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Welcome to my life - Last Night... - Peter_C - 03-10-2014
As you may or may not know, I've been a hosehead (I keep say 12 yrs..as the years keep going by-UGH) I think, close to 18-20 years now - am bad on dates as a whole, mid 1990s...anyhow..
A kind fellow forum member loaned me the needed parts so that I could track my data in Rescan. I've been doing this since last NOV. Around DEC I added a recording Oximeter to the mix as well.
Due to some of my 'many issues' I am in Pain MGNT, and take opiate pain meds daily - yes, I know this does not mix well with OSA - ...
Long story short, I've learned that in order to control my leak rates, I must sadly use a full face mask (to be clear, a mouth-nose combo mask). And with a FFM, I am able to get great numbers with my machine set for 6+7=13 (EPAP+PS=IPAP), then I leave it open-ended on 'auto' with a max of 25. With these settings I am routinely seeing an AHI of '2' to '8', with very low leak rates.
The problem is I hate using a FFM~!
So, last night I switched the setup to my 'Wisp' nasal mask, made changes to my machine to reflect the different mask type, set myself up with the Oximeter and went to bed.
Woke up dead tired with a sore neck. Just knew it was a 'bad night' before even looking at the data.
AHI 30.7
Leaks all over the place with a 95% of 31
My O2 normally is around 90-92, with less than 4-5 minutes under 88%. Last night I still maintained 91%, but had 18 minutes under 88%~!
In other words I need to use a FFM. FYI - this is the third time I have tried switching back to a nasal mask, with the same results.
Why don't I like my FFM? It's harder/more effort to put on,it tries to leak into my eyes, I can't talk to my wife or dogs with my mask on. If, when my pressure goes up (seldom, but happens) the mask starts farting and bypassing. And, sometimes in the whee hours of the morning the FFM seems to completely lose it's seal~~ causing me to wake up and futz with it.
FFMs are spendy, and I must pay for everything, so while searching for a better FFM sounds like a good idea, my fixed income would disagree.
Another night in the life of a hosehead...
RE: Welcome to my life - Last Night... - PaytonA - 03-10-2014
I worked with an F&P FFM for 6 months or so and kept getting the leaks into the eyes which woke me up. Went to nasal mask but found out that I could not control the mouth leakage. My leakage rates were terrible even with a chin strap. I have now gotten to a sleep doc and changed DME and have a Resmed Mirage Quattro. I am using as VPAP and my pressures are currently IPAP=20, EPAP=18. This mask has improved my leak rates to very close to acceptable. It does not leak into my eyes. I understand your financial concerns but I thought I would tell you my experience for whatever it is worth. Yes I can not do much talking with it on but I am happy that my leakage is better and my dry mouth is reduced. I am still working on tuning the fit and it seems that I need to cinch it down pretty tight to keep down the leakage but with the F&P I tried many combinations of tightness and none of them kept it from leaking. I am also using the same VPAP that you have listed.
Best Regards,
PaytonA
RE: Welcome to my life - Last Night... - herbm - 03-10-2014
There is the "Innomed Hybrid" which bills itself as an FFM but is really an ORAL mask plus nasal pillows.
What is the deal with the Wisp? Mask leaks or mouth leaks or both?
If it is only MASK without your mouth covered then why won't pillows work? (You can try an Airfit P10 with free return insurance for $100). The Pilairo Q is even cheaper and thus might offset the extra cost of adding return insurance to that one.
If it is mouth leaks then MAYBE the Innomed Hybrid will work for you. The pillows are easy to seal and the "mask" part is no worse than others and only covering your mouth.
It is no where near as comfortable as the Airfit, but it isn't bad.
It's my backup mask for any time my congestion wins the battle of the clear nasal airway.
Another question: What is it about the nasal mask that stops you from controlling the leaks?
I would suppose you have already investigated those issues with people here (or elsewhere) who use the Wisp or something similar?
Some people have "deep noses" or "deep eye sockets" and the standard nasal masks can't conform easily.....
RE: Welcome to my life - Last Night... - comatose - 03-10-2014
+1 for the nasal pillows.
I started with a nasal mask, had problems with leaks so I went to a full mask and was only able to keep my leaks in check with the straps very tight. I that felt my cranium would be thought to be an alien scull when dug up by an archeologist some time in the future.
I was dubious when I bought my 1st nasal pillows, to me I thought that they would be damned annoying but I could see that the sealing circumference is so much smaller and my research found that people that used them had great success.
