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Mask and CPAP machine issues.
I was diagnosed back in Dec with 31 AHI's per hour and received a Fisher Paykel Icon Auto CPAP with a Mirage Quattro full face mask.

The good is my AHI's are ~3 each night and I'm not snoring anymore. Still waking up early in the morning 4-6AM though, but am starting to feel a bit more alert during the day. Seems the worse time for me is in the evenings, a few hours before bed is when I feel the most tired.

Initially the mask was a small, but moved up to medium one week ago. Both leaked and last night I was at 50 L/hr leakage, prior I had been ~35 L/hr when I first got the mask. I do have a goatee that is trimmed very short, but it has grown in the last few days so that maybe causing the jump in leakage.

I've tried loose straps, tight straps, and its not really working, plus the mask leaves red marks on the bridge of my nose as well as on either side of my cheeks. I'm thinking a new type of mask is in order.

When I had my second sleep study to determine mask and pressures, I initially tried a nasal pillow type mask. The problem I had with it was during exhaling it was very difficult to push the air back. Could never catch my breath and would end up trying to breath through my nose. We tried both the extra small and small pillows (I'm 6'6'' but have a little nose) and ended up going to the full mask.

Initially I thought I was a mouth breather, but lately and with effort it seems I can just breath through my nose. With the leaks and still trying to get used to the mask, sleeping is better but not perfect.

From what I have read, there are other CPAP machines that allow for a drop in pressure during exhalation which may make using the pillows an option. Unfortunately the Icon doesn't have that option. Would it be worthwhile to switch both machines (I think the Resmed S9 Autoset has that feature) and the pillows?

Are there any drawbacks to the Resmed S9 Autoset, especially in regards to the drop in pressure feature? The Icon is nice and compact, but don't really care for the controls plus I can't look at my data.

Thanks in advance,
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Hi HDApnea and WELCOME! to the forum.!
If you just got that machine, you could probably take it back and trade up to an S9Autoset.
Best of luck to you and hang in there for more suggestions.
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Hi HDApnea and

Great work on the AHI.

As far as waking up early, it will take some time for your body to get used to being able to actually get sleep. It took me about a month before my body would let me sleep more than 4 or 5 hours.

AutoSets have a feature called EPR. With it you can reduce the pressure on exhale by up to 3 cm. So if your pressure is 8 and you have EPR set to 3, then the pressure will drop to 5 cm when you exhale. Some people really like this feature, but I never use it. The rapid change in pressure irritates me and even though the pressure can seem hard to exhale against, I and many others have found that with a little time we get used to it and don't even notice it. I've tried extensively to use nasal pillows or a nasal mask, but just can't seem to find a comfortable way to keep my mouth closed - even though my mouth stays closed with my full face mask.Dont-know EPR might help you out though and I would whole heartedly recommend an S9 AutoSet for data capability and central apnea detection as well. If you can keep from mouth breathing, nasal pillows are a great way to go - or even a nasal mask. See if there is some way you can try several masks in order to find the best one for you.
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Seriously. Keep trying masks till you get one that does not leak so much AND is comfortable.
(comfort being relative. I can think of more fun things than sleeping with a mask clamped on my face. )

It took me five tries. My friend tried ten different masks before getting one that worked for him.

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Or even try a smaller mask.

I have a big nose, and use the Resmed Swift FX. They measured me, and said I needed a Large sized pillow. It work OK, but leaked a lot. I happened to mention this at the CPAPtoGo store, and she said try a smaller pillow set.

I switched to a Medium, and can now wear it very loose, and there are minimal leaks.
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Thanks for all the advice. This past Monday switched to a nasal mask, the F&P Enos(I think), and so far so good. Apparently I can only just breath through my nose while I sleep, and even saw my AHI's drop to under 2 a couple of nights now.

Apparently my DME isn't as willing to work with me on the masks though. I had switched from the Quattro small to a medium, and then got the nasal mask. Was told if the nasal mask didn't work for me, I'd have to go back to my sleep doctor. I know there is a limit, but a trying one or two different masks seems to be a bit on the low side.

I'm thinking of eventually trying the nasal pillows again somewhere done the line. The nasal mask is so much better than the full mask for sleeping on my side as well as not having as many of the red lines on my face from the mask. Much less intrusive and that has been helping me get a better nights sleep as well. The pillows may be even better.

Thanks again for all your help!
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