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Transitioning from P30i to new F30i
#1
Transitioning from P30i to new F30i
Yesterday I received a new F30i.  Previously using a P30i and love the hose connection on top of the head.  A side sleeper who gets air in mouth causing leaks which causes excessive dryness in mouth.  Don't believe I'm a mouth breather!  Fed up using mouth tape.  Decided to try a Hybrid mask that kept the pillow concept and covered the mouth.

 First night using the F30i with terrible AHI numbers.  First session 44.5 and second session 22.5.  My current pressure settings are 7.0 to 8.4 which allowed me to achieve nightly AHI below 5 (mostly around 3.5).  Higher pressures caused aerophagia

I think that the venting on the F30i is much greater than the P30i so decided to increase my pressure from 7 to 10 which hopefully will reduce the AHI without encountering aerophagia.

I find that the F30i is almost the perfect fitting mask for me with very low leakage. 

Interested to know if others have transitioned from the P30i to F30i and what results they achieved.
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#2
RE: Transitioning from P30i to new F30i
I switched from the P30i to F30i also, and for similar reasons. I also find that pillow and hybrid masks, unlike FFMs, help keep the nose open (kind of like a breathe-rite strip).

I have severe apnea, and use a BiLevel set to 14/20. 0.0 nights are common. Last night was 0.2.

You should not need to change your pressure that much just because of the mask change. While the vent diffusing may be different, the vent flow rate should be similar.

I’m GUESSING that you AHI wasn’t really as low as you think before. Reported AHI is meaningless when leakage is high.

It’s also possible that you are getting some false breath hold events if you aren’t used to sleeping in the new mask yet.

However, it’s all guessing without data. Have you tried looking at it with OSCAR?
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#3
RE: Transitioning from P30i to new F30i
Thanks for your response.  Attached is last nights Oscar results.  There are lots of clusters of OA/CA and excessive mask leakage.  I adjusted the straps on the last session and improved the mask leakage (slightly).  Adapting to the mask will take some time.  I sleep on my right side so air delivery is from the left tube only as the right tube is closed from compression.  Inspecting the mask closely there are simple valves at the entrance to the mask which when sufficient air flows opens and closes the vent holes.  When the right tube is closed (in my case) the right vent will be open and increase leakage from the mask.

I think finding the right positions of the straps is an art on this mask.  Any suggestions on how you got it to work are appreciated.


   
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#4
RE: Transitioning from P30i to new F30i
I too like to switch between a P30i and F30i for the same reasons as you.  Once it is adjusted, the F30i the more reliable of the 2 as far as getting a good night's sleep with few leaks.  For me the vast majority of leaks are at the nose, which is why a prefer the P30i over the N30i when using a nasal mask.  (Evidently another company used to make a pillow/FF combo, but no more.)  I wish either "i" had the check valve type venting of a non-i mask (like the F20) but I am willing to accept more noise/venting to have the hose on the top. 

These are the things I have found most helpful with the F30i:
1) Make sure you have the right sized headgear - my DME gave me a standard when I need a small (which only comes with a small mask, but I need a small-wide mask, so you may need to mix and match)
2) Be aware there are more sizes of mask than they may initially offer.  Even though I am a skinny-nosed White woman, I need a "wide" mask as I have a relatively short face. 
3) Try those Polartec strap cover thingies. Aside from getting rid of the mask strap lines, they act as a spacer to keep the connector at a straighter angle and keep the tube from collapsing. 
4) The nosepiece seal is quite sensitive to skin oil.  I wash my mask cushion daily to keep it tacky (my personal favorite soap is the Neutrogena transparent facial bar soap, which IMO is a bit drying for a face, but works great for a mask)
5) Keep the nose cushion well up on your nose.  If your mouth falls open far enough with sleep, it may tug the cushion down and cause leaks. Conversely, if the mask is too long it may hit too far down on the chin with your mouth closed.
6) ResMed has a pillow and a full-face mask setting on the user menu, which help adjust the pressure for the mask type.

