Forum has helped...but now next step to improve

[nightgagger]

Clownbell: Thank you for the explanation on venting.  That makes perfect sense.  It's just very strange that I see some people posting graphs with zero leak levels and wondering why I had a higher baseline value.

Sheepless:  Last night's results show a better flow curve and respiration rate using an N20 mask.  I forgot to change the mask type from pillow to nasal though.  I was really tired in the evening, so I believe my strange sleeping issue caught up to me.

What I'm presuming to be the issue with the Brevida mask may be that one of the nasal prongs may have folded within itself or closed off.  I'm not sure if I can clearly describe it, but quite possibly, as I'm now a dedicated side sleeper, the side of the mask is either folding in, or pushing the prong closed. It is a very soft material and is not really reinforced as the P30i pillow, due to thickness.  This is just a presumption.  I really like the mask.  The comfort is the best of all the masks I used, and would be a shame not to use it.

I feel good this morning, though, and that's the optimum resolution for all this.

[nightgagger]

I should probably add that the first 40 minutes of my full night’s graph was spent watching TV with the mask and machine on.

[sheepless]

I'm all in on your idea that the mask is somehow affecting the prong. all I could think of is either you actually are panting or the mask has something that acts like a a flap, stopping and starting airflow, making the flow and respiration rates look as if you were panting or double breathing. good to know it's the mask and not you!

[nightgagger]

Added review from post #30. 
Moderator's Note: Please reference nightgagger's Brevida review [HERE].

Great first night with that mask, but as the week progressed something weird was happening with my respiration rate and flow waveform.  Not sure what the mask was doing but I doubled up on the respiration rate.  See attached graphs.

All this respiration rate doubling was resolved going back to the N20 nasal mask.

My suspicion is that the mask pillows were being compressed enough that they were shut off flow when sleeping on my side, which I've trained my self to sleep from the previous supine position. 

It's a real shame as I really found this mask comfortable and the fact that it is quiet and doesn't blow out air due to the filter really made this mask a winner for my treatment.

[Crimson Nape]

This was in the product review section, and the post deals with a therapy condition, I have moved the above post to the Main forum.

Please reference nightgagger's Brevida review [HERE].

[DaveL]

clownbell I went back and read your post about venting and leaks. You helped me a lot.

Thanks for posting it.

Dave

[CorruptAlligator]

@nightgagger. Now I understand what you meant when you said N20 worked so well for you. The numbers are showing. It's a day and night difference from FFM.

It's so interesting how much lower your FL is from the mask change. I have similar experience with nasal masks. However, I have better luck with leaks with Resperonics Wisp. It's pretty much the similar design as N20, but the cushion is softer and seems to seal better due to the way it's designed. I try to sidesleep as much as I can and I've had issue with N20 leaking when sleeping on my side.

I recently ordered the Dreamwisp which seems to be an improvement over wisp (I will find out). It's like the N30i or P30i, but uses nasal cushion.

Was there anything you did to improve your FL besides changing the mask? It's such a drastic different from your earlier OSCAR shots that it's quite impressive.

[Ratchick]

It reminds me of a study I saw (forgive me, I can't remember the source right now) that demonstrated that patients usually get the best results with pillows, then with nasal, then with FFM, even if they use the same pressures etc. It also explained that initially, CPAP/APAP was designed to only use a nasal mask of some variety, versus an FFM, but the FFM was often needed with BiPAP because of the higher pressures, and this has now slipped over more into CPAP therapy over the years as the default... even though the effect seems to be statistically better with nasal masks and pillows. Of course, that's going to depend upon the person, the therapy, the comfort level, etc - and ultimately, getting a full night with an FFM, even if you need slightly higher pressure, isn't "worse" than using pillows but being woken up all the time because of discomfort, leaks, etc. It's just another aspect to consider if you're struggling with getting control of your apnea with an FFM.

[nightgagger]

@CorruptAlligator
I think my FL improvement may be attributed to the fact that I'm now a pretty dedicated side sleeper. I really loved sleeping on my back, but knowing that my jaw and especially my tongue would drop to the back of my throat cutting airflow, forced me to concentrate on side sleeping.

I also think my CPAP pillow helps in this way because of the cutouts for the type of mask I'm using. Furthermore, due to side sleeping and this pillow, I don't use a cervical collar anymore. I believe I last used the collar back in May.

I may give that Respironics Wisp mask a try though, thanks for the suggestion.

@Ratchick
Interesting observation. For me the only advantage I see to using a FFM is that I wouldn't need to use tape anymore. Unfortunately I think I have an active mouth, or jaw. I do use a mouthguard due to Bruxism, so my jaw/mouth are moving at night. I know I talk in my sleep as I've been told this. Finding the right tape for my mouth/jaw structure has been the saving grace. I thank Multicast for this as his suggestion to use Fleximull, which is the European version of the BSC Cover Roll tape, was the catalyst in getting this together. I still get leaks, and also looking at detail on my flow curves, I do not have the perfect rounded breath waveform.

I believe, and thank this board, that my sleep quality has improved in the last 4 - 5 months. I still feel it can improve, due to some things that are going on in my life that are anxiety/depression causing. The basis of improved sleep will help overcome those issues, I believe.
It's a night by night struggle...but getting better.

[CorruptAlligator]

@Ratchick, that may depend on the individual. I recently had a 0.0 AHI with my nasal mask (which is crazy rare, and less than 1 was rare with non-nasal masks). Although my FL is the lowest with my nasal mask, it's still not low enough to be under .1, but I started to wear a cervical collar with it, and the combination maybe helping with FL (I will have to see what happens for several days.).

I never had lower than 1 AHI with pillows, and it's generally higher with some CAs. Last few days my CA went to 0 with nasal mask (and wearing a collar). How to explain that?

So overall for me personally, nasal mask is numero uno.

@nightgagger, thanks for the response. I try to sidesleep as well, but based on my sleep study, I slide-sleep only between 10-30% of the time. I switch up to whichever would be most comfortable at the moment. I may try a back-pack in the future, but I try to accommodate for what my body wants. Back-pack solution seems too forceful.

I have bruxism as well. I clinch, so you have a similar circumstance as me. I never open my mouth due to this and also likely due to wearing a mouth guard. But, if you talk in your sleep, that would open up your mouth.

If you side-sleep all of the night, CPAP pillow would be fine, but CPAP pillows are generally elevated that when you get back on supine during the night, there's a liklihood it will cause chin-tuck. I really thought about this, and I wish there was a better designed CPAP pillow with the elevated edges and lowered center area (for dual back and side sleepers) so that when you get on supine, it would prevent chin-tuck. I think a cervical collar would still help with CPAP pillow when in supine.