My AHI is VERY high

All masks will work at pretty much any pressure as in they are all effective up to 20 cm and some even 30 cm pressure.
Doesn't really matter if they are nasal cushion or nasal pillows or full face masks.
All masks will present challenges at higher pressures. I have used a nasal pillow mask and have it do quite well at pressures over 20 cm...there's zero reason to think that just because a person needs a higher pressure that they can't use a nasal interface mask of some sort just from the pressure side of things. Now the mouth opening thing....that's a whole different story.

I wish you were my next door neighbor. I got a couple I would just give you to try and see how you do with them.
It might be that your mouth opening issues ends up being a problem but it also might end up that the mouth opening problem is less of a problem than having an AHI you are having because the pressures needed can't deal with your apnea events with a full face mask.

What mask was used during the in lab sleep study where they came up with the pressure setting of 8.5?
Were you okay with it in general?

Me personally...I tend to lean towards the least amount of stuff on my face and head as possible but others have other preferences and that's okay was well.

Since you have to buy everything out of pocket...let's see if we can figure out something that will work without your having to spend boatloads of more money to make it work.
It might be that a nasal mask using lower pressures and keeping the OSA better managed and even if there is some mouth breathing leak is still going to end up being a better solution than what you are seeing now and the AHI you are seeing now which of course totally unacceptable. Example...I would take an hour of big mouth breathing leak over what you are seeing now should it happen.
No, not ideal but what you are having now is no where ideal either.

Okay here are last night results. I turned EPR off and increased the pressure to 20. I switched over to my Airtouch mask as they are interchangeable with the Airfit and the Airtouch is much more comfortable but it seems like there was a lot of leakage - I had to readjust a few times in the night.

The mask leakage was so bad it pretty much invalidates the data or the machine's ability to respond other than it flagged a boat load of UAs which means it knows something happened but didn't know what they were and it compromised the ability to respond.
The only "good" chunk of data is the time from probably 5:20 on.

When leaks exceed 35 L/min....pretty much all bets are off in terms of machine's ability to do much of anything accurately.

While the AirTouch is more comfy.....it's not good at high pressures in maintaining any sort of decent seal.

What kind of choices for a nasal mask do you have locally or at hand? It's too bad your sleep lab just didn't send you home with the nasal mask they used for the sleep study....that's what is commonly done here in the US.
How much would it cost you? Can you convert to US dollars so I can compare please? I will look to see what I have for free to you if you could just pay shipping. Only problem with my mailing something to you is it will take probably 2 weeks if we are lucky. What with customs in both countries and covid....it's really slow unless we do the overnight crap and then the cost is prohibitive for sure.
I once overnighted a mask to a friend in Jamaica and it was really ugly what she had to pay but she was on vacation there and no other choice.

In the meantime.....need to work harder on the fitting of the AirTouch and see if you can get it less leaky. It won't be easy.
It's just not good at the pressures you need.
Or go back to the AirFit cushion.

Our mail/postal system does not work lol. Only way is to use FedEx or DHL but ends up being more than the actual mask. Thanks for the offer though.

There are a few online stores locally that supply CPAP equipment.
I can get any ResMed product here easily as well as Phillips or Fisher Paykel or ResSmart.

The N30i for example is $80 USD after the conversion.
And the Resmed Mirage FX is $70

Which nasal mask would you recommend I try?

What mask did you use during the sleep titration study? Did you like it well enough?

I can tell you what I like but that doesn't mean you will like it.

Example...I have discovered that I don't care for the ResMed P30i or N30i thing because I hear the Darth Vadar sounds too much. They annoy the heck out of me. The mask might be fine but the sounds make it a deal breaker for me.

In general....look at the ResMed AirFit P10....it has the diffused venting which makes it silent....the down side is the headgear but that can be fixed easily later if it's a problem with adding the N30 adjustable headgear to the frame if needed later which is more adjustable.
The ResMed Swift FX...nice mask but it is noisier in terms of venting which may or may not matter to you. My husband was glad when I went to the P10...he no longer had streams of cold air from the Swift FX venting onto the back of his neck.
The P10 venting is so diffused it can barely be felt with your hand about an inch from the vent holes....and it's silent as well.

I don't like anything over my nose. I find it causes nasal congestion to have any sort of pressure on the sides of my nose so I avoid any mask that does that. So I don't have any real experience with any of the over the nose cushion masks. I am strictly a nasal pillow kind of user. Even now with the Bleep...no headgear and nothing on the sides of my nose.

Thanks - I will look into those masks

Here are my results from last night. I turned EPR back on and turned it to the lowest setting of 1.

Here is my results from last night:

I changed back to the AirFit silicon mask.
I increased EPR to 2

I used a soft cervical collar

but seems like my AHI almost doubled???

Adding in more EPR drops the EPAP /exhale pressure and can make things worse...and it looks like the cervical collar made things worse as well. For most it helps but looks like it didn't in your situation.

Check out secondwindcpap.com for if/when you decide to get a bilevel machine.
The AirCurve 10 VAuto...is what you want. Save the link. Prices are very fair and they ship internationally.

How long before you can try a nasal mask of any sort?

In the meantime you have to try a nasal masks to see what happens or not.
This is so painful obvious that it's not working that you can't keep doing this.
I am not sure if fixed at 20 with no EPR would even work.

I would like for you to zoom in on a segment of those OA clusters though and give me an about 3 to 4 minute segment of the flow rate with a bunch of OAs dispersed through out. Take your pick but I want it at the zoom level of 3 to 4 (no more than 4 minutes) level.

Question I just thought of....has anything at all changed between your sleep study and now that might account for such difference in results. Are you taking any different medications or dosages changes or anything like that.
No pain meds or muscle relaxers of stuff like that????

No, nothing's changed since the sleep study.

My new mask is arriving today - Im going to try the Resmed Mirage FX.

Here is the screenshot, is this what you were wanting?

Yes...thank you that is what I was wanting to see. Mainly just wanting to see if what we were seeing flagged looked obstructive in nature or central in nature (on an off chance) and it looks obstructive to my eye.

okay here are the results using the Mirage FX - which is nasal only.

Very different results. The AHI has come down a lot. But I woke up feeling tired.

So how was your sleep quality with the nasal mask?
Did you sleep soundly or wake often with it?

mattmceza wrote: ↑

Sat Aug 01, 2020 3:45 am

okay here are the results using the Mirage FX - which is nasal only.

Very different results. The AHI has come down a lot. But I woke up feeling tired.

Screenshot 2020-08-01 at 11.43.51.png

Why did you lower your min pressure? You should *raise* it! 13 would be a good starting point.