RE: Common to switch between nasal and full-face mask as needed?
On the pressure setting changes you do: FWIW Sleeprider is spot on. My own unique situation may highlight his response, I hope. I am on an ASV Auto, one of the most expensive machines available. As soon as it was plugged in, I was editing settings, as the DME had not a full clue on how to set it up. I did start with the initial settings as exact as the script gave them. I used it that night, following up with a SleepyHead chart. Sleeprider and others suggested tweaks as I remember on day 2 on the ASV. And I told the doc and DME I am changing the settings for MY optimization. Not one peep at all.
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RE: Common to switch between nasal and full-face mask as needed?
I don't think anyone cares about the changes if you are using the machine. This is the machine recorded changes on my machine. The changes after 4/16/11 don't exist--the machine made them up.
Changes to Prescription Settings
First Last Days AHI FL Machine Pressure Relief Mode Pressure Settings
Tue Sep 12 2017 Fri Feb 2 2018 144 2.61 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Wed Mar 22 2017 Sun Sep 10 2017 173 3.00 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Mon Mar 13 2017 Mon Mar 20 2017 8 3.31 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Mon Mar 6 2017 Sat Mar 11 2017 6 2.05 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Tue Dec 27 2016 Thu Mar 2 2017 66 2.52 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Fri Dec 23 2016 Sat Dec 24 2016 2 1.89 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Thu Apr 7 2016 Mon Dec 19 2016 257 4.67 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Fri Jun 5 2015 Mon Apr 4 2016 305 4.29 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Thu Apr 9 2015 Wed Jun 3 2015 56 3.91 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Tue Apr 7 2015 Tue Apr 7 2015 1 1.41 0.00 RemStar BiPAP Pro with Bi-Flex (650P) C-Flex x1 CPAP EPAP 12.0 IPAP 16.0 (cmH2O)
Thu Feb 13 2014 Mon Apr 6 2015 418 5.26 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Wed Nov 6 2013 Tue Feb 11 2014 98 1.19 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Sun Aug 4 2013 Sun Sep 29 2013 57 4.82 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Thu Apr 5 2012 Thu Aug 1 2013 484 5.64 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Sat Mar 31 2012 Sun Apr 1 2012 2 5.24 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Thu Jun 16 2011 Thu Mar 29 2012 288 10.53 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Sat Apr 16 2011 Tue Jun 14 2011 60 5.58 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 16.0 (cmH2O)
Fri Apr 15 2011 Fri Apr 15 2011 1 7.11 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 12.0 IPAP 20.0 (cmH2O)
Thu Mar 31 2011 Thu Apr 14 2011 15 6.24 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 14.0 IPAP 20.0 (cmH2O)
Fri Mar 11 2011 Tue Mar 29 2011 19 15.44 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 14.0 IPAP 20.0 (cmH2O)
Wed Mar 9 2011 Wed Mar 9 2011 1 30.77 0.00 RemStar BiPAP Pro with Bi-Flex (650P) Bi-Flex x3 Fixed Bi-Level EPAP 14.0 IPAP 20.0 (cmH2O)
05-03-2018, 03:53 PM
(This post was last modified: 05-03-2018, 03:56 PM by Mosquitobait.)
RE: Common to switch between nasal and full-face mask as needed?
Your insurance company only cares about compliance, not your settings. According to Resmed, 4 and 5 are considered pediatric settings. Very few adults find those tolerable. Why the docs set it that way is lack of thinking about it, I presume. Most sleep docs do not deal with pediatric patients - they are dealt with at children's hospitals.
I was always up front about my changes (same thing with my insulin). I tell the doctor what settings I changed and why and the result. The sleep doc gave me parameters and that worked fine, but since they started this bait and switch thing (I set up appointment with doc but end up with PA or NP), I don't bother going there any longer. If I did have concerns, my primary has a new place to send me.
RE: Common to switch between nasal and full-face mask as needed?
I've just swapped my nasal mask for a Dreamwear full-face mask, and want to see how that goes for a while before tinkering with any settings. But I do have a question about pressure settings for someone with mixed apnea. My Rx was for APAP variable between 4 and 20 cm. In the past week according to SleepyHead my average AHI is 6.7, almost all of that from central events (clear airway) -- obstructive index is 0.32. Average pressure was 5.69. So it would seem to me that the current pressure settings are basically taking care of obstructive apnea but not doing a lot for central. My understanding is that the device doesn't increase pressure when a central event is detected, so is there still a potential gain from increasing the minimum pressure?
RE: Common to switch between nasal and full-face mask as needed?
For someone with mixed apena events, and predominately central on CPAP, the best settings are usually fixed low pressure with EPR OFF. The EPR off is the most important thing you can do with central events.
If you would like to take a screenshot and post a Sleepyhead chart we can be much more specific on what is or is not working for you. See the two links in my signature for organizing and attaching a Sleepyhead image.
RE: Common to switch between nasal and full-face mask as needed?
