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Looking for some help - almost 5 years and not feeling a lot better
RE: Looking for some help - almost 5 years and not feeling a lot better
From what I gather from other members, it is the same headgear and both type of masks will fit it. I don't have an answer about the 'stache.
Crimson Nape
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RE: Looking for some help - almost 5 years and not feeling a lot better
@SarcasticDave94  It seems to me that your masks aren't right fitting in some way. They shouldn't need to be tight or that indicates ill-fitting. Pillows masks do have the bits very slightly into the nostrils but not by much.

Can a small Simplus cushion fit in a med/large frame?  Maybe the cushion is too large for me to seal properly.  I have to crank down the upper straps so that the forehead piece touches my forehead to seal.  Otherwise it blows full force into my eyes.  Have a narrow bridge at the top of my nose.  When I see videos of people wearing the Simplus, it does not look like what I do at all.  The forehead piece is far from the forehead.
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RE: Looking for some help - almost 5 years and not feeling a lot better
It shouldn't be touching your forehead. This is too tight and will create a cantilever effect of the lower mask seal as well as not allowing the seal to fully expand for a proper seal. The lower straps act as the main seal tension. The upper straps should be rather loose. Also, Simplus and Vitera appear to work better in a lower position on the face.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
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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RE: Looking for some help - almost 5 years and not feeling a lot better
Ok, did some pruning, so at least I can post a few screenshots.  Last night.
   
Looks ok, but I don't feel so ok.  Headache, in sinus area.  Dragging.  F10 mask, chin strap to keep it from riding upward.
Expiratory issues (palatal prolapse) from 22:56-23:12, and 23:21-23:44, plus random others varying from 30 seconds to 2 minutes through the night.
Wearing a collar.  Low single pillow.  Seemingly low sensitivity to some flow limit events.  (No action or reduce pressure.)  Third day at PS 4.2 over 9.4-15.  Slightly more aerophagia, but ok.

Yesterday was relatively good.  Meaning similar AHI (1.10), but felt much better than today (1.08).  Not much aerophagia.

Day before was my Simplus night from Hades.  AHI=1.98.  Sores on face.  Little water in mask.  Splitting headache.  Leaks in mask, flutter or farting all night.  9 CA's, probably due to pressure change.  (Was PS=4.2 over 9.0-14.6 the day before)  Aerophagia.

Any settings to change?  Let it stay for a while?  It may look ok, but I feel un-refreshed and headachey.
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RE: Looking for some help - almost 5 years and not feeling a lot better
@CrimsonNape said:  It shouldn't be touching your forehead. This is too tight and will create a cantilever effect of the lower mask seal as well as not allowing the seal to fully expand for a proper seal. The lower straps act as the main seal tension. The upper straps should be rather loose. Also, Simplus and Vitera appear to work better in a lower position on the face.

Yes, I can see from some of the videos.  I actually had to fashion a chin strap to keep the cushion from riding up.  I will work on it some more, squinting in a mirror.  The cushion is resting on the bump of my chin.  Can't go further down.  Or it will fall off.  Maybe the cushion needs to be smaller to fit me better.

Initially, when I thought I had it correct, there was 0 seal at the nose.  A lot of air went into my eyes.  Have a narrow bridge.  I'll give it a try again, once the sore heals.  Sore is still a little raw.
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RE: Looking for some help - almost 5 years and not feeling a lot better
N30i and P30i may use the same frame, headgear. I've both cushions, I'd gotten the N30i and later P30i cushions.

The Simplus support should not touch, mine for Vitera gets close but did not touch, so I suspect not fitted/suited for your features. Definitely something isn't correct for you and this.

I was not able to find my N/P frame but there's an internet image of the cushions. N30i and P30i.

       
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Looking for some help - almost 5 years and not feeling a lot better
Maybe this image gives idea how Vitera should look while wearing. I'll try to add in a Simplus too. My forehead support didn't seem as close as this image.

Vitera then Simplus

       
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Looking for some help - almost 5 years and not feeling a lot better
I suspect the Simplus headgear is too large.  I can't get it to look the same way as in the picture.  I'm near the limit for adjustment, as in the velcro patches nearly touch in the back.  I ordered a small seal and headgear.  Maybe between all the pieces I have I can cobble something together.  When I adjusted it per the picture, the leak past the bridge of my nose was like a hurricane.  It could be, that it just doesn't fit me.  So in a week maybe I'll have enough assorted sizes and pieces to try the Simplus again.  Fortunately, this experiment isn't too costly.

As for the nasal mask, I think I had tried something like the P30i cushions, but they were longer and uglier.  More like little accordions.  May have been prongs.  Might try the N30i in the hopes of giving up full face.  First, I'll see if the Simplus could work.

When I was at the dentist today, I asked if there were any dental fixtures that could prevent rearward jaw movement.  You'd think I had a hole in my head.  My dentist obviously never experienced the delights of CPAP nor full face masks.  Of course he mentioned some appliance that allegedly treated apnea.  I told him that I had looked into that and they had low efficacy.  He claimed he did not know of such a simple device that I was describing.  Oh well, it was worth an ask.  Maybe a modified mouth guard might work.
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RE: Looking for some help - almost 5 years and not feeling a lot better
The smaller Simplus head gear is better.  However, I'm just at the limit of it fitting - it's a tad too small.  However, the frame just isn't shaped right for me.  It touches my forehead or is 1/8" away, no matter what I do.  I also bought a smaller cushion.  Tried it last night and I woke up after about 90 minutes ripping it off my face.  It felt like I was starved for air.  I could breathe in fine, but there didn't seem to be any oxygen in it.  It felt that way the last time I used a Simplus as well.  I get either 0 leaks and air stagnation, or it leaks like mad, making loud sounds, or it blows a torrent directly into my eyes.  It just isn't working for me.  I'll have to try something different.

I am wondering if the ResMed VAuto is effectively treating me.  It appears it does not effectively drive down my hypopneas.  It might be that I'm the exception to their fancy algorithms which were mentioned in http://www.apneaboard.com/forums/Thread-...imitations 

I seem to have many hypopneas which have very low or no flow limit precursor.  Yes, I have "normal" ones too, and the ResMed works fine on them.  But I do see different Class flow limits which come and go and are not detected at all.  Looking at this January's data, I can say I've felt good maybe 4 days this month, and pretty horrible for about 14 or 15 days.  I dearly would like to reverse that ratio.
   
It would seem my OA's are very well controlled.  They have a tight distribution and the mean is low.  My CA's are uncontrolled by the VAuto, as expected, but are biased low.  My hypopneas are all over the place.  They don't seem to be well controlled at all.  I have looked at my UF2's and they are better controlled, but not that great either.  Maybe some of this is positional, but is not tightly clustered.  
   
It could very well be that a setting could be changed on my VAuto to get better therapy - I am very open to trying.  But I am also wondering if it is the wrong machine for me.  All I know, is after a lot of my admittedly inexpert tweaking, my good to bad day ratio (this month) is close to 0.28, rather than say 10:1.  

You can tell from my chart that I'm in the red zone today.  Dragging and unrefreshed.  The red zone is not a good place to dwell in.  So I'm asking for any suggestions that might help.  Thanks all.  Perfectly willing to zip up any data or charts if someone wants to take a look.  At the 50,000 foot level there's nothing remarkable looking to me.  
   
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