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RE: CorruptAlligator - CPAP Problems - CorruptAlligator - 06-14-2021
I recently got a nasal mask, the N20, and I like it a lot. I like it a lot compared to my F30, which was a huge full face mask. I like that it only covers up my nose, and I don't feel the strong pressure like F30, in which I had some issues with abrupt pressure changes.
I would recommend giving it a try.
RE: CorruptAlligator - CPAP Problems - CorruptAlligator - 06-17-2021
I've been using my N20 nasal mask, and my AHI is reduced even without wearing a collar. This is the perfect mask for me. I recommend all to explore different masks to see which would work best for you.
I used to wear the F20 mask that resulted in higher AHI, but I'm thinking that the mask contributed to false positives of centrals.
RE: CorruptAlligator - CPAP Problems - Geer1 - 06-17-2021
I've seen this in a few cases now, I assume your flow limitations improved as well. If so was probably an obstructive issue and like you say some of the events were falsely flagged as centrals.
FFMs appear to be an issue for some people. I think it can be caused by a couple different things. One is that the lower strap pulls chin back/down. Another is that if the persons mouth is open the pressure supplied in mouth counteracts pressure in nose/primary airway.
Trying different masks till you find the right one is important as everyone is different. Glad you found the one you like and that works best for you.
RE: CorruptAlligator - CPAP Problems - CorruptAlligator - 06-17-2021
That could be what it is, the FFM chin strap pulling my head down. I tried loosening it, but that resulted in leakage. The solution was the nasal mask that doesn't put tension at the bottom like the FFM.
This probably also explains inconstancies of my AHI values with FFM
Only mask I haven't tried is nasal pillow, but I don't know how I feel like sudden rush of pressure directly up my nose. It feel more natural to have a mask around my nose that I can breath in the air with the pressure.
I'm also glad this was a solution that ended in not having to wear the cervical collar anymore.
With regards to N20 mask, I think fit is somewhat important. I initially wore a Large, but my DME also provided a Medium thinking that Large may not work. Medium actually worked better. Getting the right fit seems important.
RE: CorruptAlligator - CPAP Problems - CorruptAlligator - 07-10-2021
I'm back to full-face mask, F20. I realized there's flaws with N20, nasal mask. I realized I have trouble breathing through it, and the AHI numbers do not reflect quality of sleep. It seems like the system just doesn't detect well at all. I really don't trust the numbers from the machine. I started feeling slight chest pain when I wake up in the middle of the night, which tells me I'm having apnea that the machine is not detecting. I cannot breath properly with the mask to go back to sleep.
I don't like the design of the N20, particularly the bottom cushion, which seems to get on the way of my nostrils, partially obstructing. This really concerns me. I had similar issue with F30i with the possibility of the cushion getting misaligned, and obstructing flow of air. Using CPAP can actually be worse than not using at all I realized with this incident.
I switched back to F20, and I do have higher AHI numbers, but I feel rested. Numbers don't reflect quality of sleep. I think I was fooled by the low AHI numbers with the N20 mask, and realized the system isn't properly detecting apneas.
RE: CorruptAlligator - CPAP Problems - CorruptAlligator - 08-04-2021
I have a question. Do I strive to get my minimum pressure closest to my 95% pressure as possible? If it's generally in the range of 11-12 (avg seems to be about 12, and it can get close to 13 on some days and lower than 11 on rare occations), how close should my minimum pressure setting be?
Is 95% pressure the 'avg pressure' on the optimization wiki? Also, if I'm increasing pressure, how gradually should I increase to my desired target?
RE: CorruptAlligator - CPAP Problems - Geer1 - 08-04-2021
No, in some cases targeting 95% is good but in other cases if you always have flow limitations etc no matter what pressure is then targeting 95% will cause an increase and then another increase and another increase etc.
What you want to try to do is determine the effective pressure and minimize pressure change to a range of lets say 3 cm. It takes a bit of trial and error but the way to get dialed in is to see where your pressure maxes depending on your min pressure settings. For example if you use a min pressure of 6 and average pressure is 12 and then you try a min pressure of 10 and average pressure is 13 you are already getting close to a good setting. Soon as you stop seeing an improvement by raising min pressure you should stop.
RE: CorruptAlligator - CPAP Problems - CorruptAlligator - 08-07-2021
Thanks for the response Geer. Oscar also has something called 'mean' pressure. Is that the avg, or do I figure avg of 95% by avg'ing several nights? Because my 95% changes daily. Some days it's 12.2 or 12.5, and today it's 13.6, depending on how high my pressure goes up on a particular night. I can handle more pressure. So, your suggestion is to increase my minimum pressure to 10 and see what my 95% changes to? Ideally my min to max pressure range should be within 3 for optimal OA to CA?
Also, I'd like to add that I got a new Airsense autoset 10 machine as I suspected my old one has issues during it's algorithm. I seem to be able to sleep better with the new one.
RE: CorruptAlligator - CPAP Problems - Geer1 - 08-07-2021
Mean and average are the same thing.
3 cm fluctuation from min to max would be a reasonable target but that might not be possible for some people. The big thing is you just don't want to see regular large pressure increases night after night. For example if your min pressure is set to 4 cm and your average pressure is always 10 cm and 95% pressure is 14 cm then that means the machine is set too low and it has to build up pressure every night to get to an effective treatment level. These machines only raise pressure after breathing issues so if you rely on the machine to raise pressure for you then you are just maximizing the time you spend breathing poorly. A few cm fluctuation most nights isn't an issue (unless there is an obvious tie with apnea), it is fluctuations of 5-10 cm that are more obviously an issue.
Rather than targeting a certain range it is better to test how the pressure range changes as you raise min pressure. If raising min pressure reduces the pressure range there is a chance it is helping, if the range stays the same or increases then the increased pressure might not be helping or may even be making things worse.
Everyone is different some people will find a level where pressure increases will stop, others will see some level of pressure rise no matter what. It all depends on what causes the pressure rise and if increasing min pressure helps to avoid it. If you aren't sure about whether a new setting is better then best to post some examples for us rather than theoretical discussions like this.
RE: CorruptAlligator - CPAP Problems - CorruptAlligator - 08-07-2021
Here's my last two night's Oscar. It's so different. What do you think, should I raise my minimum? My main objective is to prevent waking during the night if possible, or at least reduce the number of wakings to one. Not sure if it's the pressure settings that's contributing to my wakings. I think I'm used to high pressure now since when I wake in the middle of the night I see pressure of 9 or 10, and I'm fine with it.