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[CPAP] Mask selection whine
#1
To moderator, feel free to condense, move to another area, or delete if this is too long or off topic.
 
As my username indicates I am giving cpap a second chance, but not holding out much hope.  A little background, 70+ years young and very active.  I have severe but correctable hearing loss (finally found “miracle” hearing aids but off topic), which has made me a light sleeper all my life, prone to waking at slightest touch or turning over.
 
Six years ago I did the whole sleep study routine with all the wiring and straps etc.  Being the light sleeper, I didn’t get much sleep that night, but result was getting the respironics CPAP machine.  Apparently there are no “certified” mask fitters as such, it was “here are your choices, take it or leave it”.  Tried a full face (covers mouth and nose) totally uncomfortable mask, then finally ended with a mask that just put air into my nose (unsure what it called).  I tolerated it for several months before saying @#$% with this and put everything away.
 
Forward to present and my physician suggests going through this sleep study rigmarole again.  Wired up to get a base line, resulting in severe apnea >34.  Returned later for second study to determine cpap pressures.  Technician was rough as a cob, repositioning me several times, turning pressures up higher, putting on a chin strap so tight I almost couldn’t breathe.  Doctor confirmed severe apnea and also I had restless leg syndrome (read up on restless leg and I absolutely have none of those symptoms) would prescribe dopamine (no thanks).  Went to mask place and tried several with negative results, including Dreamware which leaked like a sieve.  Being a side sleeper full face masks kept poking me awake, and worst felt like a squeezing hand, plus “farting” air all night long (keeping wife awake). Bought the special ($65 non-refundable) “comfort” pillow with side cutouts for mask, which gave me a terrific stiff neck the next two days.
 
Fortunately I volunteer at a medical loan closet that had donated cpap masks.  I took several types, sanitized them, and tried them before settling on QuattroAir that had minimal leakage and mostly conformed to my face.  I also tried a nasal mask that seemed to work even better so had mask place order a ($150 non-returnable) Comfortgel Blue nasal mask.  Instead of soft comfort, it was like razor blades cutting my nose bridge and under nostrils, no matter how I positioned it.

As an retired engineer I soon figured out how to access the clinician menu and enabled the AHI parameter and so far the best I can do is 15+ and apparently slow breathing and shallow.  Pressures are 8 and 16,  when at 16 mask makes rude noises.  I do not have any readout software, just what I read from display and google topics.

 
QUESTION:
So here is what I want to know from you experienced users.  The QuattroAir insert (large) is due for replacement, will the comfort version of this be soft and conform and REALLY be comfortable or should I just continue with the non gel version?  I see I could order stuff on line but the clinic is being a donkeys rear saying prescription sent electronically only locally will not give me a printed copy (policy ya know).
 
So, oh wise ones, what say you??     And yes I will have some cheese with this whine. Wink
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#2
Welcome to the forum,

Since you are having a lot of mask problems I'm going to ask you to read the Mask Primer, a lot of hints os mask usage and fitting in there (see my signature)
To be clear you should not be using a chinstrap with a full face mask.  

Many of us use the P10 pillows and I manage my mouthbreathing by taping my lips, there are other solution (see the Mask Primer)

Regarding your treatment we like to have data, I am not familiar with your remstar a-flex auto and it's data capabilities.  I'll suggest you dowload Encore Pro (below link)
http://www.apneaboard.com/forums/Thread-...hines-only
then post the charts that you get.  
Take a screenshot then see th IMGUR instructions in my signature.

This will alow us a better look at what is happening and allow us to better help you.

Fred
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#3
Hi CPAPreturnee,
WELCOME! to the forum.!
It sounds like you have had a rough time with finding a mask.
I sure hope you have better luck this time around with CPAP therapy.
Hang in there for more responses to your post.
trish6hundred
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#4
Thank you for the kind welcome.  I have read the primer especially Jeffery suggestions.  Unfortunately in this town we have several DME suppliers but all seem to carry Resmed or Respironics products.  All have a thirty day trial with just two chances at mask exchanges then tough luck and out.  I tried "interviewing" them to see whats available how they do fittings etc.  All but one DME more or less said go away until we have a prescription then we will talk.  Not even willing to say here's what we carry or let me look.  So went with the one place where the salesperson did spend time showing and talking about various mask options and asking what machine I had etc.  Needless to say she was the place I went to with prescription.  Tried the Resmed full face mask (forgot model) then Dreamware, with little success and returned them (now out of luck with two tries and out rule that these places seem to have).     The loan closet had a mask with really soft green colored foam seal, though was wrong size but felt comfortable around nose tip, so thought that would work for a correct nasal mask.  I even printed off the Resmed nose fit guide and showed the medium would work.  I ordered it through the DME and the mask is labeled S/M (small/medium?) apparently Resmed stopped making S and M individually, with a bluish get that felt stiffer, and this of course was probably why it was so uncomfortable.

