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Mask Fit vs Pressure
#1
As per prescription my replacement cpap was set 5 - 18. Wanting more air, I bumped the base pressure up to 7. All was good and mask fit was 90% to 100%. Still wanting a bit more air, the base was set to 8 and I am now seeing mask fit of +-70% with long duration air leaks of two hours or more. Even with the leaks, AHI has been +-1.

Is 8 likely a point where mask fit is decreased by pressure or is this more likely a mask adjustment problem?

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#2
I use a nasal pillow. That being said, progressively, nasal pillows leak the least, then nasal masks, then FFM, so yes that could be the tipping point. I had a DME prove it to me when I had LL issues with a pillow and wanted to move up. Turns out I just had to learn how to manage leaks with a pillow, which was much easier for me then progressing to a different style mask. I'm not trying to get you to switch.

Couple of questions to help narrow this down:
1-Do you ramp?
2-Do you use EPR?
3-Why did you feel you needed more pressure? (Suffocating feeling)?
4-What is your average pressure through the sleep cycle?

Chuck
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#3
I start at 11 with a FFM; and run as high as 18. Have have near zero leak.
IMHO: most people start with the mask too loose. However, it's not good to be too tight either.
So, you just have to find that "sweet spot" of mask tension.

(03-13-2016, 09:15 AM)Zeeez Wrote: Is 8 likely a point where mask fit is decreased by pressure or is this more likely a mask adjustment problem?

Admin Note:
JustMongo passed away in August 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#4
Being a mouth breather FFM is a necessity. A few times, I felt like I was having to pull air in and that was causing a semi - hyperventilating response. Sounds weird, but it was necessary to take the mask off for a few minutes and settle down. Going form 7 to 8 felt better and I could still go a bit higher. It could be waking from an OSA but I can't say for sure. Complicating the matter, I have been trying to loosen mask straps for less mask lines in the morning. Interesting you can go to 11 without leaks. I used the Quatro for three years before this Airfit F10.

Not ramping
Only have dream mapper software for now, So no average pressure.
Don't know what EPR is. (except on a jet engine)
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#5
(03-13-2016, 02:04 PM)Zeeez Wrote: Being a mouth breather FFM is a necessity. A few times, I felt like I was having to pull air in and that was causing a semi - hyperventilating response. Sounds weird, but it was necessary to take the mask off for a few minutes and settle down. Going form 7 to 8 felt better and I could still go a bit higher. It could be waking from an OSA but I can't say for sure. Complicating the matter, I have been trying to loosen mask straps for less mask lines in the morning. Interesting you can go to 11 without leaks. I used the Quatro for three years before this Airfit F10.

Not ramping
Only have dream mapper software for now, So no average pressure.
Don't know what EPR is. (except on a jet engine)

It's hard to tell somebody exactly what to do , but it sounds to me like your doing the right thing.
If you look at your stat's you could see where your pressure is at 90% and start yours a few points lower and if you have a mask testing option on your machine you could test your fit (tightness of your mask at your 90% level) , I found that option helpful for me to help keep the leaks down without getting mask pressure sore spots. (EPR is what will lesson the back pressure when you exhale) 1 is least and 3 most,
Good Luck and...
Sleep-well
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#6
As a side sleeper, It may not be possible to loosen the mask up enough to prevent the lines. On the Dream Station, I had the idea that the EPR was adjusted automatically. The exhaust from the mask increases dramatically when inhaling and it seems there is much lest exhaust when exhaling. There is no perceptible resistance when exhaling also.
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#7
(03-13-2016, 02:04 PM)Zeeez Wrote: Being a mouth breather FFM is a necessity. A few times, I felt like I was having to pull air in and that was causing a semi - hyperventilating response. Sounds weird, but it was necessary to take the mask off for a few minutes and settle down. Going form 7 to 8 felt better and I could still go a bit higher. It could be waking from an OSA but I can't say for sure. Complicating the matter, I have been trying to loosen mask straps for less mask lines in the morning. Interesting you can go to 11 without leaks. I used the Quatro for three years before this Airfit F10.

Not ramping
Only have dream mapper software for now, So no average pressure.
Don't know what EPR is. (except on a jet engine)


What is EPR?
EPR™ (expiratory pressure relief) is an effective alternative to standard Continuous Positive Airway Pressure (CPAP) therapy. It offers a more natural breathing experience, enabling reliable and predictable therapy control while delivering a higher level of comfort. EPR is a special inclusion only available on some of our newer flow generators.



How does EPR work?
When you breathe out (exhale), the flow generator device (if EPR is integrated) detects the beginning of exhalation and reduces motor speed to drop treatment pressure. The patient or clinician can select one of three comfort levels:



Setting 1 = mild comfort (1 cm H20)
Setting 2 = medium comfort (2 cm H20)
Setting 3 = maximum comfort (3 cm H20)

Oddly enough, I don't know what EPR is on a jet engine!Laugh-a-lot

All machines may not be capable of this. Most people don't use it, or ramping. For me a 5 minute ramp is ideal. I'm usually asleep before the light goes out.

The EPR, eliminated that suffocating feeling I was getting even using a nasal pillow, causing me to mouth breath. Still being a mouth breather, a chin strap put me well within acceptable limits for therapy.

Be patient, a solution will be forthcoming.
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#8
Well,,, It is kind of like Exhaust Pressure Ratio. I get it. Thanks for the explanation. If Dream Station has a setting for EPR, it's not evident. Maybe they have another name for it?

I'm doomed to being a mouth breather. With a narrow nose bridge, The slightest congestion clogs up my nose.

Lightning are looking pretty good this year. Bishop is spectacular! I've been a Bruins fan since the Bobby Orr days.
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#9
Zeeez.

As others have said, if your machine has a mask fit feature and I imagine that it does use it or set your machine to CPAP mode at the max pressure that your auto is set for and use one of these methods to adjust the tension on your head gear. The FFMs are not a lot harder to eliminate leaks with they just require more strap tension because they have more force trying to push them off your face at the same pressure and more seal area to worry about.

There is a good thread on this board written by one of our members about fitting full face masks. The thread is here: http://www.apneaboard.com/forums/Thread-...434#pid434

I agree with everything that Jeffy says but in some areas he could have carried it a little further. The FFM is well worth the effort. I do not know for sure about your mask but with my Mirage Quattro, once I g3et it set right all I have to do is strap it on and let 'er fly. No muss, no fuss. Have to refit after a month or 2 when the straps stretch permanently.

I too am a side sleeper and with the forehead stabilizer on my Mirage Quattro, I almost never have a problem. One other thing my pressure goes up to 20.6 cm/H2O.

Maybe some of the F10 users will chime in here.

Best Regards,

PaytonA

Admin Note:
PaytonA passed away in September 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#10
(03-14-2016, 08:37 PM)Zeeez Wrote: Well,,, It is kind of like Exhaust Pressure Ratio. I get it. Thanks for the explanation. If Dream Station has a setting for EPR, it's not evident. Maybe they have another name for it?

EPR is only on Resmed machines, Respironics has something like 'epr lite' in that it does up to about half as much pressure relief, they call it flex.
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