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Hi... er... Mantis.
I can tell you that in certain instances, adding some supplemental oxygen to VPAP (or CPAP) can have very positive results. It's a very individual thing. Do you have a specific question about it? I don't use it myself, but I do use it with a significant number of my patients.
Simplus is a model of mask made by Fisher & Paykel. The size should correspond with the size of your F20, if that was fitted correctly. I have never used CPAP liners because where I work we would have to throw them away after one use and it would get too expensive, so I know nothing about them. Others on this forum can fill you in there. If you struggle to adjust the mask yourself, when you are at the lab make sure you test the mask at 15 (your max pressure) and lying down as this will affect the shape of your face. Have a bit of a roll around and see how easy it is to introduce a leak. Adjusting yourself is better, but this will get you as close as possible in the lab. I also don't use Sleepyhead, but the consensus here seems to be very positive. I should be able to help you out with some of the terminology though.
Perhaps you could try a Simplus. I generally prefer them to the F20 (but horses for courses). I'm a little surprised that the Amara View hurt your face that much. Perhaps it was too tight? Do you adjust your own mask while using it, as required? I have lots of patients who have masks leaks because they don't want to adjust their mask straps.
It is not uncommon to feel worse when you have just started using CPAP. When you brain has not been able to sleep properly because of OSA and then the OSA is suddenly removed (by CPAP) what can happen is that your brain gets really excited and has a little party. Instead of getting the normal amount of each stage of sleep, it tries to make up for lost time and get way more of the stages it has been missing out on than you would normally have in one night. This is called rebounding. This can leave you feeling very tired and thick headed until you brain settles down into more normal sleep architecture. Hopefully it will pass in a little time.
By the way, I think the "game changing" thing is probably more rule than exception (based on my many thousands of patients), but that a site for people struggling with OSA and CPAP will not reflect that. This is where people come when they have problems (or to offer help, obviously).
There is no one combination of settings that will work for everyone. There is too much variation in bedroom micro-climates, general weather patterns, personal preferences for humidity, etc. In theory, if you are dry you turn up the humidifier temperature until dryness stops. If you start to get rain out (excessive condensation in tube or mask), turn the tube temp up until the rain out stops. However, it may well be worth trying it all an auto first because, if it works then yay!
That is a lot of variation, and 47 is pretty high for residual AHI. What is your leak level like? If you have bad leak on some nights, this could be reducing the sensitivity of your machine to your events leading it to report an artificially low AHI. Overall, a sleep study with your BiPAP on will give the best answers.
In case you are wondering, if your humidifier runs dry nothing bad will happen to your machine. So, if that was a concern for you, don't worry.
Increasing the max pressure setting of an auto is fairly low risk. The auto should only turn itself up if it thinks you need it, and all increasing the max pressure does is let it go higher if it thinks it is necessary. Having said that, I always advocate consulting your doctor. Any reasonable doctor should be open to this.
An AHI of less than 1 simply means less than one event per hour. If your machine only registers 3 events over 8 hours of use this will be an AHI of 0.38. The machines do tend to overestimate AHI, which is one reason a result of 5 or less is good. An AHI of less than is excellent and you should all feel proud if you are getting that kind of result.
An AHI of 11 - 14 is not great. You posted initially that Autoset has a max pressure setting of 12. This is pretty low and may be preventing the machine from delivering sufficient pressure in the worst parts of you sleep. Perhaps this could be adjusted upward and see if your AHI goes down. The autoset should, in theory, only increase its pressure if you need it.
