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Changed masks, AHI went up. So confused, help?
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kameeleun Offline

Members

Posts: 14
Joined: Oct 2015

Machine: resmed s9
Mask Type: Nasal pillows
Mask Make & Model: swift fx (for her?)
Humidifier: yes?
CPAP Pressure: 6
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location:

Post: #1
Changed masks, AHI went up. So confused, help?
Hi there,
I posted an intro thread a couple days ago and have been downloading my machine's data daily ever since.

From looking at the data on Sleepyhead I've been noticing some patterns, and it finally convinced me I need to try a full face mask. So I took the plunge and bought one, a Quattro original, last night was my first time using it.

I'm still new to all this, and was hoping someone could help me figure out what information this mask change should be revealing.

First off, my AHI went up. Now, I had mentioned in my previous post that my AHI is always really low but I'm still very sleepy, and that I'd played around with Sleepyheads 'user defined events' to flag some 'mini apneas'. Well I still have a lot of mini apneas, but now I also have more officially flagged apneas. Also, still almost all centrals. Here's some info:

Two days ago with swift fx:

Large Leak 0.00%
Clear Airway 0.88
Obstructive 0.44
Unclassified Apnea 0.00
Hypopnea 0.44
User Flag #1 0.88
User Flag #2 0.73

Total time in apnea 00:03:19


Last night with Quattro:
Large Leak 0.02%
Clear Airway 1.54
Obstructive 0.14
Unclassified Apnea 0.00
Hypopnea 1.26
User Flag #1 1.82
User Flag #2 0.14

Total time in apnea 00:08:03


Quite frankly, I really just didn't believe what the machine was telling me before wtih regards to my AHI or my leak rate, but I'm not sure what to believe after this change. One thing I already know is that this was certainly one leaky mask, so I will have to exchange it and try to get a better fit, but my jaw pain is already way less so I think my nighttime clenching was mask related, and that the full face mask is the way for me (at least for now...).

Does anyone have any thoughts on all this? Is my AHI increase a result of the machine being able to detect apnea more reliably or is my AHI increase a result of the mask itself?
11-03-2015 11:42 AM
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PaulaO2 Offline
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Moderators

Posts: 8,065
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #2
RE: Changed masks, AHI went up. So confused, help?
First, did you change your machine to reflect that you had changed masks?

Second, it is normal for AHI to increase after changing a mask. Different variable was added.

Third, it is only one night. You are looking for trends. You cannot use a single night of data as a determination point.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
11-03-2015 07:14 PM
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kameeleun Offline

Members

Posts: 14
Joined: Oct 2015

Machine: resmed s9
Mask Type: Nasal pillows
Mask Make & Model: swift fx (for her?)
Humidifier: yes?
CPAP Pressure: 6
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location:

Post: #3
RE: Changed masks, AHI went up. So confused, help?
(11-03-2015 07:14 PM)PaulaO2 Wrote:  First, did you change your machine to reflect that you had changed masks?

Second, it is normal for AHI to increase after changing a mask. Different variable was added.

Third, it is only one night. You are looking for trends. You cannot use a single night of data as a determination point.

Hi, thanks for your response. I did change my machine settings to full face mask.

Of course I'll continue to download my data and look for longer term trends, I'm guess I'm just looking for guidance about what changes from changing the mask can and can't tell me. For instance, is there another variable I can look at that can tell me if the mask itself is causing the increase in apnea or if it is just the case that the apnea is now better reported by the machine.

I also need to decide relatively quickly if I want to exchange the mask for a different one, because of the particular return policy, so I'm curious if these things are an issue of all full face masks or if I just don't have the right one for me yet. Alternatively, if this is a common thing and often settles down in a week, that's important to know before I run back and exchange it.

Ultimately I just feel relatively unknowledgeable about a lot of this stuff, even tho I know the basics about sleep apnea and CPAP, so I was hoping people here would help me out with more of the nitty gritty details because you all have been dealing with this stuff firsthand for a while.
11-04-2015 08:33 AM
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PaytonA Offline
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Monitors

Posts: 3,013
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #4
RE: Changed masks, AHI went up. So confused, help?
First, it is not unusual for Centrals to increase a bit temporarily when a change is made. Secondly, if you are having trouble controlling leaks and there is time pressure, return the mask for another. Full face masks can require a lot of fiddling to get to where leaks are well controlled but once one has found the sweet spot, they are quite repeatable.

Generally, people who have switched from a FFM to a nasal pillows mask have reported a decrease in AHI so some increase going the other direction would not surprise me.

Centrals are not caused by the mask. A small increase in obstructives when going from nasal pillows to full face mask is probably normal.

