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#11
Update:

I have been using the p10 pillows for the past few nights and I think I'm growing more comfortable with them than I did with my nasal mask. I am starting to wake up less at night and can start to feel some of the benefits. I'm not as tired as I used to feel during the day and go longer periods before the yawning starts.

Here is a picture of my stats.



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#12
The numbers looked ok till I saw the leaks - they are way too high. Anything over 24 l/min is too high, and you were over that for a quarter of the night. With leaks that high for that long you can't trust any of the other information, so those good looking AHIs are suspect.

The leaks may be caused by the pillows losing their seal in your nose or else you might be losing the pressure through your mouth (which will usually make a loud hissing noise). If you have a bed partner they might be able to tell you what's going on.
DeepBreathing
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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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#13
I have been waking up with a very dry mouth, guess I am breathing through my mouth too much? I don't feel it leaking through the pillows..I am using the small.. maybe I should try the med size for a better seal? Or if it is because of my mouth..then I may not have a choice and might have to go with a full face mask?
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#14
There are several steps that you can take before going to a full face mask. First you can try practicing sealing off your mouth with your tongue. Place the tongue up against the roof of your mouth behind your upper teeth. Practice while awake and especially in the time between when you go to bed and when you fall asleep. If that does not work you might want to try a chin strap ( never worked for me but does for many). Merely keeping your mouth closed is not the solution but may remind you in your sleep to keep the tongue properly situated.

Even if you do end up having to go to a full face mask, the tongue block is still important but not as critical. A full face mask will keep mouth leaking from affecting your therapy but you still may have dry mouth.
An imperfect tongue seal plus humidity can eliminate dry mouth.

Best Regards,

PaytonA

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#15
Thanks PaytonA!

I'll try that and see what kind of success I come up with. Want to avoid a full face if I can. the machine right now is on auto humidity..I'll increase it a bit each night and see what results I get.
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#16
(07-01-2015, 10:37 AM)PaytonA Wrote: There are several steps that you can take before going to a full face mask. First you can try practicing sealing off your mouth with your tongue. Place the tongue up against the roof of your mouth behind your upper teeth.

Well, wasn't very successful in that last night. My % of time above Leak Rate threshold was 55.47%. So last night I leaked about half the night, and my AHI was at 3.14 (Pi anyone? Grin ). With how high my pressures are I might not be able to do it with my tongue alone. Woke up three times last night to an extremely dry mouth. I tried repositioning my tongue and going back to sleep..didnt go to well.
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#17
(07-02-2015, 07:53 AM)ShadowSeeker Wrote:
(07-01-2015, 10:37 AM)PaytonA Wrote: There are several steps that you can take before going to a full face mask. First you can try practicing sealing off your mouth with your tongue. Place the tongue up against the roof of your mouth behind your upper teeth.

Well, wasn't very successful in that last night. My % of time above Leak Rate threshold was 55.47%. So last night I leaked about half the night, and my AHI was at 3.14 (Pi anyone? Grin ). With how high my pressures are I might not be able to do it with my tongue alone. Woke up three times last night to an extremely dry mouth. I tried repositioning my tongue and going back to sleep..didnt go to well.


ShadowSeeker,
It takes practice to perfect that tongue trick. During the day, you can practice it by placing your tongue on roof of mouth behind front teeth, then suck your tongue gently upward. It took me a few weeks to get this right.
If you get it right, you can open your mouth during therapy, and no air will escape.
Don't give up.
Smile

OpalRose
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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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#18
Hi Chris,

Is your machine in ASV therapy mode, or ASVAuto mode?

In the statistics you posted:

The average Apnea Hypopnea Index for the last 7 days was 2.46 per hour, and the Hypopnea Index was 2.24 per hour, so your Apnea Index must have been 0.22 per hour. (Your machine does not classify obstructive apneas versus central apneas, so those rows are all zero.) But, as DB mentioned, with so much leaking going on, it hard to trust these statistics.

I think it is likely that the hypos and apneas are probably all happening during the times of high Leak, when the machine might not be able to provide adequate pressure.

In the Last Week statistics, the 90% pressure was 22.04 cm H2O. This means that at least 90% of the time the IPAP was 22.04 or lower. It also means that at least 10% of the time the IAP was 22.04 or higher.

Assuming your machine is in ASV mode (using fixed EPAP of 13 all night long) a 90% pressure of 22.04 would mean PS was 9.04 or higher at least 10% of the time. That is a fairly high amount of Pressure Support, indicating that the machine was doing for you just about all the work of breathing at least 10% of the time.

