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Significant AHI results with different masks.
#21
RE: Significant AHI results with different masks.
(02-16-2019, 09:04 PM)ttsleeper Wrote:
(02-16-2019, 07:31 PM)Sleeprider Wrote: What does your doctor have to offer?



I had a sleep study early Dec 2018 after 5 years of reasonably successful use of ASV machine.
The resp tech said the study "looks good" and that was it. I requested a full face mask because of possible mouth breathing and they recommended the F30.
They then scheduled me for a follow up in 5 months (May 2019)!!
I recently complained to them about the F30 not working well and eventually wrangled an appoint for the end of March 2019.

This is a university sleep clinic and I am not satisfied with their patient care but am in too deep to transfer without significant hassle. I feel they do a good job when you get or force their attention.

I think It's obvious that what changed is the mask. A mask is cheap compared to a sleep study or machine.  Have you tried using your old mask or one like it?  Can you post a typical chart for the time before the mask change, or post the overview chart from Sleepyhead?
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#22
RE: Significant AHI results with different masks.
Hi
As you know I have had same problem with F30 mask - increase in AHI. I think I found what is my problem. With FF mask I was snoring. Whenever I stopt snoring (middle part of night) AHI stoped.

When I use nasal mask I tape my lips - no snoring = mutch better results in my case anyway.

I am posting chart with full night with F30.

Mila


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#23
RE: Significant AHI results with different masks.
(02-17-2019, 01:32 PM)Mila Wrote: Hi
As you know I have had same problem with F30 mask - increase in AHI. I think I found what is my problem. With FF mask I was snoring. Whenever I stopt snoring (middle part of night) AHI stoped.

When I use nasal mask I tape my lips - no snoring = mutch better results in my case anyway.

I am posting chart with full night with F30.

Mila

Mila, interesting and I'm glad it may help you. I looked back (posted) at a recent nasal mask night in which there was considerable snoring but a decent AHI. 

The next post shows the f30 and no snoring but a poor AHI. So, it didn't hold up as an explanation for me. 



                
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#24
RE: Significant AHI results with different masks.
My saga of significant different results with the Resmed FX Nano nasal mask and the Resmed F30 full hybrid mask continues. The following screenshots show this in spades!
I have tried pressure changes, Respironics advised mask settings (1x) etc with no difference. I am back to using last sleep clinic settings (Dec) as I have a follow-up appt end of March and would like to avoid being blamed for tampering with settings. I also previously submitted 1 min interval screenshots as requested by sleeprider. Can anyone shed some light on this situation?

          


Also, is there special software a sleep clinic uses to analyze your SD data card or do they use, as in my case, basic Dreamapper?
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#25
RE: Significant AHI results with different masks.
ttsleeper, if your appointment is with the sleep clinic, I would presume they intend to conduct another titration test, not look at existing machine data. Can you clarify?
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#26
RE: Significant AHI results with different masks.
(03-05-2019, 12:12 PM)Sleeprider Wrote: ttsleeper, if your appointment is with the sleep clinic, I would presume they intend to conduct another titration test, not look at existing machine data. Can you clarify?

What is a titration test? All the follow -ups  I have had consist of an office visit and evaluation of my data. They take the ASV unit with the card and evaluate it in the back office.
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#27
RE: Significant AHI results with different masks.
I have not experienced a sleep clinic that will rely on machine data as "reliable". Most find it more profitable to conduct polysomnograpy testing. I guess you found the exception. From a pragmatic point of view, changes in the settings will give an opportunity to see if an alternative setting is better or worse. An autocratic doctor will view it as an assault on his authority to stipulate compliance with his prescription. A scientist or caring doctor will see an improvement or regression, and make appropriate changes.

Titration is a chemistry term that has been applied to CPAP.
"Titration, also known as titrimetry, is a common laboratory method of quantitative chemical analysis that is used to determine the concentration of an identified analyte. Since volume measurements play a key role in titration, it is also known as volumetric analysis." https://en.wikipedia.org/wiki/Titration

In PAP, titration is a trial and error analysis that follows a protocol to identify the pressures at which desired outcomes occur. In general, EPAP pressure is used to control obstructive events, while pressure support is used to mitigate flow limitation, hypopnea and snoring. In ASV Pressure support is also evaluated as a threshold that can cause a breath in the event of no patient respiratory effort. Sleep doctors use experiments in positive pressure and pressure support to identify the prescription parameters to resolve a problem. In your case, at your last test, they suggested a change in mask and this apparently resulted in worse results:

Quote:I had a sleep study early Dec 2018 after 5 years of reasonably successful use of ASV machine.
The resp tech said the study "looks good" and that was it. I requested a full face mask because of possible mouth breathing and they recommended the F30.
They then scheduled me for a follow up in 5 months (May 2019)!!
I recently complained to them about the F30 not working well and eventually wrangled an appoint for the end of March 2019.

I think your patient approach is fine. I also think that any variables that you try simply provide more data and information for your doctor to make a good therapy decision. I don't worry about offending doctors. In my opinion, the things I try, that are made with good judgement and data feedback, can do nothing but help both of us. If you fear your doctor might be offended or critical of therapy "tweaks", then I would suggest it is the doctor that has a bad attitude, not you. Hopefully, he welcomes the additional information and effort. It's not like things are working well and you should stay the course.
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#28
RE: Significant AHI results with different masks.
I've seen big differences between masks.

My current mask I average around 0.6 AHI, with a different mask that I've used in the past I'll see 2.5 AHI.

The difference is that one mask works better when I'm on my side. The other mask isn't nearly as comfortable and tends to lean when I sleep in any position other than on my back. On my back I will always have higher AHI.
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