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Forum has helped...but now next step to improve
#31
RE: Forum has helped...but now next step to improve
Hi all...the continuing story...

I switched back to my nasal mask and Fleximull tape.   This seems to work well, still having a leak, but below the 24L/min. 

The Fischer &Paykel mask leaks too much.  I believe the combination of cervical collar is pushing my lower chin too much and the mask seems to pull over my bottom lip causing a leak.   I'm in such a deep sleep condition, I don't even notice it.   So that's one reason I went back to the nasal mask last night.  I can't afford to experiment some nights because I need to be fresh and focused the next day.

Woke up ok, but still felt a bit tired.

Attached is my all night graph, but my concern is the waveform around the 12:45AM point.  

The second graph shows this anomaly in the waveform.

A very strange flow rate waveform.  Has anybody seen this type of waveform?   Any suggestions on what it may mean?


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#32
RE: Forum has helped...but now next step to improve
Very common wave form usually means oral expiratory breathing. In hale nasally, exhale orally. Fischer Paykel calls it puffing.

[Image: Flow_limitation_images_zpsdb148d1f.jpg]
Sleeprider
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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.
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#33
RE: Forum has helped...but now next step to improve
I've been on Cpap over 4 years and for the most part I rarely go over 1.00 AHI and I owe it all to this forum. I just wanted to point out a few problems you mentioned that I have experienced. You are using the Resmed F30i mask. I tried it after using the original F30 for a year. Both these masks only come in small & medium cushions, and seem to end up over your bottom lip. I went back to the F30 as it seemed to work better for me as very light and less bulky and as a side sleeper, the F30i had air travel down both sides of the headgear and my head would twist as I tossed and it leaked too much. What you said you liked was the cushion came up to your nostrils. So does the F30. What I found out was when the mask gets older, the silicon gets more flimsy and leaks and slides up over you lower lip. Unlike a few masks I have used, the F30 series requires more frequent replacing of the cushion. Why Resmed does not make a large cushion is a mystery to me. There are others that come up to your nostrils like Amara View and Dreamwear to mention a few.

Another thing that caught my eye on your post, was taping with a full face mask. I taped with pillows and nasal masks and when I tried it on a FFM, (F20) I became sick one evening and started throwing up. I started to panic trying to get the mask off before I gagged. Fortunately I was a side sleeper or it could have been tragic. The same can hold true with power losses.

The most difficult thing about apnea for me and I'm sure many others, is finding the perfect mask. Whoever invents the perfect mask, will become extremely rich.
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#34
RE: Forum has helped...but now next step to improve
Thank you Sleeprider for the illustrations on waveforms.  Is the huffing something of a concern as far as using settings on the machine to reduce this type of breathing?

Thank you for your comments michael9346, but there are some corrections needed in what you wrote.

I stopped using the F30i after a week due to it's leaks.  It was a brand new mask. 

I replaced it with a Fischer & Paykel Simplus.  I've never taped my mouth with a full face mask.

I only tape with a nasal mask.

Last night I used the F&P mask and got a good seal. I also changed out my cervical collar to the 3 1/2" width model (as opposed to the 2 1/2" that I've been using), and chose not to use my tooth guard as well.  I had some wake up episodes, the mask was leaking at the bridge of the nose, on occasion. I'm still not sold on the liners, which I have.
Woke up a little sleepy, but felt somewhat rested.

I'm going to give this Simplus mask another couple of nights tryout and if it keeps the leak rates low, I haven't gotten a 0 night, ever, I'll stick with it.  I may also try the Vitera mask...I still have tryout time on this mask.
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#35
RE: Forum has helped...but now next step to improve
The Vitera is just the next generation of the Simplus.  The Vitera has a longer compression travel around the bridge of the nose and lighter headgear.  Of course, they changed how the mask connects to the headgear, thus making them noninterchangeable.  Other than that, I can't see any vast differences between the two.  A side note; Now that the Vitera is out, replacement Simplus masks are a lot cheaper.
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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.
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#36
RE: Forum has helped...but now next step to improve
Thank you Crimson Nape...will consider your observation going forward.

I now know, or at least have a good assumption on why I'm getting the " puffing" exhale. For the past two nights I haven't used my upper teeth mouth guard (grinding prevention). One advantage of not using the guard is I can better press my lips together to seal when using tape with my nasal mask.

I also have larger lips, and that may be another reason for the "lip farting" and leakages I get. Last night, with the full face mask and not using tape (don't do that with FFM), I saw in my data run that "puffing" waveform. Deep sleep point I'm assuming as well.

I'll see over the next few nights with the F&P FFM.

Thanks all for comments...always helpful on this board.
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#37
RE: Forum has helped...but now next step to improve
You might consider purchasing the next larger size mask, if you're not using the large. I usually use the medium, but find that the large allows a wider contact without much more in length. This allows me to get more of my face into the mask. At some point though, my face realizes this and adjusts to this size. I then drop back down to the medium and all is well.
Crimson Nape
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___________________________________
Useful Links -or- When All Else Fails:
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Beginner's Guide to Sleepyhead and OSCAR
Apnea Helpful Tips

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.
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#38
RE: Forum has helped...but now next step to improve
(02-19-2021, 01:59 PM)Crimson Nape Wrote: You might consider purchasing the next larger size mask, if you're not using the large.   I usually use the medium, but find that the large allows a wider contact without much more in length.  This allows me to get more of my face into the mask. At some point though, my face realizes this and adjusts to this size.  I then drop back down to the medium and all is well.

Hmmm...Interesting.
If I were to describe my facial features, and if looking from the top of my head down, the sides of my face slope, so it would almost look like a triangle from the top down.  I don't have a wide face, narrow.  When I weighed 40 lbs heavier, my face was wider, puffier...but I've lost that weight.

In any case, last night I had the least amount of leakage in the week or so that I've used the Fischer & Paykel mask.  I think I have the straps placed in the right orientation to secure the mask. 

Nevertheless, I still woke up with a face itch, and then kept waking up through the night.  Still, I'm feeling OK this morning, so I must have hit some deep sleep states.  There were dreams, but nothing I can recall.

I've attached the graph.  Not sure what could be gleaned from this, other than reducing the leaks to non-existant.  I think I'll try mask liners again because I'm getting comfortable with this mask.


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