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Newbie post - how am I doing/mask issues
#1
Hi all,

I was diagnosed back in mid August, and have been using a machine ever since. I'm on my second nasal mask (the first was too big), and I'm still having issues with leaks depending on how I lay my head on my pillow while side or stomach sleeping. The sleepyhead leak data doesn't seem to imply I have leak issues, but I keep having to adjust the mast at night and it's annoying. I'm thinking of asking for nasal pillows when I go back to see the respiratory therapist on Friday - any suggestions/thoughts?

My AHI in the sleep study was 52. I've gotten as low as 5.5 once and 5.8 one other night, but have been hovering around 10.

Here's my data from last night:

AHIGraph showing running AHI for the past hour 9.20
RemStar Auto with A-FlexPhilips Respironics System One 561CA P10012171C999
PAP Mode: CPAP
Pressure: 9cmH2O
Date Sleep Wake Hours
14-08-31 23:12 08:18 09:01:24
Hypopnea 2.44
Obstructive Apnea 1.77
Clear Airway Apnea 4.99
Respiratory Effort Related Arousal 0.78
Vibratory Snore 0.66
Periodic Breathing 0.79

Event Breakdown

Statistics
Channel Min Med 95% Max
PressureTherapy Pressure (cmH2O)
W-Avg: 9.00 9.00 9.00 9.00 9.00
Minute Vent.Amount of air displaced per minute (L/min)
W-Avg: 4.80 0.12 4.62 7.75 28.00
Resp. RateRate of breaths per minute (Breaths/min)
W-Avg: 10.57 5.26 10.60 12.40 16.67
Leak RateRate of detected mask leakage (L/min)
W-Avg: 1.64 0.00 0.00 8.00 13.00
Total LeaksDetected mask leakage including natural Mask leakages (L/min)
W-Avg: 24.76 21.00 23.00 32.00 37.00
SnoreGraph displaying snore volume (??)
W-Avg: 0.02 0.00 0.00 0.00 1.00
Insp. TimeTime taken to breathe in (Seconds)
W-Avg: 2.86 0.40 2.60 4.66 9.72
Exp. TimeTime taken to breathe out (Seconds)
W-Avg: 2.83 0.26 2.86 3.72 6.46
Tidal VolumeAmount of air displaced per breath (L/min)
W-Avg: 451.91 13.33 420.00 760.00 2720.00

Time over leak redline 0.000%
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#2
Hi Zoe, nice to see you here.

As to your mask, I always recommend the Resmed P10 pillows mask. Of all the many, many, many (well, four anyhow) masks I have tried this is by far my favorite (favourite, for those North of Chicago or South of Texas........)

Right off the bat I think I'd raise my CPAP min to 10. My only reservation with that is I would not want the CA's to climb anymore. But I think the odds are pretty good they are mostly mis-identified events anyhow. So going to 10 might be just enough to get you to that next level, where the ahi drops significantly. Anyhow it's something to talk with your Doc about.

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#3
Hi zoecat5,
WELCOME! to the forum.!
You might ask about the AirFit P10. I really like mine and a lot of people use that particular nasal pillows mask here on the board.
Hang in there for more mask suggestions and help with interpreting your graph.
Best of luck to you with your CPAP therapy.
trish6hundred
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#4
(09-01-2014, 03:04 PM)zoecat5 Wrote: I'm thinking of asking for nasal pillows when I go back to see the respiratory therapist on Friday - any suggestions/thoughts?

There are a lot of Nasal Pillows out there, the most adjustable I know of is the Adam System, but there are a few others out there to choose from, all have advantages/disadvantages. Have a look of as many as you can before choosing one.

Masks are the area where most people have problems, even after they get used to the machine, so hang in there. Smile
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#5
Without knowing anything about what her sleep study said and whether she has been diagnosed with mixed apnea (a possibility based on her numbers), I would be very careful suggesting she increase her pressure without her doctor's advice. Before simply increasing the pressure with the machine in CPAP mode, it would make more sense to try APAP mode with a narrow range (beginning close to 9). I would definitely give her doctor a chance to figure it out - if he proves less than capable, then she can either get another doctor or take the therapy into her own hands.

I like both the Airfit P10 and Swift FX nasal pillows.
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#6
Is there any reason they didn't put you right on the pillows? Asking them about it is a good idea.
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#7
(09-02-2014, 12:35 AM)NickDanger Wrote: Without knowing anything about what her sleep study said and whether she has been diagnosed with mixed apnea (a possibility based on her numbers), I would be very careful suggesting she increase her pressure without her doctor's advice. Before simply increasing the pressure with the machine in CPAP mode, it would make more sense to try APAP mode with a narrow range (beginning close to 9). I would definitely give her doctor a chance to figure it out - if he proves less than capable, then she can either get another doctor or take the therapy into her own hands.

I like both the Airfit P10 and Swift FX nasal pillows.

Thanks everyone for your suggestions - no idea why nasal pillows have not been suggested to me, but I sent a note off to my tech this morning to let her know how I've been doing and that I'd like to try the pillows when we meet on Friday.

I originally had the machine in APAP from 6-15 and when I went back the tech decided to try my on a steady 9 as that seemed to be the average my machine was running when it was responding to events (I think).

I had suggested to the tech by phone bumping up my pressure to 10, and he was worried about it increasing the CA's so suggested I give it another week since I had an appointment already booked, to see if the CA's resolved themselves. Last night my AHI was 6.1 and the CA's were what dropped so it does seem to be getting better, but it's not consistent.

I'm hoping a new mask will help as I'm not loving the Eson right now - I end up with marks on my cheek from sleeping on my side, but maybe that's just the reality of side sleeping on a strap.

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#8
(09-02-2014, 11:43 AM)zoecat5 Wrote: I had suggested to the tech by phone bumping up my pressure to 10, and he was worried about it increasing the CA's so suggested I give it another week since I had an appointment already booked, to see if the CA's resolved themselves. Last night my AHI was 6.1 and the CA's were what dropped so it does seem to be getting better, but it's not consistent.

As frustrating as it is to wait another week to see if the CAs go away, the tech's suggestion makes sense.
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