Are these settings OK?

[multicast]

I'm taping with great success. Just give it a try to benefit from your P30i; I'm using the same on.

[BobbieM]

Thanks. I really like the nasal cushions. Much more minimalist. And because I move about a lot in my sleep, it’s more comfortable than lugging around a full face mask.

[BobbieM]

Multicast, I did not realize FFM refers to full face mask. I thought it was short for some fancy new gadget lol.

[BobbieM]

Hi everyone. I am posting to this old thread as some of my previous charts are here and I thought it might be helpful to keep everything in the same place. But let me know if I should have started a new thread.
 
I switched to VAuto about a year ago from Dreamstation (just before the recall) and at the same time switched over to the new minimialist masks in the Airfit 30i series. I was just getting the hang of the Dreamstation and CPAP therapy when I got a present of the VAuto from my kids. Bad news is: I just haven't been able to get the new machine and new masks right - I often wake up feeling not rested, sometimes having headaches, sometimes with a runny nose deprending on the previous night's pressure on the machine, and I have found that the average pressure which used to be around 10-11 on my previous Dreamstation and mask now registers 13-14 and that the AHI has risen from around 1.5 on my best days a year ago to an average 2.5 these days. My oxygen levels based on a home use oxymeter has dropped from around 97 to 93-94. I've had a checkup and am otherwise in good health and a good weight.

MASKS: I've experimented with the nasal, pillow and full face mask in the AirFit 30i series as well as the Dreamwear pillow mask. I've even dug out my old Philips EasyLife nasal mask to see if the problem is a mask problem. I always get the red devil face for mask fit when I use the nasal or the pillow but the full face mask gets the machine's approval. I find the mask pressure using the full face uncomfortable and wonder if mask pads are the answer (or have I over-tightened the mask straps)? I prefer the pilow mask which is more comfortable but it has more of a leak problem than the full face mask.

PRESSURE: Some nights, the pressure is very high and is uncomfortable enough to wake me even though the machine records the pressure at only about 14.5 which does not seem that high. Anyway, I tried turning down the maximum pressure to 14 and to 12 for a couple of nights. But nothing I do to the machine seems to make much difference to my lack of rest. 

What am I doing wrong? I am attaching screen shots of three nights with three settings and face masks. I would be grateful for any help.

[Gideon]

I see likely two different issues.
On the first and 3rd chart you are showing obvious though mild clustering of obstructive events. This usually indicates a form of positional apnea that forms from tucking your chin. Hanging from a DS to VAuto would have nothing to do with this.
The fix is either a pillow modifications to a flatter, less firm pillow or using 1 vs 2 pillows to keep your neck straighter when you sleep or use a well fitted soft cervical collar, see the wiki linked in my signature,, to keep your neck straight.

The second issue is your flow limits are a bit high, but mostly at the same time as your positional apnea noted above.

IF the flow limits were not high mostly coinciding with the positional apnea I'd suggest a bump in PS to 5, but I'm not, at least until you have cleared up the positional apnea. Clear that up then repost and we can take it from there.

If it weren't for your symptoms I'd say to leave well enough alone.

[Sleeprider]

I agree with Gideon. I responded to some early charts when you first started using the Vauto in this reply http://www.apneaboard.com/forums/Thread-...#pid411307 You increased the minimum EPAP pressure and some of those issues have resolved nicely. You still have a positional component that causes the clusters of OA to occur. Your next step is to look for a solution to prevent chin-tucking.

[BobbieM]

That's great. Thanks for getting back so quickly. Two follow-up questions: 1) What about the masks? I much prefer the nasal or pillow to the FFM but I'm worried that my problems are being caused by mask leaks (which means I wake up unrefreshed). The machine often shows the red devil face when I use the nasal or pillow masks. 2) Is an increase of pressure to 13-14 cm anything to worry about? Is the machine compensating for the mask leak? Or is my apnea worse?

Three questions actually. I've been using these aeroplane neck pillows rather than a proper cervical collar. Clearly it's not working. Amazon has a lot of choices. Any recommendations based on your experience? 

Thanks.

[frankwil]

One observation is that it seems you are still having a substantial problem with mouth leaks. Did you ever try taping as a previous poster had suggested?

[BobbieM]

Thanks yes I did but only on and off as it's uncomfortable. Can you tell from the charts whether it is a mouth leak or mask leak? I presume with a FFM, there is no need for a tape?