Feel like my Pillow isn't giving good therapy...reco to try?

[hegel]

I think Dave is right. The first step has to be to address the leaks and get them down. Then the other numbers will begin to make sense, and you can go from there. With so many large leaks, the number that you're getting aren't accurate. Or in any case, nothing can be done without lowering leaks first.

I would work with Dave and perhaps others on getting your leaks under control. That's step one. The rest will follow from that. Dave is very good on this.

[tierdal]

With a minimum High leak rate of that group at 20, the data about therapy and events is questionable in what you see and in accuracy in what you're getting. So the leaks need addressed.

You wanted to know why you feel bad for the effort of therapy. Here it is, consistently large leaks.

Ok. So lets go with the AHI is wrong and the leaks need addressed. I am with you on that.

Where do I start? I have an evora, i try to get it pretty tight before bed to make sure its not leaking. 

How do I know if these are mouth leaks? Or leaks around the pillow itself? What mask should I try? I was thinking of trying ther brevida but im worried itll leak just like the Evora? My other thought was Dreamwear Gel since it goes in the nostrils and supposedly gives a good seal?

I have a chin strap : Deluxe Wide Adjustable Chin Strap - White - i cant link here but if you search apria an dthat youll see the one i have. looks like a mummy wraping. Its completely garbo imho but i tried it and it didnt seem to make the leaks any better. We have some surgical tape Ill try taping up my mouth tonight and see if that gets leaks down.

[SarcasticDave94]

The Evora is a Fisher and Paykel model. If it's like it's sibling my Vitera, it will not take well to a tight adjustment. Start there.

Lying back on the bed, start your PAP, and then hold the mask in place without straps.
Use your fingers to hold it there.
Breathe through the mask as if you're sleeping.
Adjust finger tension to minimize the leaking from the mask cushion.
Now put the straps on and mimic finger tension.
Wiggle the mask a bit (not harder bumps but just moving it a bit) and see if it maintains seal.
If it's OK there, try it a night without adjusting further.

Your latest chart appears to have some what I think are mouth leaks, indicated by the leak chart trace of rounded or maybe nearly straight long lines. I think mask leaks are the spikey stuff. Both patterns present themselves. Spikey at 0300, elongated near flat at 0130 to almost 0250, maybe mouth leaks at 0515-0740 but definitely more than just this. 0120-almost 0300 where spikey mask leaks are.

Unless there's one I don't recall, I don't think any Pillows mask actually insert into the nostrils. They may rest on the nares of your nose, and barely will be inside. To me, not the same as inserting/goes into the nostrils.

Consider trying a Knightsbridge Dual Band strap. It's a cap with 2 sets of Velcro straps that pull up on the jaw and not at all backwards.

[tierdal]

Ok I taped my mouth last night, I dont think that is the issue. Its barely any different than the night before (link to 7.30: http://www.apneaboard.com/forums/attachm...?aid=34292)

7.31 attached.

If its not my mouth what do we think it is then? Whats the next step? Cause it really feels like I woke up foggy brained =/

[SarcasticDave94]

You went from large leaks Max 46 or so to 19. It did cut leaks a lot, like roughly cut in half. Now if the spikey leaks trace sections are truly mask leaks, now you'll focus on proper fit, strap adjusting that's not torqued to the nth. If proper adjusting doesn't work, then again fit as in size, type as in nasal, pillows, full face, hybrid, or that model specific issue. The mask needs to be as good as it can and for the unique facial features of you.

[tierdal]

the day before was 20.4, then last night was 19.20. I don't see where you are getting 48.

are you saying i need to tape my mouth every night going forward?

Also - what is to the nth? How do i fit the mask and know its right? I do try to get it pretty tight as im afraid of leaks...are you sure it wont leak if i losen it? I try to make it tight so that if i jostle the pillow i dont hear any air.

thank you for trying to help me Dave - I am trying to work with you best i can. Its so hard not having the right answers. If I cant trust the machine to tell me im getting good therapy i hav e no idea if im groggy in the morning or its Apnea brain fog =/ Like how do i know? Its so hard =/

[SarcasticDave94]

nth = (in general use) denoting an unspecified item or instance in a series, typically the last or latest in a long series

You posted those OSCAR charts of some recent nights, 7th chart yesterday representing 7/14/21.

Again read what I posted on the Evora, do not go tight. You just said you're going as tight as you can, and I think you're needing to loosen it up. Fisher and Paykel masks work best under light tension not as tight as you can. Try loosening it up.

We know something is off in the OSCAR versus you saying you're fatigued. That helps back up that the likeliness the reported numbers are not accurate, in this case it appears to be due to leaks.

[hegel]

Tierdal, one way to look at last night's numbers is to find the "leak rate" line over on the left. You'll see the number 12 below the bold black 95% at the very top. That indicates that you were at or below a leak rate of 12 for 95% of the time during the night. Mostly below, and in fact below 10. that's much better than before. Your maximum leak was 19.20, which is below the 24 leaks per minute threshold that constitutes a Large Leak. that's why you got a 0% in the Large Leak column.

It often takes some time to begin to feel the benefits of effective cpap therapy. That's because people have what they call a sleep deficit if they haven't had rem sleep, or much, for a period of time. So they need to catch up. Do you remember dreaming? That means you were in rem sleep.

I hope I have all of this right!

[tierdal]

Tierdal, one way to look at last night's numbers is to find the "leak rate" line over on the left. You'll see the number 12 below the bold black 95% at the very top. That indicates that you were at or below a leak rate of 12 for 95% of the time during the night. Mostly below, and in fact below 10. that's much better than before. Your maximum leak was 19.20, which is below the 24 leaks per minute threshold that constitutes a Large Leak. that's why you got a 0% in the Large Leak column.

It often takes some time to begin to feel the benefits of effective cpap therapy. That's because people have what they call a sleep deficit if they haven't had rem sleep, or much, for a period of time. So they need to catch up. Do you remember dreaming? That means you were in rem sleep.

I hope I have all of this right!

i havent dreamt in years, i never really dreamt much my entire life tho

[Benzi]

I use the AirFit P10 with headgear from an AirFit N30 (it is adjustable). I will also use an N30 intermittently when my nose is chapped. As you probably know masks can be very tricky since everyone has one that works perfectly for them and for the next person it is an utter failure. I counted recently and I’ve tried seven different masks to find what works with my sleep style and facial anatomy. I’ve only been on treatment four 4 months.

Hi

What's the difference between the P10 (which I use) and N30? They look the same. Thanks