If you ever do try a FFM, I recommend trying a Mask Liner, which is a piece of doughnut-shaped cloth which goes between your face and the mask. A mask liner makes leaks softer and less bothersome, completely eliminating face trumpeting or face burping and allowing the straps to be a little less tight. I use RemZzzs brand, which recommends using a new liner each day, but I use one for 1 or 2 weeks before washing (I wash them in a mesh laundry bag meant to keep small or delicate items from being damaged or eaten by the washing machine) and ironing and re-using. Would probably be better to make my own, though, because the RemZees ones quickly stretch out and become too large, unless one is very careful to never pull on or stretch the fabric.

I usually use the AirFit F10 FFM with liner, but a few nights a week or month, when my nose bridge needs a rest, I use a TFM (Total Face Mask), the Respironics FitLife. I use the Extra Large size mask with RemZees liner size 6B-FLK (ExtraLarge) from www dot directhomemedical dot com but I use the standard size (Medium) head gear. The Extra Large headgear for the FitLife TFM was unusably and absurdly huge.



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#19
(07-03-2015, 09:58 PM)vsheline Wrote: Hi Chris,

Is your machine in ASV therapy mode, or ASVAuto mode?

In the statistics you posted:

The average Apnea Hypopnea Index for the last 7 days was 2.46 per hour, and the Hypopnea Index was 2.24 per hour, so your Apnea Index must have been 0.22 per hour. (Your machine does not classify obstructive apneas versus central apneas, so those rows are all zero.) But, as DB mentioned, with so much leaking going on, it hard to trust these statistics.

I think it is likely that the hypos and apneas are probably all happening during the times of high Leak, when the machine might not be able to provide adequate pressure.

In the Last Week statistics, the 90% pressure was 22.04 cm H2O. This means that at least 90% of the time the IPAP was 22.04 or lower. It also means that at least 10% of the time the IAP was 22.04 or higher.

Assuming your machine is in ASV mode (using fixed EPAP of 13 all night long) a 90% pressure of 22.04 would mean PS was 9.04 or higher at least 10% of the time. That is a fairly high amount of Pressure Support, indicating that the machine was doing for you just about all the work of breathing at least 10% of the time.

If you ever do try a FFM, I recommend trying a Mask Liner, which is a piece of doughnut-shaped cloth which goes between your face and the mask. A mask liner makes leaks softer and less bothersome, completely eliminating face trumpeting or face burping and allowing the straps to be a little less tight. I use RemZzzs brand, which recommends using a new liner each day, but I use one for 1 or 2 weeks before washing (I wash them in a mesh laundry bag meant to keep small or delicate items from being damaged or eaten by the washing machine) and ironing and re-using. Would probably be better to make my own, though, because the RemZees ones quickly stretch out and become too large, unless one is very careful to never pull on or stretch the fabric.

I usually use the AirFit F10 FFM with liner, but a few nights a week or month, when my nose bridge needs a rest, I use a TFM (Total Face Mask), the Respironics FitLife. I use the Extra Large size mask with RemZees liner size 6B-FLK (ExtraLarge) from www dot directhomemedical dot com but I use the standard size (Medium) head gear. The Extra Large headgear for the FitLife TFM was unusably and absurdly huge.

Greetings Vsheline! Thank you for the response.

Yes I did just confirm that the machine is in ASV mode and not ASVAuto. Sorry to say, being so new to this, the first part of your message kinda went over my head with the pressure numbers. Just bare with me as I am still learning all this and trying my best to understand it all. With all the leaking still going on..Last night being 30% last night above the leak rate threshold.. I did switch back to the nasal mask from the pillows, the leaking hasn't changed. So I may need to call my RT and discuss this with her and see what my options are regarding a FFM is. I will definitely take your advice into consideration if it comes to the point of me having to use a FFM.
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#20
Well, heres the update.

After using the machine for the past 2 1/2 weeks (17 days), i'm hanging on through this pretty well. I've had a hard time with mouth breathing, so I talked to my DME about a chinstrap. Well If I want one I have to go back to my Sleep doc and ask for a script for one... Huhsign WTF?!?! Why do I need a separate script for one if I already have one for a machine and supplies? Dont-knowHuh

Needless to say, with all that going on, I decided to just try out a FFM. My RT is coming by Wednesday to show me a few and try them on. Since I am still within my 30 days, it won't cost me anything to switch out the mask and try out a FFM. Most nights are doing well....But leak is still excessively high. I did have one night where i woke up extremely agitated with the nasal mask that I took it off and went back to sleep without it. Only got about 3 hours with it that night so compliance is down to like 94% Tongue . My average nightly usage is 6/7+ hours.
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