AHI# increasing/mask problems?

[pwgphoto]

Nine nights using my CPAP now. Things seemed to be going pretty well other than the sore I got on my nose from my AirFit P10 Pillow after the first two nights. I switch to my Wisp nasal mask and things seemed fine. My AHI#s were in the 3-4's until two days ago when they jumped into the high 5's and 6.

I had noticed I seemed to be waking up more because it felt like my nasal mask was riding up and blocking my nostrils, if that makes sense, and I couldn't get air. So I would mess around with my mask and straps until it felt right again and the air seemed flowing. I am using the large mask piece of the set because according to the sizing chart I am borderline S/M and large, I am right on the edge. I wonder if the XL would be too way big.

I like wearing my AirFit Nasal Pillows due to the minimal head gear and mask size, but they have been hurting my nose. I have the medium pillows and my right nostril has been having pain and that is where I got my sore when I first started.

I had increase the starting pressure from 4 to 7 over the period due to me feeling like I have not gotten enough air when starting out.

Any suggestions? Thanks

Mon 11-2 by Paul Gillespie, on Flickr
Tues 11-3 by Paul Gillespie, on Flickr
Wed 11-4 by Paul Gillespie, on Flickr

[OpalRose]

As far as nasal pillows, the rule of thumb is (and don't know how true this is), but use one size up than what you were fitted for. I can use a xsmall or small, with no difference in AHI.

I also use nasal gels, less chance of developing problems.

Are you using the DreamMapper numbers instead of machine numbers??? I was just reading your other thread. I think it's a bad idea to depend on DreamMapper instead of what your DreamStation is showing.

I may be wrong, but it's your therapy. Call your DME back until you get an answer on why you are getting different AHI numbers.

In comparison with the three days you are showing here, what AHI does the DreamStation give you?

[pwgphoto]

I will have to check later for the machine #'s, but I can say they are all about double of what the app says, which confuses me, as you know. If the total number of CSA's and OSA's is correct in the app, I would think the app # would be right. The machine only gives the AHI#. I will post later when I get home from work. As far as contacting the DME, that has become my new Monday ritual, it's my only weekday off. Are nasal gels replacements for the pillows in my pillow mask? Will they work with the AirFit P10? I may try the larger pillows tonight.

Thanks
Paul

[OpalRose]

I will have to check later for the machine #'s, but I can say they are all about double of what the app says, which confuses me, as you know. If the total number of CSA's and OSA's is correct in the app, I would think the app # would be right. The machine only gives the AHI#. I will post later when I get home from work. As far as contacting the DME, that has become my new Monday ritual, it's my only weekday off. Are nasal gels replacements for the pillows in my pillow mask? Will they work with the AirFit P10? I may try the larger pillows tonight.

Thanks
Paul

The nasal gel I use is called Ayr nasal gel. You can buy almost anywhere.
Also try Lansinoh Cream. You can find it in the Baby isle of any drugstore.
It's great for healing and preventing those sores.

I had to laugh at your comment about DME. I still do battle with my DME and I have been dealing with them for over a year now.

One thing you need to be aware, and you will realize soon enough is that you know more that they do! They just like to show some authority and act knowledgeable.:grin:

[Napmeister]

My nose only hurt for a couple of weeks or so, .. and then the skin toughened up.
You can use a gel if the pain is too much but mine only hurt when the pillows moved or I touching the nostril area. Kept my hands off the raw area and the skin became less sensitive over time. Hurt slightly when I'd put the pillows in at night but once they were seated the pain quit.

Don't know anything about the Respironics equipment but think Sleepyhead gives more detailed info. Sometimes the AHI number is not indicative of the sleep quality. Example: I can have lousy numbers with the majority of AHI's basically happening in a 15 min. period but sleep quality for the remainder of the night being excellent.

G'luck

[pwgphoto]

Well I switched the Wisp Mask to an extra large last night, while it no longer felt like it was blocking my nostrils from getting air, my AHI #'s was its highest since starting CPAP at 10.8 on my machine. My DreamMapper app says it was AHI# of 8.3. I did only get 6.5 hours of sleep last night. I think some of it may be from having problems when first going to bed. I sometimes have trouble getting a deep, cleansing breath while going to sleep and repeatedly try, sometimes mouth breathing to try and get more air.

[justMongo]

Paul: I suggest turning off the ramp. Starting at 5 cm-H₂O for 15 minutes is counterproductive when the auto pressure range is 7 cm-H₂O to 11 cm-H₂O.

BTW -- Nice Avatar.

Kindest Regards,

Mongo

[pwgphoto]

Thanks Mongo. While my screen shot says Ramp "On" I have not been pressing the Ramp button when I turn on the machine. I was under the impression that I was not using Ramp. When I press the main on button, my pressure usually reads 7. I could probably even bump that up a bit and not be bothered. My Dr and DME originally had my range/machine set up between 4-11 and I upped it to 7 becuase I felt like I was suffocating when starting out each night. I am wondering if I should increase the pressure max to 12. MY 90% has been 11 for a while.

How do doctors and DME's usually react when they find out you have been changing settings on your own?

Paul

Paul: I suggest turning off the ramp. Starting at 5 cm-H₂O for 15 minutes is counterproductive when the auto pressure range is 7 cm-H₂O to 11 cm-H₂O.

BTW -- Nice Avatar.

Kindest Regards,

Mongo

[DariaVader]

How do doctors and DME's usually react when they find out you have been changing settings on your own?

Paul

depends. My Doc is bemused by the amount of information I have gathered, but has cautiously agreed with every change I made and requested that I discuss all changes with him either in our appointments, or more commonly via the "mychart email" function that the organization provides. The RT was more like "Don't you dare" but I have never talked to her again after the day I picked up the CPAP and no one has ever mentioned that they saw a change when I call for supplies. They really only look at compliance and only care about getting paid by your insurance.... They *have* to say you may not as CYA.

Some docs get bent if you "do your own doctoring". I find I cannot keep that kind as part of my group of professionals.

[justMongo]

Thanks Mongo. While my screen shot says Ramp "On" I have not been pressing the Ramp button when I turn on the machine. I was under the impression that I was not using Ramp. When I press the main on button, my pressure usually reads 7. I could probably even bump that up a bit and not be bothered. My Dr and DME originally had my range/machine set up between 4-11 and I upped it to 7 becuase I felt like I was suffocating when starting out each night. I am wondering if I should increase the pressure max to 12. MY 90% has been 11 for a while.

How do doctors and DME's usually react when they find out you have been changing settings on your own?

Paul

Many people say they feel like they are suffocating when the start pressure is 4.

Since auto machines are able to differentiate between clear airway apnea and obstructive apnea, the maximum pressure can be bumped up. The machines will only use the extra headroom if needed to suppress: snore, flow limitation, HA and OA. It will not increase pressure in response to a CA.

As with many things; don't make too many changes at one time; and make small deltas. If you wish to increase the 11 cm max, bump up to about 11.5 cm. (Some machine can only be adjusted on 0.2 cm increments.) See how that works out.

As for the doctors -- the reaction varies. Some go berserk; others just ask how it's working out.

The DMEs -- They wouldn't know a single lens reflex from a pinhole camera (a little photography analogy!)

Kindest regards,

Mongo