Best Regards,

PaytonA
11-04-2015 11:52 AM
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Ghost1958 Offline

Advisory Members

Posts: 957
Joined: Aug 2014

Machine: PRS1 Series Sixty Auto Aflex
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: PRS1 with Heated Hose
CPAP Pressure: 10.5 min 16 max
CPAP Software: SleepyHead EncoreBasic

Other Comments: Moderate to Severe SA Obstructive. Rapid O2 desat off the machine.

Sex: Male
Location: KY

Post: #5
RE: Changed masks, AHI went up. So confused, help?
1You will likely need a pressure imcrease onthe min pressure to get the same ahi with F FFm as you do with pillows.
E-hem. Try a Simplus FFm.
some folks are resistant to try one first. Butwindup With one. Lol.
Less sore noses to try one first.

Think I Will hush now. Before I get slapped LOL.
( inside joke there LOL).
(This post was last modified: 11-05-2015 12:00 AM by Ghost1958.)
11-04-2015 11:59 PM
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kameeleun Offline

Members

Posts: 14
Joined: Oct 2015

Machine: resmed s9
Mask Type: Nasal pillows
Mask Make & Model: swift fx (for her?)
Humidifier: yes?
CPAP Pressure: 6
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location:

Post: #6
RE: Changed masks, AHI went up. So confused, help?
(11-04-2015 11:52 AM)PaytonA Wrote:  First, it is not unusual for Centrals to increase a bit temporarily when a change is made. Secondly, if you are having trouble controlling leaks and there is time pressure, return the mask for another. Full face masks can require a lot of fiddling to get to where leaks are well controlled but once one has found the sweet spot, they are quite repeatable.

Generally, people who have switched from a FFM to a nasal pillows mask have reported a decrease in AHI so some increase going the other direction would not surprise me.

Centrals are not caused by the mask. A small increase in obstructives when going from nasal pillows to full face mask is probably normal.

Best Regards,

PaytonA

Would leaks cause centrals or hypopneas? Obstructives have gone down and stayed down on the full face mask. I always suspected my mouth openings were interfering with the machine being able to detect events, is that possible?

I returned the mask for an extra small of the same kind, fits a bit better but still leaks out the sides of my nose bridge a bit. Not sure what to do about that, my nose bridge is high and skinny. Also I'm already not swallowing the massive quantity of air that I was on the small, so somehow that was related. I'll give this one a few nights now and try to figure out the fit.
11-05-2015 12:27 PM
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PaytonA Offline
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Monitors

Posts: 3,013
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #7
RE: Changed masks, AHI went up. So confused, help?
Which Quattro are you trying? Does it have the stabilizer that rests on your forehead or not?
11-05-2015 12:54 PM
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kameeleun Offline

Members

Posts: 14
Joined: Oct 2015

Machine: resmed s9
Mask Type: Nasal pillows
Mask Make & Model: swift fx (for her?)
Humidifier: yes?
CPAP Pressure: 6
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location:

Post: #8
RE: Changed masks, AHI went up. So confused, help?
(11-05-2015 12:54 PM)PaytonA Wrote:  Which Quattro are you trying? Does it have the stabilizer that rests on your forehead or not?

I think it's the original. It has a thing on my forehead as well as a knob to adjust the angle of the mask (the knob is why I chose this one, I was hoping it would help). If this doesn't work I'll try one of the masks with the nasal pillows and the mouth part, and leave my dumb nose bridge out of it.
11-05-2015 01:41 PM
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jec335 Offline

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Posts: 22
Joined: Nov 2015

Machine: sleepeasy
Mask Type: Full face mask
Mask Make & Model: AirFit F10
Humidifier: none
CPAP Pressure: 8
CPAP Software: Not using software

Other Comments:

Sex: Female
Location:

Post: #9
RE: Changed masks, AHI went up. So confused, help?
i like the resmed airfit f10. it sits lower on the nose, away from the bridge. i also have to agree, the simplus mask, works for a lot of people that have fit difficulty. fisher paykel makes the foam inserts that sometimes will help a hard to fit bridge. i have not had any luck with hybrid masks
11-06-2015 09:10 AM
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jec335 Offline

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Posts: 22
Joined: Nov 2015

Machine: sleepeasy
Mask Type: Full face mask
Mask Make & Model: AirFit F10
Humidifier: none
CPAP Pressure: 8
CPAP Software: Not using software

Other Comments:

Sex: Female
Location:

Post: #10
RE: Changed masks, AHI went up. So confused, help?
oh! and believe it or not, in cases of large leak, adding a chin strap under a full face mask has worked miracles for some people. fixes dry mouth when leak is eliminated.
11-06-2015 09:14 AM
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