Very large leak rates

[snorybob]

Dr. Dakota RBE 1003 on Amazon. It was not quite high enough for me so I added a small tight rolled washcloth underneath held with 2 rubber bands.
Personally, I like this one better because the strap in the back is about 1 1/2'' wide (less hot). Any model you choose it takes a little while to get used to it but it definitely works. In the end, it's your choice! 


                   sb.

[boomba212]

Dr. Dakota RBE 1003 on Amazon. It was not quite high enough for me so I added a small tight rolled washcloth underneath held with 2 rubber bands.
Personally, I like this one better because the strap in the back is about 1 1/2'' wide (less hot). Any model you choose it takes a little while to get used to it but it definitely works. In the end, it's your choice! 


                   sb.

Thanks for the info!

[sheepless]

just a word of encouragement: hopefully a collar won't be uncomfortable for you but honestly it's probably fair to say most find them something less than pleasant. otoh, they are very effective in preventing event clusters and mouth leaks. even lip leaks. I'd much rather not wear a collar but I have learned to tolerate it because it is so effective. my ahi and especially my lip leaks are too high without it. yes, it will likely be hot, yes it might itch, yes it's one more thing to have to get used to and care for and yes it can feel like a neck iron at first. but we can and do get used to it. now I find putting it on and taking it off is more of a pain than wearing it through the night. it'll be great if it feels okay to you right off the bat; just saying it might take a while to adjust and it's worth the effort for those of us that need it.

[boomba212]

just a word of encouragement: hopefully a collar won't be uncomfortable for you but honestly it's probably fair to say most find them something less than pleasant.  otoh, they are very effective in preventing event clusters and mouth leaks. even lip leaks.  I'd much rather not wear a collar but I have learned to tolerate it because it is so effective.  my ahi and especially my lip leaks are too high without it.  yes, it will likely be hot, yes it might itch, yes it's one more thing to have to get used to and care for and yes it can feel like a neck iron at first.  but we can and do get used to it.  now I find putting it on and taking it off is more of a pain than wearing it through the night.  it'll be great if it feels okay to you right off the bat; just saying it might take a while to adjust and it's worth the effort for those of us that need it.

Thanks for the words of encouragement! I am going to get one today and if it takes care of my leaks, then I will definitely put up with it, because right now I'm very sleepy throughout the day.

[boomba212]

OK folks, so I got a cervical collar and used it last night. I feel the same tiredness as usual this morning, my Philips software tells me I had a 0% "mask fit," and Oscar tells me I had -99% (yes, it is negative, whatever that means) large leaks. Do you guys think it could be my machine, which I've had for about 4 years? The only other thing I can think of is my beard. It's not long and I don't hear leakage though. And my large leaks are consistently in the 90's%. I am going to get a new machine today and I hope that's it, because I don't know if they accept returns...

[Melman]

There are many full face mask users with beards who don’t have leak problems with FF masks. Have you checked all the hose connections for leaks? Also check the hose itself and the humidifier for air leaks.

You mentioned a new machine. If you were diagnosed with obstructive sleep apnea and your sleep study or machine data don’t show a lot of central apnea, you should consider the Resmed airsense 10 autoset or Resmed airsense 10 autoset for Her. Your Phillips Respironics choice is the  Dreamstation.  The Resmed Airsense 10 Autoset and Autoset For Her have significantly different features from your Dreamstation that affect both comfort and efficacy for most people.  
The Dreamstation does work well for many, but tends to fall down where more flow limitation and upper airway restriction exist, or respiratory flow volumes are not strong.  The Resmed auto algorithms are sensitive to flow limitation, hypopnea and snores so the machine quickly increases pressure quickly before an obstructive apnea occurs.  By comparison, the Dreamstation is much slower to increase pressure, and tends to reduce pressure too quickly, allowing many more obstructive apnea and hypopnea to occur.  

In addition to the better preventive pressure algorithm, the Resmed uses exhale pressure relief (EPR) which is a true bilevel pressure with up to 3 cm pressure difference between inhale and exhale.  Philips machines use CFlex, CFlex Plus or AFlex which provides pressure adjustment as respiration cycles to exhale and triggers inhale, but it tends to be poorly timed for people with flow limitation as discussed above.

[boomba212]

There are many full face mask users with beards who don’t have leak problems with FF masks. Have you checked all the hose connections for leaks? Also check the hose itself and the humidifier for air leaks.

You mentioned a new machine. If you were diagnosed with obstructive sleep apnea and your sleep study or machine data don’t show a lot of central apnea, you should consider the Resmed airsense 10 autoset or Resmed airsense 10 autoset for Her. Your Phillips Respironics choice is the  Dreamstation.  The Resmed Airsense 10 Autoset and Autoset For Her have significantly different features from your Dreamstation that affect both comfort and efficacy for most people.  
The Dreamstation does work well for many, but tends to fall down where more flow limitation and upper airway restriction exist, or respiratory flow volumes are not strong.  The Resmed auto algorithms are sensitive to flow limitation, hypopnea and snores so the machine quickly increases pressure quickly before an obstructive apnea occurs.  By comparison, the Dreamstation is much slower to increase pressure, and tends to reduce pressure too quickly, allowing many more obstructive apnea and hypopnea to occur.  

In addition to the better preventive pressure algorithm, the Resmed uses exhale pressure relief (EPR) which is a true bilevel pressure with up to 3 cm pressure difference between inhale and exhale.  Philips machines use CFlex, CFlex Plus or AFlex which provides pressure adjustment as respiration cycles to exhale and triggers inhale, but it tends to be poorly timed for people with flow limitation as discussed above.

Wow, thanks for sharing all that knowledge! It is in fact a Resmed Airsense 10 that I will be getting. On the phone the DME didn't mention "autoset" so I'm guessing it'll just be the regular one. I really hope this will do the trick. Yep, I and the DME guy checked the hose and machine for leaks on my current Philips machine.

[Melman]

You should get the autoset. There are several airsnese 10 models. If you are covered by insurance the DME is paid the same amount by insurance for the most basic machine as the autoset. By not providing the autoset the DME just makes more of a profit at your expense. If your paying yourself you can buy one from a supplier on the forum supplier list for less than your DME will charge.

[boomba212]

You should get the autoset. There are several airsnese 10 models. If you are covered by insurance the DME is paid the same amount by insurance for the most basic machine as the autoset. By not providing the autoset the DME just makes more of a profit at your expense.  If your paying yourself you can buy one from a supplier on the forum supplier list for less than your DME will charge.

I'm there now and it actually is an Autoset! So I'm good to go. Hopefully this will fix my issues. Thanks for all your help!

[Melman]

That's good news.  If you were prescribed a fixed pressure they will probably set it at that fixed pressure. You may benefit from the autoset  function in which the machine which adjusts the pressure to meet your needs. Your DME will not tell you but you can change pressure settings yourself. We can help you with that. We will want to see how you do with the new machine first. I see from your profile that you have OSCAR. After your first night with the new machine I suggest you post a daily chart formatted and organized as described in the links below.

Also, if you have a copy of your sleep study please post it. If you do not have a copy you should be able to get one from the Dr. or clinic that performed it. In the meantime, please give us as much information as you recall.