(05-03-2018, 07:55 PM)Creosote Wrote: I've just swapped my nasal mask for a Dreamwear full-face mask, and want to see how that goes for a while before tinkering with any settings. But I do have a question about pressure settings for someone with mixed apnea. My Rx was for APAP variable between 4 and 20 cm. In the past week according to SleepyHead my average AHI is 6.7, almost all of that from central events (clear airway) -- obstructive index is 0.32. Average pressure was 5.69. So it would seem to me that the current pressure settings are basically taking care of obstructive apnea but not doing a lot for central. My understanding is that the device doesn't increase pressure when a central event is detected, so is there still a potential gain from increasing the minimum pressure?
Your machine is currently set at the factory defaults of the very minimum pressure of 4 cm and the very maximum of 20 cm. It will respond to obstructive apnea events, flow limitations, and snoring, and increase treatment pressure as it sees appropriate. I have the same machine and have looked at many CA events and it does not respond to them just as they claim. Your CPAP is not going to reduce CA events with pressure, so that is appropriate. An average pressure of 5.7 cm is very low, and I would not suggest your CPAP is causing the CA events, which seem to be driving your AHI up.
There is no problem switching your masks back and forth. Just remember to switch the mask type in your case from full face to nasal.
It would be very helpful if you posted some SleepyHead daily screenshots. Make sure you include pressure, flow limitations, and snoring. That would be revealing as to what the machine is responding to. If I had to guess, at this point, I would suggest it may be worthwhile to just set your machine to fixed pressure CPAP mode and set the pressure at 6 cm.
RE: Common to switch between nasal and full-face mask as needed?
Hi Creosote,
Welcome to the Apneaboard.
A lot of people do switch when they have a cold and find it more difficult to breath through their nose.
What you should be aware of is that some machines require you to change the settings from a nasal/nasal pillows and a full-faced mask.
Other than that there is no real reason why you can't change when you have a cold or whatever.
However, on saying that it is more difficult to keep track of how you are doing as changing masks can affect results a little.
Not so much drastically, but there is different leakage rates between masks ans this will affect your results, even between two full-faced masks there can be a change, thought sometimes very small but at other times can be very noticeable.
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.
RE: Common to switch between nasal and full-face mask as needed?
(05-03-2018, 07:55 PM)Creosote Wrote: My Rx was for APAP variable between 4 and 20 cm. In the past week according to SleepyHead my average AHI is 6.7, almost all of that from central events (clear airway) -- obstructive index is 0.32.
Average pressure was 5.69.
So it would seem to me that the current pressure settings are basically taking care of obstructive apnea but not doing a lot for central. My understanding is that the device doesn't increase pressure when a central event is detected, so is there still a potential gain from increasing the minimum pressure?
It would be unusual for a machine to be left at factory settings to take care of someone's Sleep Apnea, unless you happen to need a very low pressure.
What was the pressure the machine rose to, forget the average?
You might benefit from a slight increase in low pressure, however, we would like to see some data before recommending anything.
If you have a machine with a card and is Sleepyhead compatible, download it and follow the instructions found on some peoples signatures.
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.
05-04-2018, 01:22 PM
(This post was last modified: 05-04-2018, 01:23 PM by Creosote.
Edit Reason: minor expansion
)
RE: Common to switch between nasal and full-face mask as needed?
Thanks for the recent replies, all.
The other day I went in to my DME provider and swapped the nasal mask for a Dreamwear full-face mask. Last night was first try and it was pretty disastrous on the whole -- pressure levels went up to way more than with the Resmed nasal mask, and when they did I had all sorts of mask leakage and gave up after a couple of hours. Will need to try to sort that out before posting any graphs, sigh--but will try to get back with more info once I've had a few nights to see how things go.
RE: Common to switch between nasal and full-face mask as needed?
(05-04-2018, 01:22 PM)Creosote Wrote: The other day I went in to my DME provider and swapped the nasal mask for a Dreamwear full-face mask. Last night was first try and it was pretty disastrous on the whole -- pressure levels went up to way more than with the Resmed nasal mask, and when they did I had all sorts of mask leakage and gave up after a couple of hours. Will need to try to sort that out before posting any graphs, sigh--but will try to get back with more info once I've had a few nights to see how things go.
If it makes you feel any better I just made the switch from a ResMed AirFit P10 nasal pillow mask to a ResMed AirFit F20 full face mask. So far it has been a disaster. My purpose of making a switch was to reduce leaks, but so far leaks have not really been reduced and AHI has gone way up. Mask pressure has also gone up by almost 1 cm and I now need to increase my max pressure setting. I will stick with it for a while but I am starting to think that I just blew $165 on a dust collector... Here is a SH chart for the nasal pillows from a week or so ago and the best one I have gotten so far with the full face. I think the full face has the possibility of improvement. I will boost max pressure by 1 cm for tonight, and I think if I can get comfortable with it, then the sleep wake noise may be reduced. We'll see...
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