1 week in--Cant decide on Nasal cushions vs Pillows

[greeknasty]

Hey all..long story short im a 35 male.  Recently diagnosed with OSA.  AHI was 8 but my RDI was high?  Exact note from doctor was "Sleep study shows mild sleep apnea with AHI of 8, with significant worsening in some positions with RDI 25, with oxygen levels falling.  Based on oxygen decrease, would recommend auto CPAP 5–20"

I am a week in with my airsense 11 and overall im satisfied, some days i am more energetic than others but overall doing well.  My only thing is i cant decide on the mask.  Ive used the N30i both airfit and airtouch nasal cushions and currently the last 2 days used the p30i pillows.  The only reason i switched is because i could not get initially comfortable with the n30 nosepiece but when i switched to the p30i its comfortable and fall asleep fast, but i am not sure if my numbers are worth using the p30 over the n30.
Here is my sleephq link:  https://sleephq.com/public/teams/share_l...4be7d862c5
as i said, the last 2 entries are with the p30i mask, just want to know if i should stick with that or be better off going back to the n30i

Currently i have ramp and EPR disabled, i feel like i can exhale easier with these settings off. 

thanks for reading and hope to learn insights from everyone.

[Rickyricardo]

EPR off makes exhaling harder not easier. Ramp offers nothing other than air starvation until you get to a proper pressure.

I tried the P30i and due to the design faults, I got rid of it PDQ.

If you want a good nasal pillow mask get the Swift FX which is not in the current product line, but readily available.

Two way adjustment makes it superior to the others.

[greeknasty]

EPR off makes exhaling harder not easier. Ramp offers nothing other than air starvation until you get to a proper pressure.

I tried the P30i and due to the design faults, I got rid of it PDQ.

If you want a good nasal pillow mask get the Swift FX which is not in the current product line, but readily available.

Two way adjustment makes it superior to the others.

Yeah, for some reason I just couldn't get comfortable breaths, after I turned it off the next few nights I was ok, so I've left it off for now
Will check the swift out. Thanks!

[jdougc]

Welcome to the forum,

You need to have EPR on full time, not ramp. Try EPR set to 3 full time

Your minimum pressure is too low for an adult, your doctor set the pressures as the machines defaults 5-20 cm, very lazy and bad.
 Set your minimum to 8 cm and your maximum to 10 cm.
You won't have wild pressure swings that probably disturb your sleep.
You could turn ramp on for 5 minutes for comfort, but set ramp pressure to 7cm.

Try these settings for a few nights

Download Oscar and post a few charts using F12 or Fn F12 for a mac
show these charts:
 Events Flags
 Flow Rate
 Pressure 
 leak rates
 Flow limits

Also show the statistics and device settings

[greeknasty]

Welcome to the forum,

You need to have EPR on full time, not ramp. Try EPR set to 3 full time

Your minimum pressure is too low for an adult, your doctor set the pressures as the machines defaults 5-20 cm, very lazy and bad.
 Set your minimum to 8 cm and your maximum to 10 cm.
You won't have wild pressure swings that probably disturb your sleep.
You could turn ramp on for 5 minutes for comfort, but set ramp pressure to 7cm.

Try these settings for a few nights

Download Oscar and post a few charts using F12 or Fn F12 for a mac
show these charts:
 Events Flags
 Flow Rate
 Pressure 
 leak rates
 Flow limits

Also show the statistics and device settings

Alright so for some reason i did 6cm instead of 8cm but last night actually went pretty well, no central apneas.  ive attached screenshots 
so this may be a bit drastic, but what are the odds the nasal pillows causing me to have a sore throat?  I have humidifier on and havent had any issue until i started using this pillows.   It could be a coincidence and im just getting something the kids may have given me, but i havent had a sore throat in over 5 years so its a little odd to me. I have cleaned it.

Here are my screenshots.  Thanks!

[jdougc]

I have to give your props for effort on the charts, but use F12, or FN F12 for a Mac and Oscar will do the screen grab and save the file for you. You can change the heights of the charts to make all 5 fit.

You had excessive flow limitations, see the tops of your breaths are not rounded. 
Your airway was restricted, not fully blocked.

Studies have shown that numerous flow limitations during sleep can cause drowsiness.
Some flow limitations is acceptable. But yours are worse, especially when you see them grouped like that and the total is over 0.02 in the statistics chart.
Since you are at EPR of 3 already, only raising the pressure is the tool you have left to deal with the flow limitations.
Try raising the minimum to 8 cm tonight and see how you feel.

You had a gentle sleep until your 1st REM sleep around 10:30. It stayed rough with events and multiple Flow limitations until another REM session around 2:00. You slept lightly then until after 3:00.

How did you feel besides having a sore throat? I would blame the kids for that issue.

[greeknasty]

I have to give your props for effort on the charts, but use F12, or FN F12 for a Mac and Oscar will do the screen grab and save the file for you. You can change the heights of the charts to make all 5 fit.

You had excessive flow limitations, see the tops of your breaths are not rounded. 
Your airway was restricted, not fully blocked.

Studies have shown that numerous flow limitations during sleep can cause drowsiness.
Some flow limitations is acceptable. But yours are worse, especially when you see them grouped like that and the total is over 0.02 in the statistics chart.
Since you are at EPR of 3 already, only raising the pressure is the tool you have left to deal with the flow limitations.
Try raising the minimum to 8 cm tonight and see how you feel.

You had a gentle sleep until your 1st REM sleep around 10:30. It stayed rough with events and multiple Flow limitations until another REM session around 2:00. You slept lightly then until after 3:00.

How did you feel besides having a sore throat? I would blame the kids for that issue.

will try the 8cm pressure.  thats funny cause i was a bit drowsy during the day but nothing too crazy.  Could this be why my oura ring detected variations in my oxygen last night?  Last 2 nights my oura picked up variations but 3 nights ago it picked up none.

[jdougc]

Flow limitations don't always cause drops in O2 sats, but they can lead to arousals and daytime sleepiness.

https://pmc.ncbi.nlm.nih.gov/articles/PMC4688581/

[greeknasty]

Flow limitations don't always cause drops in O2 sats, but they can lead to arousals and daytime sleepiness.

https://pmc.ncbi.nlm.nih.gov/articles/PMC4688581/

alright so last nights numbers seem better, i think, except i had more CA's.  I think the data may be a bit flawed as i am severely congested, i may end up having to skip using it tonight because I just cant get comfortable with it when im congested.  May need to buy a full face for situation like this. 

will use these settings a few more nights and get back with you.

thanks again for all your help.

[Rickyricardo]

EPR on to lower pressure when you want to exhale. Ramp, never. Don't understand the idea of starting off at a level where it is too hard to breathe. 

Turning off EPR should not mean exhaling is easier, quite the contrary.