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Airsense 10 hybrid mask setting
#1
Question 
Airsense 10 hybrid mask setting
[attachment=3414]I am new to this forum (and extremely happy that I found it) and have been on CPAP for over 14 years (had a doctor sitting next to me on a plane wake me and tell me I had a serious problem).  I was not aware of the leakage problem till I started using the new PAP and am attempting to minimize the problem.  I have other complicating issues affecting my sleep especially a large range of allergy problems so I switched from nasal to the hybrid mask and my events/problems went through the roof using the full mask setting on the PAP machine.  Looking at other posts and my readings it appeared that the full mask setting was pushing the pressure up too high and causing events so I reset the PAP mask setting to Nasal and the readings are more acceptable (at least AHI under 5 which is hard for me to get to).  Max pressures are now topping out about 1.5 less than with the mask set on full face.  Is this an acceptable or wise choice to make for the Airsense 10 mask setting?
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#2
RE: Airsense 10 hybrid mask setting
Hi TexasTiger,
I will let someone else answer the question of mask setting with a hybrid mask, but nasal seems acceptable since you've noticed a difference.

A few things just looking at your graphs, which call for a slightly higher minimum pressure.  Your flow limitation and snores are high, and the machine will react to these by raising pressure.  In order to help with FL and snores, the minimum pressure should be raised.  I would dial it up to start at 10cm, this should also help with the obstructives and hypopneas.  

The other thing I see on the pie chart are clear airway events.  In order for those to show up on your events graph, go to the bottom left of the daily screen, and you will see a drop down box for flags.  Click CA on so that these events will show up.  

I would also lower the EPR setting from 3 to 1, as this seems to cause more clear airways in some.  

You should see a difference with these changes.

An AHI under 5 is considered clinically treated, but when you start to look at SleepyHead charts, you can correlate the rise in FL and snores and Obstructives with the rise in pressure.

Leaks aren't too bad, you could be breathing from your mouth, or your jaw drops.  Many here have tried using a chin strap, but another alternative is to use a "soft" cervical collar.  This keeps the chin/jaw from dropping, and keeps the neck aligned.

Let us know of your progress.
OpalRose
Apnea Board Administrator
www.apneaboard.com

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#3
RE: Airsense 10 hybrid mask setting
(04-29-2017, 12:15 PM)TexasTiger Wrote: I am new to this forum (and extremely happy that I found it) and have been on CPAP for over 14 years (had a doctor sitting next to me on a plane wake me and tell me I had a serious problem).  I was not aware of the leakage problem till I started using the new PAP and am attempting to minimize the problem.  I have other complicating issues affecting my sleep especially a large range of allergy problems so I switched from nasal to the hybrid mask and my events/problems went through the roof using the full mask setting on the PAP machine.  Looking at other posts and my readings it appeared that the full mask setting was pushing the pressure up too high and causing events so I reset the PAP mask setting to Nasal and the readings are more acceptable (at least AHI under 5 which is hard for me to get to).  Max pressures are now topping out about 1.5 less than with the mask set on full face.  Is this an acceptable or wise choice to make for the Airsense 10 mask setting?

The experts may say differently.  My very amateur opinion is that I care about results.  How do I feel.  If the number is low that is a plus.

I would not worry about lowering the number as long as I feel good and especially if the numbers got better. 

I might hesitate increasing them without a doctors okay or learning a lot more about what is really going on with my lungs.
OTOH if you are healthy I don't think it is possible to make the pressure so high as to cause a problem.  
That said, many folks here seem quite happy to keep increasing the values if that helps their problem.  

A full mask needs more pressure to allow for the volume of space in the mask.  So if there is no setting for your mask you have to compromise somehow.  Either change the mask type or change the pressures that are set as nominal or some of both.
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#4
RE: Airsense 10 hybrid mask setting
I'm new too, but I would think the obstructive events are there and the machine is chasing them. I would set the machine on what mask you use. I may be wrong, but I think mask setting adjusts the leak rate, at least that is how it appears to me, on my S9.

My pressure settings turned out to be 15-20. I need what I need and I got use to the pressure quick enough. It will be interesting to see what the experienced people think. If it was my chart, as you are hitting the pressure ceiling, I would open the max setting to 17 and perhaps increase the minimum to 10 or 11, to see if that pressure stopped a few of the OA and H from happening in the first place. Leaving the auto function to chase when rolling onto your back etc.

I would keep an eye on your tidal volume in the left hand column, as 340 is a bit low, I would bring this to your doctors attention.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#5
RE: Airsense 10 hybrid mask setting
Hi TexasTiger,
WELCOME! to the forum.!
A hybrid is considered a full-face mask, (FFM).
Hang in there for more suggestions and answers to your question.
Good luck to you as you continue your CPAP therapy.
trish6hundred
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#6
RE: Airsense 10 hybrid mask setting
Many thanks to all for their replies and suggestions.  Last night tried increasing min. pressure 1 cm. and the AHI more than doubled plus the CAs up 4X.  Increased pressure made the leaks hard to control also.  Going to try different nasal pillows in the hybrid mask to better control the leaks and going back to the min. pressure of 9.0 to see if I at least get back to AHI under 5.  Any/all suggestions will be greatly appreciated.  Hope to not have to go back to doctors who just concentrate on AHI and leak data....

Note - my mask is a hybrid - full face style but only small mouth cover with pillows - half or less the volume as a complete full face mask - PAP only has selection of full, nasal, or pillows and this is not any of those choices so still sorting out the best PAP setting for me.

Tried to attach a chart but out of quota(?) - suggestions to get around this issue?
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#7
RE: Airsense 10 hybrid mask setting
Looks like I cannot show the results till I have 4 posts - guess you'll have to  wait to see the bad results.....

Here's another post - hope this helps me get the results posted....
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#8
RE: Airsense 10 hybrid mask setting
Huhsign


should be my 4th post - hope this let's me post the results.....

guess not...
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