Pillows vs Hybrid surprised at AHI difference

[Bampf]

Hi all. Very happy to find this board, and especially the OSCAR program.

I am a longtime snorer and positional apnea sufferer. My sleep study measured 18 AHI. Doctor recommended BiPap, though he admitted that as a moderate sufferer I might not be motivated enough to stick with it. But I can be stubborn..


My first mask (full face) was a poor fit. Now using nasal pillows N30i, and that's going well. AHI between 2-4 most nights. But I sometimes I am congested, and am a bit of a mouth breather. (Chin strap helps a little.) So I tried a hybrid F30 mask for 5 days.

Unfortunately with the F30 I consistently get much higher AHI, between 8 and 12. I'd like to know what went wrong with the hybrid mask before completely giving up on it.

OSCAR shows some clues: when an OP happens they repeat while the machine ramps up the pressure to no avail. Also there are a handful of hypoapnea events. Neither of these happen with the pillow. But I don't know why, or if it is fixable.

Hybrid:
   
N30i:
   

I feel bad asking when my results are already pretty good, but I do want to understand this better, and be prepared for when I speak to the doctor again in a couple weeks. Thanks!

[SarcasticDave94]

Your OSCAR chart labeled Hybrid has clusters of Obstructive Apnea indicating you're dealing with Positional Apnea. The other N30i chart has a small bit that might be Positional as well, it's just not as obvious.

Thumbnail sketch on Positional Apnea: your chin tucking which is physically kinking closed your airway. Think of your garden hose, kinked closed little to no water flows.

Solution? Examine your pillow. It's a good description stack, very thick, or several pillows? Yes, then you probably need to thin it down. Otherwise, you'll need to physically hinder the kinked neck situation, members here do this in most cases with a soft cervical collar that's fitted in such a way to prevent chin tuck. However it does not need to prevent all neck movement as in an injury situation.

Take a look at the wiki on Positional Apnea

[staceyburke]

Dave has got it just right about the positional apnea.  But I don't think your pressure settings are as good as they could be.  I would suggest these setting:

Min 7
EPR on Full time
EPR 3

That should give you a better nights sleep.

[Bampf]

Thanks! Great tips about positional. I'm wondering why positional is so much worse with the hybrid - I'm thinking it's just because the hose comes in the front instead of top of the head. I probably arranged my pillows differently. I will pay attention to that next time I try it. (There's also a version of the hybrid mask with the hose on top.)

Those pressure adjustments are also welcome. I will work on my position first, then tweak settings gradually and see what happens.

Plus I'll read all those links. Thanks again!