Trying another mask. Better AHI but feel more tired.

Been using a Mirage Liberty for 2 weeks. It's been reasonably comfortable, but started getting a sore on my upper lip. Decided to try a Swift Nano FX. Besides the obvious difference of going to a hybrid versus nasal only, the AHI was a bit better in spite of waking up a few times for various reasons. Definitely felt more concentrated pressure and my chest was a tad uncomfortable. Any reason why I would wake up wiped out with a better AHI? Should I stick with the Mirage and wait a while before mask cycling?

Thanks,

Tech Guy wrote:the AHI was a bit better in spite of waking up a few times for various reasons. Definitely felt more concentrated pressure and my chest was a tad uncomfortable. Any reason why I would wake up wiped out with a better AHI?

I suspect the frequent wake ups for various reasons are going to impact how you feel. Your sleep is fragmented and you aren't getting the normal cycles of sleep stages in the % that you need. Fragmented sleep for any reason...even for people without OSA...is a recipe for feeling pretty bad.

Also if you happen to have your OSA so that you have more events in REM stage sleep...if you wake often you likely don't get as much REM stage sleep.

Finally I have read where people using full face masks seem to need a little more pressure than people who use a nasal mask of some sort. Meaning their AHI is a little higher with the FFM and they need a little more pressure to get the AHI to be about the same with either type of mask.
I know in theory that X cm of pressure should be the same no matter which mask a person uses but I have seen enough people comment on the fact that they can get by with less pressure when using nasal mask, that I have to say the theory isn't 100% absolute all the time.

Thanks for the reply Pugsy. Will probably go back to the hybrid for a while. Any idea why or how sleep in general get's fragmented? It's been fragmented for a long time. How do most people handle fragmented sleep? For sure, not getting enough quality REM. Do you think if I lowered the 6.0 to 5.0 the nasal would be adequate or it's probably going to require experimentation?

After you have been using a pressure for a while the body gets used to it and a reduction sometimes causes a person to feel rather stifled. I had it happen when I went from 13 down to 10 in one of my experiments. I had worked my way up to 13 minimum (using APAP at the time) to see if AHI would change (it didn't) and while I went up slow I came down fast and it was uncomfortable for a few nights. To go from 6 to 5...I wouldn't bother. A lot of people think that there simply isn't enough air movement at 4 or 5 cm.
Your pressure is so low now it isn't worth the doing. Now if you were using 15 with a full face mask and could use 12 with nasal mask then it would be worth trying because that would be a nice reduction.

How do we handle fragmented sleep? Well that's a tough one because it all depends on what is causing the fragmenting.
Since you say this isn't new to you then we can't blame it all on just the mask and machine and tell you that giving it time will likely help.
We have to try to figure out what is causing it. You might google "sleep maintenance insomnia" and start reading up on various things to see if you can spot a possible factor. It's hard work. Lots of turning over rocks to see if we can figure out what might be the culprit. I have fragmented sleep but mine is easy to figure out what the problem is...Pain from some old injuries and arthritis in the fracture sites. If I didn't address the pain issues I would wake up probably 30 times a night. I still wake up a few times even with meds but maybe just a handful of times. When I have a bad night and can't get the pain under control the next day I feel like I haven't slept at all no matter how many "hours" it shows.

Of course it would be nice if the sole cause of fragmented sleep was the OSA and get the OSA under control and the fragmented sleep goes away but most of the time OSA isn't our only problem. But we try to fix what we know needs fixing and then go from there. If the mask is a factor...work on finding the right mask. Discomfort from the mask or leaks....work on fixing those issues.
Fix what you know for sure needs fixing and then see what's left. Sit back and take a hard look at everything.
Do you take any meds...even OTC? If so do some deep research on side effects and look for anything that points to restless sleep or wakefulness. You would be surprised how many times meds affect sleep quality and how we feel the next day.
One of my pain pills comes with a may cause drowsiness sticker but one of the side effects for a very small percentage of people is insomnia and guess who is a member of that small percentage...yep, me. I can't take it after 6 PM or I can only sleep for about 4 hours and then I am up cleaning house. So I have to take something else for pain at bedtime.

You might even talk to your doctor about maybe taking a little something to help sleep through whatever is causing the wake ups.
There are some OTC sleep aids..as well as RX sleep aids. Maybe take something to help the body break the habit of waking if you and your doctor are okay with that approach. Something to consider if you can't find something that you know for sure is a factor...like the mask maybe.

Appreciate the reply Pugsy. Years ago had a reaction to some medicine and never recovered. Slept great up until that time. REM has been broken a long time and unsure how much the OSA has contributed to it. I'm not a user of pills. Google "TENS unit." You can buy them on amazon for $30. It might be something you can try in between meds to help with pain. It works on the concept of over stimulating the nerves for a particular area. Hook up some electrodes and run the unit for 20 or 30 minutes. Very good way to get pain relief when a little extra is needed. Run the unit above a normal comfort level until, it starts to hurt, that's when the treatment is most effective. Everyone's comfort level is different. This fragmented sleep is frustrating. Spent the last 15 years practically not sleeping lol. How I manged to function like that is beyond me. Now I'm in a place that's going to require some brain power and desperately need to overcome this REM issue sooner than later.