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Hypopnea and mask removal
#1
Almost every night I find that I've removed my mask at some point. The sound of it blowing unobstructed wakes me up, then I find it and put it back on. Looking at the SleepyHead data I see that in most cases right before there's a big gap (where the mask if off of my face) a hypopnea was recorded. Could this be recorded because I've taken the mask off or could that be the reason I'm taking the mask off? Is there any way to know for sure? If that's what's causing me to take the mask off what can I do to prevent that from happening?
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#2
The hypopnea is probably real. Many new users actually show a cluster of events at the time they remove the mask that may be related to sleep stage/ dreaming or sleep position. The machine will usually show the large leak, and if that overlaps with the event on closer examination of the flow chart, then that would introduce some doubt. The machine has a hard time detecting actual events during large leak periods.

Maybe zoom in on the period just before you take off the mask and post the events, flow, pressure and leak charts. https://sleep.tnet.com/reference/tips/imgur

Prevention is a tough call. If an obstructive event is causing you to take off the mask then pressure might be a solution, or it could just be part of adapting to the therapy.
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#3
(08-03-2015, 08:37 AM)ISnoreBadly Wrote: Almost every night I find that I've removed my mask at some point. The sound of it blowing unobstructed wakes me up, then I find it and put it back on. Looking at the SleepyHead data I see that in most cases right before there's a big gap (where the mask if off of my face) a hypopnea was recorded. Could this be recorded because I've taken the mask off or could that be the reason I'm taking the mask off? Is there any way to know for sure? If that's what's causing me to take the mask off what can I do to prevent that from happening?


Not sure why your taking it off, except that the sound of blowing air means that you have a mask leak. You probably don't have a good seal on your nasal pillows or you knocked the masked off a bit when turning. Also, check you leak rate.

You can try one size larger or one size smaller nasal pillow and use a lanolin cream or nasal gel to help make a better seal.
OpalRose
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#4
(08-03-2015, 08:47 AM)OpalRose Wrote:
(08-03-2015, 08:37 AM)ISnoreBadly Wrote: Almost every night I find that I've removed my mask at some point. The sound of it blowing unobstructed wakes me up, then I find it and put it back on. Looking at the SleepyHead data I see that in most cases right before there's a big gap (where the mask if off of my face) a hypopnea was recorded. Could this be recorded because I've taken the mask off or could that be the reason I'm taking the mask off? Is there any way to know for sure? If that's what's causing me to take the mask off what can I do to prevent that from happening?


Not sure why your taking it off, except that the sound of blowing air means that you have a mask leak. You probably don't have a good seal on your nasal pillows or you knocked the masked off a bit when turning. Also, check you leak rate.

You can try one size larger or one size smaller nasal pillow and use a lanolin cream or nasal gel to help make a better seal.

I meant when I hear the sound of air blowing I wake up and find the mask on the floor, or next to me on the pillow or whatever. It's not on my face at all.
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#5
(08-03-2015, 08:45 AM)Sleeprider Wrote: The hypopnea is probably real. Many new users actually show a cluster of events at the time they remove the mask that may be related to sleep stage/ dreaming or sleep position. The machine will usually show the large leak, and if that overlaps with the event on closer examination of the flow chart, then that would introduce some doubt. The machine has a hard time detecting actual events during large leak periods.

Maybe zoom in on the period just before you take off the mask and post the events, flow, pressure and leak charts. https://sleep.tnet.com/reference/tips/imgur

Prevention is a tough call. If an obstructive event is causing you to take off the mask then pressure might be a solution, or it could just be part of adapting to the therapy.

This is last night:
[Image: AAu2EDq.png]

This was the night before:
[Image: aPcjNm4.png]
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#6
ISnoreBadly,
If I remember correctly, your the one who was going to use the auto trial. What result did you get? Just curious, did it set you at the same 12cm as you were using.

I ask because it looks like you could use a little higher pressure.
OpalRose
Apnea Board Moderator
www.ApneaBoard.com

How to Organize and Post ScreenShots

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https://sleep.tnet.com/reference/tips/imgur

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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#7
(08-03-2015, 09:26 AM)OpalRose Wrote: ISnoreBadly,
If I remember correctly, your the one who was going to use the auto trial. What result did you get? Just curious, did it set you at the same 12cm as you were using.

I ask because it looks like you could use a little higher pressure.

Yep, that was me. I set it to auto-trial for 3 days, the results are on this thread: http://www.apneaboard.com/forums/Thread-...ode?page=2. Basically I found that the AHI went up each night (2.87, 3.58, 3.94) that I had it on auto-trial. The last night I had the pressure at a minimum of 11 and a maximum of 15. The AHI going up every night worried me so I went back to CPAP at 12 cm (what it was originally).

I have an appointment with my doctor on the 12th and will see if the thinks that APAP would be better than CPAP for me... or if I need to go to a higher CPAP pressure.
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#8
You have a problem with leak rate. Must fix; or data not meaningful.
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#9
The first chart you are already in large leak before the H event. That is shown in the flow rate and leak rate.
On the second chart, the event looks real, although you still have a high leak rate for a P10 mask at only 12 cm pressure. It would be nice to see that total leak around 30, rather than 42. It looks like you took a large breath (possibly a recovery breath from some disturbed breathing starting at 36:20) then you basically stopped breathing with just enough respiration to avoid an apnea score. I would probably call that a long CA rather than an H. Then you take off the mask.

That doesn't tell you why, but I think both nights show the same sequence of events. It's interesting, and I'd show that to the doctor when you discuss it. You basically stop breathing for nearly a full minute and take off the mask. That leaves me wondering if you wouldn't benefit from bilevel to remove the exhale resistance.

What are you doing for Cflex/Aflex?
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#10
(08-03-2015, 10:00 AM)Sleeprider Wrote: The first chart you are already in large leak before the H event. That is shown in the flow rate and leak rate.

Yeah, I think I had taken the mask off a few minutes before that one, then took it off again. Here's a less zoomed view:

[Image: ABiTYRi.png]

Quote:On the second chart, the event looks real, although you still have a high leak rate for a P10 mask at only 12 cm pressure. It would be nice to see that total leak around 30, rather than 42.

Going back through all of the data I have I don't have any nights where the total leak rate it at 30, even on nights where I don't have any large leaks recorded it's in the mid 40s up to the low 50s.

Quote:It looks like you took a large breath (possibly a recovery breath from some disturbed breathing starting at 36:20) then you basically stopped breathing with just enough respiration to avoid an apnea score. I would probably call that a long CA rather than an H. Then you take off the mask.

That doesn't tell you why, but I think both nights show the same sequence of events. It's interesting, and I'd show that to the doctor when you discuss it. You basically stop breathing for nearly a full minute and take off the mask. That leaves me wondering if you wouldn't benefit from bilevel to remove the exhale resistance.

What are you doing for Cflex/Aflex?

The C-Flex+ is set to x3 (the maximum I think).

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