My first two nights - some questions

First some background:

DIagnosed OSA with an AHI of 118.7. Lowest O2 was 73%. Followup titration was done using Airfit P10 nasal pillow mask. Did not sleep on my back. Prescribed pressure was 8cm.

I purchased the Airsense 10 Autoset new from Craigslist. Decided to set it with APAP settings of Min: 4 Max: 10. ERP is on (set to 3), ClimateControl is on Auto.

I slept the first night fairly well. I used Airfit P10 nasal pillows. AHI shown was 1.2. Reviewing Sleepyhead, pressure seems to have been at or near 10 most of the night. It did show a decent amount of snoring. I am not sure if that is normal or not. I felt more rested than normal through the day yesterday, despite the fact I did have trouble falling asleep and didn't get as much time asleep as I would have liked.

Yesterday, I started getting a cold. I was too congested to breathe through my nose. I purchased a F&P Simplus full face mask for such an occasion. I changed the settings on the machine to indicate I was using a full face mask, and did a mask check to ensure there were no leaks. All good there. Kept all other settings the same. I fell asleep slightly faster last night. But my quality of sleep was not as good. I am back to my all-too-accustomed exhausted self today. The AHI shown on the machine was 38.6. Better than the 118.7 when i was diagnosed. But still terrible. Sleepyhead shows pressure was at 10 pretty much the entire night.

Is it to be expected to have issues when ill? Was it wrong to set the machine in APAP mode with 4-10 pressure (instead of constant 8cm as prescribed)? Should I turn ERP off (I do like the easier exhale when the pressure is higher)? Should I turn the pressure up when I am sick? Or when I wear a full-face mask instead of the nasal pillows?

I am not in panic mode. But I definitely want to do the right thing, and get the best sleep possible, consistently. So, I am looking for the sage advice of the community. If there is more info you might want from me, please let me know.

I think I would set it to auto 8 to 14 .... use ramp if you like .. keep it short time on ramp.
Did you try the P10 with the cold ... I have found that it can keep the nose open ... even with a cold

If you like EPR, try it at a lower setting - it may still be effective enough but let your AHI's be a bit lower. And if you're using humidity try it on high (using heat with a cold or not) but also try none, as it can give you cold symptoms if not needed depending on prevailing humidity where you live. You need to experiment with things, one at a time, and try them for a few days each. Most people find a pressure of 4 next to impossible to breathe at and it generally adds almost nothing therapeutic.

Since your Rx was for 8, I would put the settings on APAP at min 8 and max 15 since you said it spends a lot of time at 10. Then leave it for a few days to see where the machine thinks it needs to be. With your setting at 4 you are missing some apnea events before the pressure gets raised. Also if you were awake much of the time some of the events could be SWJ (sleep/wake/junk).
Get Sleepyhead so you can see exactly what is happening. https://sleep.tnet.com/resources/sleepyhead
I see Grayghost4 gave 8-14 so I'll also go with that. The top number will only be used if needed. So you could set it to 20, but sometimes the changes in pressure disturbs some people so to solve that we might limit the top.

Thanks! I did try the P10 nasal pillows first last night. I had to stop and swap it out with the full face. I couldn't breathe enough to get comfortable... it just wasn't happening.

I will try upping the pressure settings to range from 8-14 and see how it goes. I did use Sleepyhead, and the majority of the events were after I was asleep. Some of them could have been during the 2 elongated "wake" periods in the middle of the night. But those were maybe 10 minutes a piece and the events were fairly well spread out. My wife also noted that at one point, I had made it on to my back, was snoring really noticeably, and even stopped breathing at one point.

I just wasn't sure if this is just sorta "normal" with a cold or respiratory infection. Still so new to this. So, I really appreciate the feedback. I'll fill in with how things go tonight.

I also use the simplex ff mask ... it is the only one I have found that works for me . As with all masks strap adjustment is an "art" .. not to tight ... not to loose ... and the top strap over the head in critical to get it right ... spend an hour before bed time experimenting with the strap adj.

Mike, anxious to hear how your first few days went.

Last night was interesting. I had a terrible time falling asleep. I started off with the Simplus full face mask, as my congestion was still annoying me. In some ways, I actually prefer the ability to breathe through my mouth. I spent a bit more than an hour before I started to drift off. And just as that started to happen... some squeaking from the mask. It did not appear to be a seal issue on the perimeter of the mask. It would come and go with each inhale, and it seemed like it was from the vents. It started to go away after awhile, and I started to drift off. Then I shifted a bit.. mask leak. Fixed that, squeak came back on inhale....

At this point, I seemed to be breathing OK enough through my nose, so, I stopped the machine, changed masks to the Airfit P10. Couldn't fall asleep. Played a game on my phone, read some articles online. I was concentrating too much on the breathing, and not "relaxing". I did some breathing exercises I used to do when I would have panic attacks. It calmed me, and about 2-2.5 hours after I laid down for bed, I finally fell asleep.

About 3.5 hours later. I awoke to a gurgle sound in the tube and an awkward feeling when trying to inhale. Stupid rainout! I did enjoy the extra humidity with the cold, but it was not to be. I reset the Climate Control to "auto" after emptying the water from the tube. After about 30-40 minutes. I fell asleep again. Got another 2 hours or so, then my 5 year old son woke me up. Spent the next hour or two drifting in and out of sleep.

Now: the good news. My AHI for the night was 0.7! The median pressure was 11.2. So changing the settings from 4-10 to 8-14 appears to have done the trick.

Thanks everyone for the suggestions. Here's to hoping I can get less broken sleep tonight!

Nights will get better. You just had the perfect storm of events. On the rainout, be sure your machine is lower and the hose is raised. I put mine over the headboard.