None of the DMEs here have a fitting room or way to lie down to try masks horizontally like Jeffry suggests.  You have to take masks and try at home.  Gee even clothing places have dressing rooms to try on pants and shirts.

Somebody could really make some money with a try it and return it no matter how many time it takes.  But I guess it comes down to money and how fast DMEs can move people through (not unlike the fast burger joints).  Has something to do with insurance, even if you pay out of pocket full price.

I will reread the wiki again for more ideas and see if the suggested software download will work.
As one online place said about going on CPAP, "you feel you are being punished for a crime you didn't commit"


Sam "I am, I do not like green eggs and ham"

Thanks
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#5
It sounds like you can use a Nasal Mask, Can you take it a stepdown, try the ResMed P10 Pillows, get the "Fit Pak" which contains 3 different pillow sizes. These rest on, not in the nares of your nose and are essentially leak free.
Supplier #1 (supplier list in the top banner) offers low cost return insurance of most masks, for some this is free.
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#6
Just downloaded the Respironics software and after a few false starts (stupid computer, do what I want, not what you want!! Oh-jeez ).  Used the suggested  help link to get setup and downloaded my data. Holy details Batman, so much data!!  Just started at April first and just wow, will have to print this off and see what I am looking at (good bad, ugly).

Obviously the machine has a built in timekeeping function that is current as machine has been off for six years (have to open spare machine and look for a timekeeping I.C. chip (sorry EE speak)),  Explains why it has so many thousands of hours since it was "born".

Would be nice if you could erase ancient 2011 history except for current 2017 period starting April first.

What a great board! like
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#7
It certainly sucks that you've had a negative experience so far. I would say start by documenting your experiences with each mask in detail. i.e. go back and find the model of the resmed mask you tried and note exactly what didn't work - leaked at high pressure, or it farted in your mouth area or whatever. Once you have that, you could bring it here, or some of the online CPAP vendors have call lines where they will talk you through things. Supplier #1 on the list apneaboard.com/forums/Thread-CPAP-Supplier-List has what looks like a dedicated line for this. They also offer return "insurance" which makes trying out masks a bit less expensive.

What was it that made you say Eff it after several months of tolerating it 6 years ago? You mentioned that you had some limited success "with a mask that just put air into my nose" before you put your machine away. That sounds like "nasal pillows" to me. Of which the Resmed P10 seem to be the most popular around here. They seem to have improved a lot over the last 6 years, so maybe give that a try.

Finally, your pressure could be wrong if you don't tolerate in-lab studies well. Posting your processed machine readouts might help the helpful folks here dial in your pressure which might make a given mask more tolerable.

Good luck!
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#8
(05-03-2017, 11:45 AM)bonjour Wrote: ......
Supplier #1 (supplier list in the top banner) offers low cost return insurance of most masks, for some this is free.

I ordered my current mask from Supplier #14
30 returm/exchange
bad part is, its out of pocket.

14 nights wearing this mask. I'm keeping it.
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#9
Is the machine you are using a System One series, or the older M-Series. If the data is a SD card, then you have the System One and can use SleepyHead. Much easier to use this software and understand what is going on, and you can limit the data imported by date (File/Preferences/Import, and just check the box and fill in a date). It would be a lot easier if you can share data with us as shown in my first two signature links.

With Sleepyhead you can offset the time to be correct. The Philips Respironics machines do not have a provision for setting time, and are set to GMT by the factory. Do not try to correct the time in the machine.
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#10
(05-03-2017, 01:45 PM)Sleeprider Wrote: Is the machine you are using a System One series, or the older M-Series.  If the data is a SD card, then you have the System One and can use SleepyHead.  Much easier to use this software and understand what is going on, and you can limit the data imported by date (File/Preferences/Import, and just check the box and fill in a date).  It would be a lot easier if you can share data with us as shown in my first two signature links.  

With Sleepyhead you can offset the time to be correct.  The Philips Respironics machines do not have a provision for setting time, and are set to GMT by the factory.  Do not try to correct the time in the machine.

Yes System one.
Will check out sleepyhead software
Thanks
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