[CPAP] Switched from nose mask to full face and AHI has increased

[touwmus]

Hello forum members,

I'm new here and quite new to CPAP. I've tried a MAD device but even with it on I had an AHI of 25+ in a sleep study.

I have a Resmed Airsense 10. Pressure was set by the technician in the hospital (at 6).

Because I had a lot of mouth leaks I needed to switch from nose mask (Resmed Mirage FX) to full face mask (Resmed Airfit F30). 
With the mouth leaks I had quite a low AHI (nose mask but with leaks, so maybe no accurate measurement) but I woke up a lot of times during the night and sleep was not refreshing.

I'm getting used to the full face mask but :

1) my AHI has risen in comparison to the nose mask (to between 6-18 AHI) 
2) sleep still is unrefreshing

I'll attach some screenshots here (hope I do it right as it is the first time).
If someone has any suggestions that could help, I would like to hear from you ! 

Good night to you all


picture 1 : 09/06

[attachment=51436]

picture 2 : 10/06

   

picture 3 : 11/06

   

[touwmus]

I overlooked this, but the OSCAR screenshots are in dutch. Is it necessary these are in english in order to make conclusions on this forum ?

I presume i can adjust the language settings in OSCAR and make new screenshots, so it wouldn’t be a problem to do so.

[Sleeprider]

I see two possibilities for this increase in obstructive apnea. Clearly a higher pressure is needed, and since you own a Resmed Airsense 10 Autoset, you can simply turn on the Autoset option for automatic pressure adjustment. I would suggest changing settings to Autoset mode with minimum pressure 7.0 and maximum pressure 10.0 with EPR on full-time at setting 3 to help with the really high flow limitations. Your settings were far from optimal at 6.0 pressure and the nasal vs full mask is only a small part of the problem. Try the higher automatic pressure, then return to discuss how it feels and your comfort with this revision. To change these settings, you need to use the clinical settings. https://www.apneaboard.com/resmed-airsen...setup-info

Second problem is positional. You are chin-tucking and this is closing off your airway resulting in clusters of obstructive events. We have a couple wiki articles that can help you to understand this. Read the Positional Apnea wiki and note how similar the characteristic clusters of apnea are to your own chart https://www.apneaboard.com/wiki/index.ph...onal_Apnea A common solution to this problem is to use a soft cervical collar. https://www.apneaboard.com/wiki/index.ph...cal_Collar

[touwmus]

Thank you so much !
I’ve set the parameters and my collar is ready to wear.

I’ll keep you posted on how it goes after the adjustments.

[touwmus]

Hello, I slept one night with the settings :

• Auto APAP
  
• Min pressure : 7
  
• Max pressure : 10
  
• EPR : 3
  
• Cervical collar
  

I didn't sleep better then other nights and didn't wake up refreshed - I had the feeling that I inhaled air during the night which caused bloating today, a very "gassy" feeling.

Here i upload my OSCAR graph, If there are any hints to ameliorate results - I would be pleased. I will follow up and post my progress here. Thanks in advance !

   

[Sleeprider]

You have large clusters of obstructive apnea typical of positional apnea. This is where you sleep in a position or chin-tucking that bends the airway causing obstruction. As previously suggested, Soft Cervical Collar https://www.apneaboard.com/wiki/index.ph...cal_Collar

[touwmus]

Hello Sleeprider, the last graph is of sleep with a cervical collar and the new settings. I’ll give it another try then ?

[Sleeprider]

The clustered apnea suggest something is getting by the collar. Since you are experiencing air in your stomach, I'd much rather see you resolve how this occurs than to simply raise pressure. A different size or style of collar may be needed, but I have not often seen clusters of apnea like this that don't eventually respond to a collar or similar thing. If you have a means to video sleep to see how these events occur, it would help you to design a mitigation.

[Expat31]

Hello forum members,

I'm new here and quite new to CPAP. I've tried a MAD device but even with it on I had an AHI of 25+ in a sleep study.

I have a Resmed Airsense 10. Pressure was set by the technician in the hospital (at 6)

Hi, in your sleep study quoted above, you had an AHI of 25+. Did the study show the breakdown of this value between your sleeping positions, back, front, side etc?

[touwmus]

Hello,

my sleep study showed that it was when i lay on my back, at least this is what the doctor said.
They told me to sew a tennisball on my back to prevent this (but this was before cpap).

I include my OSCAR graph of last night (same settings and the cervical collar tighter then the night before).
AHI was still high (i think), as you can see in the picture :