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[Diagnosis] Mask types producing very confusing results
#1
Mask types producing very confusing results
Hello everyone and thank you for reading this post.  If you have any thoughts in response, they will be greatly valued.

I've been using CPAP for most of two years, having been diagnosed with obstructive apnea.  As cases go, it was relatively mild (around 5 events per night), but it profoundly affected the quality of my life - and my wife's.  Treatment with an AirSense 10, set at a constant pressure of 8, has left me feeling much improved.  Unitil recently, I used a Swift LT nasal pillow, which worked well, but created considerable discomfort with dry mouth.  I've tried everything I've read on this Board to remedy it, with minimal success.
My average monthly numbers using this mask were as follows:  AHI .28, Obstructive .14, Hypopnea .03, Clear Airway .11, C/S .00 with an average leak rate of 0.

In June, I switched to an Amara View mask to combat the dry mouth.  It took care of that problem and was extraordinarily comfortable to wear, but my quality of rest seems to have declined.  I didn't realize how much decline until I recently downloaded Sleepyhead and compared the two masks using the stats (as I struggle to understand them.)

Stats using the Amara View in September yielded the following:  AHI 1.72, Obstructive .31, Hypopnea .2, Clear Airway 1.21 C/S .00 with an average leak rate of 4.0, 7.2 at 90%, and .05 %time above.

In November, the data with the same mask showed an AHI 2.7, Obstructive .57, Hypopnea .28, Clear Airway 1.82, C/S .01.  Ave. leak rate was 4.7 with 10.8 at 90%, and 1.98 above % time.

Some notably poor nights have occurred recently, such as one with an AHI 6.3, Obstructive .36 Hypopnea .61, Clear Airway 5.0, and C/S 2.8.  Large Leak 2.1.

In the earlier data using the nasal pillow, clear airway events were rare, with none showing up on many nights.  Now, they are frequent and getting worse.  I recently tried going back to the nasal pillows for two nights, and the data returned to the old levels, with few, if any, clear airway events.

I tried switching to auto pressure between 8 and 12 for several nights, using the Amara mask.  It operated at an average pressure of 9.5, but there was little difference in the frequency and type of events.

For as long as I can remember, I've had a tendency to sleep soundly during the first 3-4 hours of a night, then wake up and doze lightly and intermittently for the remainder of the night.  During that period, my mind is pretty active, making sleep difficult.  The data consistently show this disturbance occurring in line with that pattern, with few clear airway events happening until the mid-night wake up time.  Then they go crazy for the rest of the night.

The clear airway events are nearly always accompanied by increased leakage with the Amara View.

I have several questions, should anyone be kind enough to venture an opinion.  First, why would a full face mask (or perhaps it is a hybrid) be accompanied with more apnea events, and in particular, more clear airway events, than the nasal pillow mask?  Second, am I correct that I should switch back to the nasal pillows and just deal with the dry mouth?  And third, are these clear airway events, occurring with one mask only, a reason to seek treatment for central apnea?  Any other thoughts are also appreciated!

Thank you kindly for your consideration!
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#2
RE: Mask types producing very confusing results
If you could down load a chart from sleepyhead it would help see whats going on.

If you use the links below you can download and learn how to post the charts here.

Right now if I had to guess it's not the mask causing the problems but your pressure requirements have changed.
Download SleepyHead
Organize your Sleepyhead Charts
Posting Charts
Beginner's Guide to SleepyHead
Mask Primer
5
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#3
RE: Mask types producing very confusing results
(12-02-2017, 01:54 PM)23Tucson Wrote: The clear airway events are nearly always accompanied by increased leakage with the Amara View.

I have several questions, should anyone be kind enough to venture an opinion.  First, why would a full face mask (or perhaps it is a hybrid) be accompanied with more apnea events, and in particular, more clear airway events, than the nasal pillow mask?  Second, am I correct that I should switch back to the nasal pillows and just deal with the dry mouth?  And third, are these clear airway events, occurring with one mask only, a reason to seek treatment for central apnea?  Any other thoughts are also appreciated!

Did you set the mask type correctly on your device? (Pillows, Full Face, Nasal)

While there is some controversy about what this setting actually does, it can affect the way therapy is delivered and the leak rate.

Best of luck sorting out the issues.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#4
RE: Mask types producing very confusing results
If you change from Nasal Pillows to either a Nasal Mask or a Full-Faced mask you need to adjust the machine to deliver a slightly higher pressure or flow rate.  The vents tend to be bigger in these masks, so more air is required in order to keep your airways open and deliver the same pressure at the mask, which might mean the flow rate has to go up just to keep the same pressure.  There is a setting on the machine to change mask type.
I am NOT a doctor.  I try to help, but do not take what I say as medical advice.


Every journey, however large or small starts with the first step.

Sleep-well
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