Aircurve 10 bilevel and Dreamwear

[smiledog]

Thanks Sleeprider.

[quiescence at last]

Did you perhaps step on or roll over on your mask?  it may be springing a leak from a different joint than you think.  Also, check the hose.
Can you ask for new replacement pieces?  Perhaps, just maybe, one is faulty.

I use a full face mask and use a soft but sturdy cloth pad between the mask and my face.  It allows more leakage, but is also more comfortable with slightly higher strap pressure, and cuts down of facial flatulence.  Do they make such a thing as a pad for the nasal pillows?

I bet you already have a chin strap and are using the tongue to top teeth (tttt) method for reducing or eliminating mouth leaks.

Good luck.

QAL

[smiledog]

Thanks. Any advise is helpful. I don't have a chin strap, but I did buy a cervical collar. I used it last night for the 1st time and it helped with the leaks, didn't stop them but helped. My AHI's are low, so that's a good thing. So I'm getting some use from the machine. I'm a full bearded man and I don't want to go to a full face. I used one years ago (20-25 years ago) and stopped because of the hose in the front , and the noise the machine made. I didn't have a beard back then. I'm not ruling out a full face, just trying to find a way to get the Dreamwear to work. It worked great when I was on the Resmed Airsense 10, set pressure 11. Then after the 2nd sleep study the doc said I needed a bilevel set at 13 -17. I do realize times have changed and so has the equipment. The Resmed Aircurve is nothing like the beast I had year's ago. I also have an eye issue that requires me to wear a mask over my eye's at night. So I feel like h%ll I'll just put a bag over my head. . I'm going to give the collar a week or so, If I can't get the leaks under control I will be looking for a chin strap. I'm open to any ideas. So any body that has a thought I'd like to hear it. Thanks Again.

[smiledog]

I want to thank everyone on Apnea Board. After doing a lot of reading and getting support from strangers all with the same goal of getting the best results from our machines. I have learned a lot. I finally got a green  smiley face on my leaks. I purchased a cervical collar and have been trying to train my self to keep my tongue against my front teeth.  I started the collar 3 nights ago and every night the leak rate got lower. I'm going to use it for a month, and then try not using it.  
                                             

[Solipsiste]

I use the Dreamwear too, and tried about 25 different masks, I can only return to it, it's so unique... My machine is the Resmed Airsense 10. I just want to tell you something strangely contradictory with both your experience and what Philips says. If I use the chart, I should use a "small" head. Since I felt that it was a little too narrow (opening), I used the "medium" for over 6 months. No leak, it was perfect. Recently, I tried using the small again and felt it was too narrow again, so just to try, I used the Medium-wide... It was fine. So I tried the "large" (remember, the chart said "small"). I have been using the large head for a week. I see no more leak in Sleepyhead with it that with the medium, and I have the impression that I breath through an "air torrent" (!!), since the opening is so large. Of course, I am mostly a back sleeper, it could be the reason... Also, I believe the Medium-Wide is wider than the large (but not as deep).

I tried the P10 for weeks and could not sleep well with it because of a burning sensation in the nostrils.

[smiledog]

Thanks I've gone back and fourth with the medium and large. The large was working fine until the doc changed me to the Resmed AirCurve 10 VAUTO. I went back to the medium and still leaking badly. I've been wearing a cervical collar for 4 nights now and my leak rate has dropped . Last night I felt I slept well. my leak rate dropped to the lowest since I started this machine, but my AHI's went up last night. They are still in a acceptable range. I'm wondering now if my AHI is higher because of less leaking. This is my first time using IMGUR so I hope I'm doing this right. Any help is appreciated.

[Solipsiste]

I find it quite curious that the machine should affect the leak rate, unless your pressure is largely different with the Aircurve than it was with the Airsense?
Your pressure metering seems off chart. Also, I am surprised by the inspiration/exp time. I have something more in the range of 5/5 med. Those leaks are indeed quite important.
Have you considered returning to the Airsense?

[Sleeprider]

Solipiste, Smiledog is using an auto bilevel in fixed bilevel mode with IPAP at 17 and EPAP at 13, so the pressure lines are the top and bottom of that pressure chart. The inspiration/expiration times are normal with longer exhale than inhale. We see a lot of people with what is considered inverse I:E ratio.

Normal I:E ratio at rest and while asleep is 1:2 or less. On exertion the I:E ratio is 1:1. Inspiration is normally an active process (requiring work). Expiration is passive, and usually longer than the time required for exhalation, resulting an a no-flow period.

Smiledog, any interest in going to Vauto mode? You could use lower pressure most of the night. If so, just change to vauto mode with EPAP min at 10, IPAP max at 20 and PS at 4.0. Those OA clusters at the end of the night look to me like neck and head position, where your chin may be tucking toward your chest and cutting off the airway.

[smiledog]

SleepRider, I've change it to VAUTO over a week ago. I didn't lower the pressure because of  possibly being non compliant and my insurance company. I really don't know what they can do other then making me pay the full price of the machine. I did for the first time last night since I've been on this machine turned to my side. I've been wearing a cervical collar for the last 4 nights and my leaks have dropped down. I spoke to my DME about me adjusting my own pressure, they said I can't do that IT"S A PRESCRIPTION! They didn't say a word when I upped my pressure on the AirSense 10. I really wonder if they pay attention to any numbers other then $$$$. I go back for a follow up on the 5th. I've came up with a list of questions like why a bilevel machine? why was it set to S mode and not auto? Why won't the Doctor return my calls? I am doing my best to be compliant and polite to them. At this point my wife is asking me why are you being so nice, "It's not like you" What she means is I normally start off with people nicely but after several calm calls not being returned at all and we are spending our money for this service, By now I would be sounding off and yanking someone through the phone. As you already know I've been fighting bad leaks, the collar seems to be helping. That's another question. If you can think of any other questions I'd like to hear them

[Sleeprider]

Compliance is hours per day on the machine. You need to use the machine for 4 or more hours at least 21 days in a 30 day period during the first 90 days. The settings on the machine? They are just trying to intimidate you. It seems to me you got a bilevel, but there is not any supporting titration information to support the "prescription". No reason not to use Vauto mode with a lower minimum EPAP and see how the machine responds.