Very bad night with new mask

[sleepytimegal]

Hi Forum members, Need your expert help again. I'm sorry I didn't get the Sleepyhead image inserted as instructed. (I read the instructions and tried several times unsuccessfully to get the URL posted to use for enlargement. Hopefully this will be adequate.)
I decided I wanted to try the Amara View mask (full face minimal). I have been using the DreamWare and have had good luck with that. (I checked my average for the last 6 months and it was .9 AHI.) But this summer I had bronchitis and had trouble with my treatment because of all the coughing and my AHI went up to about 5 for the worst part of the illness. Not too bad, but I thought I might do better with the full face mask because I know with the cold I was breathing through my mouth and had a lot of leaks. 

Before I went to bed I put the Amara on and watched TV in bed for awhile to see how it fit and get used to it. It seemed to fit fairly well - I did some tightening to fix the leaks, and according to Sleepyhead this morning leaks weren't really a problem, but I had some. It was fairly comfortable and I thought I could make it through the night. I wanted to breathe through my mouth but that didn't come naturally, and when I forced it I got the puffy cheeks that I don't like, so I thought I would just breathe through my nose, as usual. Things seemed pretty normal as the night progressed. I woke up a couple of times and decided to get up after just 5 hours sleep since I was getting uncomfortable. All in all it seemed to be an OK night - didn't expect to be as comfortable as with the Dreamware. 

I expected my AHI to be about the same, and was shocked when it was 9 - never had one so high outside my sleep study (which was 57). 

So I have two things (heavily) on my mind: 
1.  Why was my AHI so high when I didn't have any major leaks and the night seemed fairly normal to me? But I'm not going to use that mask anymore anyway, so that point is rather moot.
2.  The question I really am most interested in having answered it this:
      Even though my AHIs have been good with my Dreamware I have been concerned (started treatment a little over a year ago) about long apnea events. It's not unusual for me to have ones that last around 30 seconds. I'm used to that now and don't fret about it. Everyone once in a while I have one that's about a minute - the longest being 84 seconds. I mentioned it to my sleep doctor (who since has been fired, so don't have one now) and he said he's more concerned about my AHI and I shouldn't worry about it. He acted like he didn't believe the Sleepyhead data - had never heard of it. I thought it was something to worry about, but since they weren't that frequent I was able to ignore it, as he suggested. But the length of the obstructive apenas I had last night was shocking, because there were so many that were long. I'll include the length of the first 15 or so - 15 - 15 -23 - 18 - 55 - 55 - 71 - 65 - 68 - 50 - 61 - 58 - 76 - 69 - 32 - 62 - 45 etc. I found this shocking since I was on the machine and it was on and working. Several times during the night I checked my pressure and it was at the max  (13), whereas with the Dreamware it is usually 11.7 to 12.2. And like I said, it seemed like the air was coming in. I am wondering if it was because I was just breathing through my nose, but that doesn't make much sense. 

So I'm wondering if I need to make an appointment with a doctor at University Hospitals in Iowa City (a little over an hour away) to see if I should be on something besides my apap. I am really concerned about my readings and am nervous that maybe they'll be the same tonight with the Dreamware - like maybe my apnea has become even more severe. 

Thanks so much for any help I can get with this. This really is of great concern to me and it's so great to have the Forum to present it to. Even if my sleep doctor was still around I never would have called him - he was never helpful nor is my respiratory therapist. 

Again, sorry I didn't do better with the Sleepyhead attachment. I really tried to follow the instructions.

Oh, now I'm wondering if I should have used the attachment option at the bottom for the Sleepyhead date. I just pasted it in. 

Sleepytimegal

[Walla Walla]

It's not uncommon for a full face mask to require higher pressures than nasal masks/pillows. You may need to adjust your pressure up. Try increasing the pressure up 1cm and see if the API drops down. Also you have clusters of events that usually means your chin is tucking in and cutting off your airway. The use of a soft cervical collar can help keep your chin from dropping.

[kiwii]

For the chin tucking...

If you are a side-sleeper and the cervical collar presses into your throat, you could try a child's u-shaped neck pillow (under your chin) or a buckwheat pillow. The buckwheat pillow is working well for me and I'm very pleased with the ComfyComfy brand quality and service. Unfortunately the cervical collar pressed against my throat and there were more events with it than without it. I think the child's pillow-thing would have worked well too, but haven't had a chance to actually try it.

Btw, I purchased the travel sized pillow (cylindrical) and like it so much that I haven't even used the standard sized (flat) pillow yet.

[Gary1of2]

Did you change the setting on the machine to fullface fron nasal?

[sleepytimegal]

Walla Walla, That theory makes sense because I found that there was some leaking noises around my chin, but if I moved my head they went away. I don't recall but the move was probably one that diminished my airway. With the DreamWear I have a pillow that tilts my head back  (which I didn't use last night), and I stay on my back because the DreamWare doesn't work for me on my side. I know it does for others. So with the Dreamwear I've always  got my head in CPR (open airway) position. I guess I'm doing the right thing with the DreamWare and think I"ll just forget about the Amara and stick with what works. And even with the cold, my AHI (with DreamWare) wasn't too alarming like it was last night. I think the full-face was just an expensive mistake. It's not returnable.  

Thanks for the input. 

Sleepytimegal

[sleepytimegal]

Gary 1 of 2 - Yes, surprisingly I did change the setting. I'm glad you brought it up because I need to change it back tonight. I'm done the with the Amara. Hate wasting the money, but I really wanted to try it. 

Sleepytimegal

[sleepytimegal]

Kiwii, I like the idea of the travel size cylindrical pillow. I think that would be something that would work for me. I like to have my head tipped back to open my airway and that might work better than what I have.  Thanks.

Sleepytimegal

[Gary1of2]

You can try rolling up a towel at first before you buy a collar. It can give you an idea it a collar might work for you. Also if you use the right supplier the do have an 30day exchange program for a small fee.

[OpalRose]

Kiwii, I like the idea of the travel size cylindrical pillow. I think that would be something that would work for me. I like to have my head tipped back to open my airway and that might work better than what I have.  Thanks.

Sleepytimegal

I use a small toddler size neck pillow, so that it is open at the back of my neck.
It is small enough that it hugs my neck in the front and sides and stays with me when I move.

They’re very inexpensive, $5 to $10.

[sleepytimegal]

Opal Rose, Will check out those pillows - sounds like a good thing for me - need to keep my airway open.

Sleepytimegal