Good luck!
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#5
RE: Transitioning from P30i to new F30i
I use the F30i and the leak rate shown from the OSCAR image is not as bad as I have experienced on some nights while showing an AHI of around 2-3. What I look for is LARGE leak rates, and I believe I was experiencing them because of pressure. I recently visited my pulmonologist and he agreed to lower my BiPAP pressure from 22/18 to 20/14. My large leak rate dropped significantly while my AHI's are between 5 and 6. Since I am sleeping better I'll take the slightly higher AHI and gladly trade them for more time sleeping with my mask on — previously I was removing the mask after meeting my compliance requirement of 4 hrs/night. I'm guessing my AHI will eventually get below 5 with time but I couldn't care less if it is 3 or 6 — I believe the AHI level of 5 is arbitrary and it is better to sleep longer with the mask and have slightly higher numbers than to take it off after 4 or 5 hrs. and have potentially much higher AHI's during the remainder of the night.
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#6
RE: Transitioning from P30i to new F30i
RainBowFish

Thanks for the many suggestions.

3)  I'll look into the Polartec strap covers.

5)  My line of thinking was similar as thought that during the night when I'm relaxed my jaw drops and pulls the mask away from underneath my nose resulting in leaks.  The very dry mouth experienced using the P30i has disappeared so perhaps not opening my mouth.

6)  I reset the mask type to Full.  Reviewing the vent chart in both manuals the F30i has much higher venting shown.  Not sure how Resmed compensates for the difference between FFM venting.

I was concerned that perhaps the nostril holes weren't aligned correctly but checked this morning when I was removing my mask and their centered.

Also need to start to clean my mask something which I've been pretty relaxed about.
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#7
RE: Transitioning from P30i to new F30i
Mel062969

I've been able to get over 7 hours although I get up for bathroom breaks typically two times per night.  Last night there were too many large leaks (21) .  During one cluster of CA/OA over a 1 hour period there were the majority of the LL.  I need to understand why this is happening quickly.

There were 65 OA alone!  Very unusual for me.  I do get clusters of typically CA events which appear to be Periodic Breathing (PB).  I took OSCAR results to my respirologist and he said it was classic  CSR!

I was surprised to see this with the F30i as it has lots of venting.  My target is to get these leaks under control.  The F30i seems to fit perfectly when I'am awake so something is causing the leaks.  Perhaps the mask is getting pulled away from my nose but when I awaken its always in correct position so puzzling.
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#8
RE: Transitioning from P30i to new F30i
success!

Had an excellent night with 4hour first session with AHI 0.4 and second session 2.8.  First session taped the bottom of the mask to my chin. Also adjusted both head straps.  There was a burst of CA/OA when I woke up on last session but this is just "junk"

Overall good results but need to see if its repeatable.

   
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#9
RE: Transitioning from P30i to new F30i
Another excellent night.  8hr 26min with AHI 2.85.  Think the mask fit is dialed in as only LL was taking mask off on last session.

Felt more rested this morning which is the real goal.

The key to avoid the high AHI numbers at least for me is to avoid sleeping on my back which causes clusters of CA/OA.

Next step is to fine tune the pressure as many of the flow rate breath show a step during inhalation typically below the mid line and sometimes oscillations.  Need someone more skilled in waveform interpretation than me to advise how to correct this condition.

   

   
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#10
RE: Transitioning from P30i to new F30i
interesting first session. I turned onto my back and then started into cluster of OA which became CSR until I woke up. I was dreaming during this time period a nightmare were I was running in a tunnel which came to an abrupt stop and I woke up.

Clearly shows that I have blockages when on my back.  BTW on this night I had changed PSR 3 from 2

So other than keeping off my back my sleep quality is very poor with being seriously tired during the day. 

Open to any suggestions to improve my sleep quality.

   
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