Switched to nasal pillows from full face mask

[iNeedis]

Hello all. I recently posted in this forum over a week ago about my journey with the cpap machine. I switched to the P10 nasal pillows from the F20 full face mask and was easy to get used to the nasal pillows , but I would wake up each morning EXHAUSTED! I tried them for 3 days straight. My AHI was always bellow 1 event per hour which I was happy about and my leaks were very minimal. I was able to sleep comfortably all night with the nasal pillows but like I said, I would wake up exhausted and be tired entire day. I believe I would have problems with nasal cycle as I would wake up in morning with one nostril blocked and this was waking up sleeping on my side. I went back to the full face mask and have had a lot more events per hour, but I would wake up refreshed. I am very curious why I was struggling with the nasal pillows even though my seal was great and my AHI was very low?!

[southerndoc]

That's interesting that your AHI was the same but you still were tired. Did you look at your data via OSCAR to see if you had large leaks? One of the things I've noticed with nasal pillows is that sleeping on your side can push the cushion so that it creates a leak. You should be able to identify this through myAir (if you have a ResMed) or OSCAR.

Have you tried the ResMed AirFit N30/N30i cushions? It's a nice compromise between nasal pillows and a traditional nasal mask. I found I have less congestion with the N30 as compared to the P30 or Swift FX.

[dataq1]

could you post an OSCAR report that would be typical of each condition (P10 vs f20)?

[iNeedis]

here are my oscar reports . the first 2 are the ones where i used nasal pillows. the last one is me using full face mask.
https://imgur.com/a/QWuvcye

[Pugsy]

The bulk of the increased AHI numbers with the full face mask appear to be central apneas (CA on the OSCAR software).
I don't know if those flagged events are real asleep centrals or just a bit of false positive flagging from arousal breathing irregularities but even if they were all real asleep centrals there's really not enough of them to be that big of a problem other than messing with your overall numbers a bit.

You might want to do some detective work to see if those centrals are real asleep centrals or arousal related.
Watch the videos here to learn how to zoom in on the flow rate to identify asleep breathing vs arousal/awake related flagged events.
http://freecpapadvice.com/sleepyhead-free-software

I can't explain why there would be such a difference in numbers of any events and the overall sleep quality issues that might account for the difference in how you feel each day and the pillows making things worse in terms of how you feel but IMHO if it were me I would use the mask that lets me feel the best during the day regardless of the numbers.

There really isn't much you can do about the centrals (if they are real asleep centrals) except maybe reduce or turn off EPR exhale relief. EPR can cause central triggering in SOME people. It may or may not be a trigger in your situation but it is something you can try and see if it makes any difference or not. I have my doubts since your centrals seem to be mainly in the second half of the night and you were using EPR all night. Might be worth a try though if you want to at least try reducing the number of centrals. No guarantees though.

[Miss Emerita]

You got a little more time in bed that last night. Maybe you just need at least 7.5 hours? Have you ever tried aiming for 8?

[iNeedis]

So I am just re posting in this thread because I have switched back to the full face mask just because it was more comfortable. Although, just purchased the N20 mask and really like it. Sleep great with it. Only problem is this morning after I took off the mask, there was a bunch of water the literally just fell out. I know you are all going to say it’s rainout , but when I looked at my climate hose, there was no moisture build up. The only moisture build up that was visible was in the small clear tubing that comes with the mask. I have not had this problem when wearing my full face mask and on the same climate settings. I have my settings at 86 temp, and 6 humidity.

Also, been noticing how loud the exhale vents are with this N20 mask. The F20 was no where near this loud.

[Pugsy]

There is moisture in your own exhaled breath. That can also condense in your mask. It gets added to any moisture in the incoming air. I know people who don't even use a humidifier that get condensation in the mask.

It's still called rain out.

One the air leaves the heated hose and starts going through any short hose that is part of any mask.....the air starts to cool down and the chances for condensation/rain out will start to increase.

That's why moisture can condense at the mask level or the short non heated hose level....it's still rain out or condensation.

I am not familiar with the F20....does it have any sort of short hose involved with it's assembly?
The longer any short non heated hose...the greater the chance for the air to cool down to the point it releases the moisture and condensation occurs.

[Miss Emerita]

If there's a short hose, try putting a sock over it to insulate it a bit. Just cut a hole in the toe of the sock and scrunch it up over the hose.

[clownbell]

Pardon me, Pugsy, and I do not mean to be rude, but OP refers to the N20 nasal mask not the F20 full face mask.

I like the N20 except for the exhaust jet that is strong and disturbs my wife. Can't blame her -- it is strong.

[Pugsy]

Pardon me, Pugsy, and I do not mean to be rude, but OP refers to the N20 nasal mask not the F20 full face mask.

So beat me for making a typo since I am sure you never have.

The polite thing to do when someone makes a typo or whatever error is send the person a PM and ask if "did you mean N20 and not F20"
besides....first post made it was the F20 mention.

Have a nice day.

[clownbell]

Thanks, Pugsy, I never thought about a PM. Learned something from that scenario.