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+--- Thread: Trying to get this snoreded out (/Thread-Trying-to-get-this-snoreded-out)
Trying to get this snoreded out - FredSchnoyd - 02-24-2016
Hello there feller pappers,
I'm new to the group but I've been following this forum for a couple of years. First let me say that this has been a great resource for me since my journey with this STOOPID apnea entered my life and altered it in many ways good and bad.
After 2 years of cpap therapy, I'm still struggling almost every night with poor sleep quality and discomfort/discontent while "sleeping". The old sweet spot has eluded me at every turn. I'm on a new insurance plan and hope to be able to get another sleep study or at least a in-depth consultation with the KP sleep med dept in the next couple of months. But in the mean time, I was looking to see if anyone has any wisdom to share on my latest set of issues. I'll try to keep it brief....
When I had my study they did the short study where you get diagnosed, fitted, titrated, and prescribed all in one night. The results were an AHI of 27 and no centrals, no other sleep issues noted. I was given a brick (PR60 or something IDR) set to 12 (pressure CPAP), hose, and a Mirage FX Nasal Mask with Headgear and sent to my devices. After the much longer than expected adjustment period I discovered that I had very dry mouth in the morning, certainly because of mouth breathing, and started using a chin strap. Yay! Not. Still experiencing dry mouth some months on, I read some posts on this forum about mouth taping and gave that a try. It did make things better at least in terms of dry mouth issues. Note that at some point since, about Nov of '14, I've also purchased and have been using an S9 Auto and using Sleepyhead to track it with daily.
My reports have pretty consistently indicated large leak rates or around 20 or so. I know that's too high. So A few months ago I decided to bite the bullet and try a FFM, and purchased a Quattro FX which I have since renamed the SUX2000. What a disaster. The first night I woke up with the whole mask in my mouth. Tried with a chin strap the next night and it leaked like crazy. This game went on for about 3 or 4 nights and the mask went in trash. Back to the old Mirage FX and chin strap. I haven't had a decent night sleep since.
So recently I purchased the Fisher & Paykel HC431 fitpack after some consulting with the online person at [commercial DME link removed, please refer to Supplier #1 on the Supplier List]. It arrived the other day. I tried the large size since it was most comfortable. However, in the wee hours of the morning it felt as though my machine was going to launch off th etable it was blowing so hard. Sleepyhead indicated 99% leak rate (yes, I switched the setting to FFM). So I tried the medium cushion. Still 98% leak rate. And my AHI's went from the 1-3 range to the 9 range. WTH????
I have done several dry runs on both the large and medium cushions. Cannot find any leaks in the mask, in the hose, or anything from the machine. Tried a master reset and started all over with the settings. Still a 98% LLR last night and an AHI of 9.81
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Any thoughts?
RE: Trying to get this snoreded out - Evpraxia - 02-24-2016
I have not used a FFM so I cannot help with this.
However - I applaud you for your persistence!! You understand how important treating this beast of SA is.
RE: Trying to get this snoreded out - cate1898 - 02-24-2016
Welcome to the forum FredSchnoyd!
Getting the right mask is so important and sometimes so difficult. It can be expensive. Take your time and go down the supplier list to find which of them offers a 30 day money back (or exchange perhaps) on masks. There are some suppliers that do, I can't remember which ones off hand. Also spend time on their sites looking at the different masks and also there are a lot of videos on YouTube to show you some being demo'd. Look up videos by LankyLefty.
If you have got your mouth breathing under control, you might try the ever popular ResMed P10 mask. It's very minimalistic and comfortable. The nasal pillows just rest over the lower part of your nose with only a small tip of them going into the nostrils. Many people including myself swear by them. The DreamWear by PR is also very popular with nothing IN your nostrils at all. The mask sits over the bottom of your nose and the hose being at the top of the head makes it very comfortable to roll over in bed without having to adjust the hose.
Good luck with this, it is really worth it. Kudos for your perserverence!!
RE: Trying to get this snoreded out - woozie38 - 02-24-2016
(02-24-2016, 11:52 AM)FredSchnoyd Wrote: Hello there feller pappers,
I'm new to the group but I've been following this forum for a couple of years. First let me say that this has been a great resource for me since my journey with this STOOPID apnea entered my life and altered it in many ways good and bad.
After 2 years of cpap therapy, I'm still struggling almost every night with poor sleep quality and discomfort/discontent while "sleeping". The old sweet spot has eluded me at every turn. I'm on a new insurance plan and hope to be able to get another sleep study or at least a in-depth consultation with the KP sleep med dept in the next couple of months. But in the mean time, I was looking to see if anyone has any wisdom to share on my latest set of issues. I'll try to keep it brief....
When I had my study they did the short study where you get diagnosed, fitted, titrated, and prescribed all in one night. The results were an AHI of 27 and no centrals, no other sleep issues noted. I was given a brick (PR60 or something IDR) set to 12 (pressure CPAP), hose, and a Mirage FX Nasal Mask with Headgear and sent to my devices. After the much longer than expected adjustment period I discovered that I had very dry mouth in the morning, certainly because of mouth breathing, and started using a chin strap. Yay! Not. Still experiencing dry mouth some months on, I read some posts on this forum about mouth taping and gave that a try. It did make things better at least in terms of dry mouth issues. Note that at some point since, about Nov of '14, I've also purchased and have been using an S9 Auto and using Sleepyhead to track it with daily.