I was so happy with my extremely reduced AHI that I lashed out and bought a set of the Airfit P10, as others have said, often you don't even know that you have them on, or even feel the pressure.
I ate a packet of chockie bickies last night, yep I gutsed the whole packet and had my highest AHI since I started using nasal pillows, 4 weeks, it was 1.2.
Peter, if you can breathe ok with a nasal mask why not try pillows?
I use lower pressure now and have a much reduced AHI,
good luck mate.
RE: Welcome to my life - Last Night... - me50 - 03-10-2014
Peter, I sent you a PM
RE: Welcome to my life - Last Night... - brianwood619 - 03-11-2014
F&P simplus was the answer tommy full face mask needs. I used the hans rudolph for a long time but the simplus is way more comfortable and hardly leaks with proper fit and adjustments
RE: Welcome to my life - Last Night... - drgrimes - 03-11-2014
I'm not sure you gave the nasal rig a long enough trial period. I think all of them require some time to get going properly. Is it the nasal mask leaking or are you blowing air back out your mouth?
Nasal pillows seal really well when fitted properly. Initially I was over tightening. The fit should be fairly comfortable maybe even a bit loose when not powered on. When pressure comes up they inflate and seal to the nostrils. I would recommend experimenting with the nasal mask/pillows fit while you are awake-much easier than struggling in the dark.
If the leakage is through your mouth, try a chin strap or, I use a pad between my chin and chest. Funny but it seems my mouth has "learned" to stay shut. I hardly need the chin pad anymore.
RE: Welcome to my life - Last Night... - Peter_C - 03-11-2014
I love pillows, with the Wisp a close second. It's mouth hissing/leaking that is my bane. I'll self-talk and it'll get better for a day or two, then worse, and it's just too out of control - chin straps and me can't get along - been there, tried that
The Simplus is the most comfortable so far - but minor eye leaks bug me, and early AM seal losses wake me.
The Quattro works if tight, but isn't comfortable.
The Flexifit 321 seems to leak too much all of the time.
It's just the need to keep trying masks til I find "the one" - that works for me...
It is a shame as the Wisp is so light and easy, and with pillows practice and time would be great - I breathe best with pillows - need less pressure too.
Duct tape sounds more and more reasonable - hehe
RE: Welcome to my life - Last Night... - me50 - 03-11-2014
(03-11-2014, 11:29 AM)Peter_C Wrote: I love pillows, with the Wisp a close second. It's mouth hissing/leaking that is my bane. I'll self-talk and it'll get better for a day or two, then worse, and it's just too out of control - chin straps and me can't get along - been there, tried that
The Simplus is the most comfortable so far - but minor eye leaks bug me, and early AM seal losses wake me.
The Quattro works if tight, but isn't comfortable.
The Flexifit 321 seems to leak too much all of the time.
It's just the need to keep trying masks til I find "the one" - that works for me...
It is a shame as the Wisp is so light and easy, and with pillows practice and time would be great - I breathe best with pillows - need less pressure too.
Duct tape sounds more and more reasonable - hehe
I don't remember if you said you tried chin straps before or not. My new DME sent me a chin strap without asking me which one I use. I got a Resmed and I laughed when I opened it. I thought that it wouldn't keep a flies mouth shut IMHO; it seems so flimsy but maybe it is because I got used to the one I always use and the Resmed is definitely flimsy compared to it. But, I don't get along with Resmed headgear either and that is why I can't use any Resmed masks.
I was good at answering the phone with the mask on and nobody seemed to have any trouble understanding me or if they did, they never said they did. Leaving voice mail messages with the mask on and the machine running is another story lol
Has anyone tried a resmed chin strap?
RE: Welcome to my life - Last Night... - DocWils - 03-11-2014
Peter,
have you looked up hybrid masks other than the ones you have tried? There are a few dozen types out there that claim to be very effective, and one might be a good fit for you. Otherwise, maybe you should go with the full pressure masks, like in the old days - they resembled the masks on fighter pilots high altitude rigs, but were very comfortable. One of my mates uses one still (don't know what make, but he got his in Russia, so I don't know if it is available at all in the West) and says it works well for him. On the other hand, he has a broad, flat face, and that type of mask might sit better on such a face. I am very lucky that nose pillows worked for me from the get go. And I can also talk with it going full blast (the advantage of having been a scuba diver and trained singer - they let me chose how I breath for each activity).
The other thing is to watch what you eat in the evening - keep phlegm producing stuff out of the diet, as it only makes your breathing more difficult, no matter what type of mask you use.