is my natural way of breathing)

The pressure needed was huge and I would get a terrible dry mouth even with humidity set to max.

So anyone know why the nasal pillow works so well for me?

(or at least appear to?)


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#8
RE: Changed Mask to Nasal Pillow - Big AHI Drop
Can anyone take a look and see if the improvement is real?
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#9
RE: Changed Mask to Nasal Pillow - Big AHI Drop
Huh, my numbers went UP switching from a full face (hybrid) to a nasal pillow mask.  

Also, my full face mask produced very regular and predictable results. The nasal pillow result are all over the map.  Guessing its due to leakages and mouth breathing as i acclimate.
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#10
RE: Changed Mask to Nasal Pillow - Big AHI Drop
I think some of my problem is caused by nostril collapse while sleeping
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