My reports have pretty consistently indicated large leak rates or around 20 or so. I know that's too high. So A few months ago I decided to bite the bullet and try a FFM, and purchased a Quattro FX which I have since renamed the SUX2000. What a disaster. The first night I woke up with the whole mask in my mouth. Tried with a chin strap the next night and it leaked like crazy. This game went on for about 3 or 4 nights and the mask went in trash. Back to the old Mirage FX and chin strap. I haven't had a decent night sleep since.
So recently I purchased the Fisher & Paykel HC431 fitpack after some consulting with the online person at [commercial DME link removed, please refer to Supplier #1 on the Supplier List]. It arrived the other day. I tried the large size since it was most comfortable. However, in the wee hours of the morning it felt as though my machine was going to launch off th etable it was blowing so hard. Sleepyhead indicated 99% leak rate (yes, I switched the setting to FFM). So I tried the medium cushion. Still 98% leak rate. And my AHI's went from the 1-3 range to the 9 range. WTH????
I have done several dry runs on both the large and medium cushions. Cannot find any leaks in the mask, in the hose, or anything from the machine. Tried a master reset and started all over with the settings. Still a 98% LLR last night and an AHI of 9.81
Any thoughts?
G'day FredSchnoyd,
I expect your experience re your sleep study is similar to most of us on this forum. We are expected to understand what is wrong with us and to treat ourselves when "they" are mainly clueless and bar us from the information we need to receive effective therapy. So that leaves just you & us. There are some very wise and experienced fellow sufferers here to help.
Experience shows that large leak rates occur when the PAP pressure increases due to the machine detecting the onset of an apnoic event. There is a point where higher pressures cannot be contained by the mask's seal and leaks occur. One can change masks, change masks type, and adjust mask straps, but for really high pressure rises the solutions would seem to be either, 1. set the upper pressure limit lower, or 2. have a close look as sleeping posture. In the case of [1] 12 to 20 is too wide. A pressure range of 8 cms is much to wide, there's no way 20 cms of water pressure can be contained. If 12 is your titrated pressure, then set that as your min. then add 6 (acceptable width) for the upper pressure limit. thus giving a setting of 12 to 18. I believe this to be still too high, but one has to go with what your sleep study determined.
In [2] Sleeping supine (on back) is disastrous for most people. There are many reason why, which I won't go into, but sleeping on your side is advised by most docs. & I subscribe to it too. Mouth leaks with a FFM can be an indicator of any of the foregoing, especially sleep position. Anyway, best of luck & stick with it.
RE: Trying to get this snoreded out - OpalRose - 02-24-2016
Hi FredSchnoyd,
You were apparently titrated at a pressure of 12cm, but what is your current 90% pressure reading?
Leaving the max pressure set to 20 may be too high, but a lot depends on the numbers.
Does your AHI mainly consist of hypopaneas, clear airways, Obstructives, or a combination of?
Check your numbers out, then set the minimum pressure at 1or 2cm below the 90% number, and then bring the max pressure down to 16cm. So we're talking a possible range of 11 to 16.
Hopefully narrowing the pressure range will help with your mask problems too.
Watch for a week or more to see where adjustments need to be made.
RE: Trying to get this snoreded out - trish6hundred - 02-24-2016
Hi FredSchnoyd,
WELCOME! to the forum.!
Hang in there for more responses to your post and much success to you as you continue your CPAP therapy and good luck in getting your sleep problems straightened out.
RE: Trying to get this snoreded out - Ghost1958 - 02-25-2016
If you cant find leaks in the mask awake, there arent any and the leak rate report is clitched.
As far as your AHI going from 3 to 9 thats about par for the course going from a nasal to a ffm and not upping your min pressure.
FFM will normally take a 3 cm boost on the min pressure to hold the same AHI.
As to ffm masks ive never tried the flex fit, but the simplus will seal 20cm pressure and be comfortable doing it. With a full beard.
Test ran mine at that pressure. My actual pressures are 12 to 18.
RE: Trying to get this snoreded out - FredSchnoyd - 02-25-2016
Quote: [2] Sleeping supine (on back) is disastrous for most people. There are many reason why, which I won't go into, but sleeping on your side is advised by most docs. & I subscribe to it too. Mouth leaks with a FFM can be an indicator of any of the foregoing, especially sleep position. Anyway, best of luck & stick with it.
Thanks for the replies.
Very interesting that you mention sleeping supine. Since I've been on CPAP I have been sleeping in my recliner. Two reasons for that. One is that I have very bad back problems and our mattress made them worse. The other is not having to worry about moving around with a mask on. We got a new mattress today and the plan is to try and deal with the mask in it even though I'm a stomach sleeper by trade. Adjusted the pressures to 12-18.
RE: Trying to get this snoreded out - PaytonA - 02-25-2016
I agree with Ghost. If you can not find leaks while you are awake, The mask is capable and adjusted well enough not to leak. I have 2 different masks that both hold 20 cm pressure. The next question is,"What do you do during the night that may cause the mask to leak?" If you open your mouth too wide, like a really big yawn, the bottom seal of a FFM will leak or even fall into your open mouth. Some other facial maneuvers will cause leakage at the bottom of the mask.
I would second Ghost's recommendation of the Simplus mask and add that the Mirage Quattrro is equally good but maybe a tad less comfortable and mine seals even with my beard. I will add that the Mirage Quattro allows more movement of the lower jaw than the Simplus without resulting in leakage although if you open your mouth wide enough you can end up with a mouth full of mask
Either one of these FFMs with a chin strap could be the answer.
Best Regards,
PaytonA