Post Reply 
Using sleepyead - mouth breathing
Author Message
charliethetuna Offline

New Members

Posts: 2
Joined: Aug 2013

Machine: Resmed S9 Adapt
Mask Type: Nasal mask
Mask Make & Model: unsure
Humidifier: resmed
CPAP Pressure: unsure
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #1
Using sleepyead - mouth breathing
Hi all,

When using SleepyHead, which metrics are most useful to look at to see if the mask choice is effective?

I am a new ASV user, started about a month ago. Started with a FFM, but was difficult as I am a stomach sleeper. Switched about a week ago to a nasal mask. I am much more comfortable and getting more hours in with the mask, but still tired and wonder if I am opening my mouth when I sleep.

What data would I look at, besides AHI events in SleepyHead software to interpret this? I am curious to try alternating between chinstrap/no chinstrap or the two different masks and see which one works best.

Leaks have gone down with the new mask, but the mask pressure now shows more volatility and higher numbers.

thanks,
Charlie
08-25-2013 04:50 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
trish6hundred Offline

Advisory Members

Posts: 6,430
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #2
RE: Using sleepyead - mouth breathing
Hi Charlie,
WELCOME! to the forum.!
If you are more comfortable with your nasal mask, you could try using a chinstrap with it 'til you get your leaks under control. I would start out that way for a while and then after you see what your data says, say after about 2 weeks or so,, you could try it without a chinstrap and see how you do.
Hang in there for more suggestions and help with interpreting your data.
Best of luck with your ASV machine.

trish6hundred
08-25-2013 05:15 PM
Find all posts by this user Post Reply Quote this message in a reply
vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #3
RE: Using sleepyead - mouth breathing
(08-25-2013 04:50 PM)charliethetuna Wrote:  When using SleepyHead, which metrics are most useful to look at to see if the mask choice is effective?

I am a new ASV user, started about a month ago. Started with a FFM, but was difficult as I am a stomach sleeper. Switched about a week ago to a nasal mask. I am much more comfortable and getting more hours in with the mask, but still tired and wonder if I am opening my mouth when I sleep.

What data would I look at, besides AHI events in SleepyHead software to interpret this?

Hi charliethetuna, welcome to the forum!

I use ResScan, but SH would be much the same. I look at the plot of Leak, which in ResScan is a plot of unintentional Leak for every second of the night (the whole session). ResScan always displays the plot of unintentional Leak, but in SleepyHead I think it is an option whether you want SH to show total Leak (unintentional leak plus the designed-in or desired mask venting) or only the unintentional Leak.

For periods of high Leak, I also zoom in closely (until 1 minute or 5 minutes fills the whole screen) and look at the peaks of the High Rate Pressure waveform, to see if there are any signs that the pressure is failing to reach as high as expected during times of large Leak, which would be visible evidence that the large Leak was preventing the machine from being able to deliver as much pressure as it wanted. If the unintentional Leak gets higher than about 24 L/m the accuracy of the machine's algorithm begins to be affected. I think if the unintentional Leak plot gets much higher than 30 Liters/minute the machine may be unable to fully prevent apneas or hypopneas from occurring.

The best mask I have found so far has been the ResMed Quattro FX full face mask when worn with a RemZzz mask liner.

I suspect a chin strap would definitely be required if using a nasal mask on an ASV machine, because the pressure on ASV machines may occasionally jump really high, such as higher than 20 cmH2O.

And even a chin strap might not be enough to stop large leaks, if air escapes through your lips which might get pushed open by a high pressure pulse even if the chin strap keeps your jaw from opening.

ASV machines may need to suddenly raise the inhale pressure to be 10 cmH2O or more higher than the exhale pressure, so the machine can do all the work of breathing for you, when you have a central apnea and stop breathing on your own.

If the patient has Complex or Mixed Sleep Apnea (Obstructive Sleep Apnea in addition to Central Sleep Apnea), treating the OSA may require the exhale (EPAP) pressure to occasionally be moderately high (10 cmH2O or higher), and if a central apnea occurs when the exhale pressure is, say, 10 then the pressure may need to jump up to 20 or higher during inhale. So leaks are likely to occur. Even if your jaw stays closed, if your lips open this may prevent the inhale pressure rising enough to completely prevent central apneas.

Not saying to go back to using a Full Face Mask; only recommending you keep a close eye on your sleep data to make sure unintentional mask Leak is not interfering with your machine's ability to treat you.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 08-27-2013 01:17 AM by vsheline.)
08-26-2013 12:32 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
charliethetuna Offline

New Members

Posts: 2
Joined: Aug 2013

Machine: Resmed S9 Adapt
Mask Type: Nasal mask
Mask Make & Model: unsure
Humidifier: resmed
CPAP Pressure: unsure
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #4
RE: Using sleepyead - mouth breathing
Thanks Trish for the encouragement, this stuff is a little tricky to get used to.

Thanks Vaughan for the data, I was thinking along those lines and it's good to hear it spelled out.

Charlie
08-26-2013 10:39 PM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  Bite Guard for Mouth Breathing mcsheltie 11 464 11-29-2016 11:46 AM
Last Post: mcsheltie
  [CPAP] Mouth slips below mask Carbonate 5 240 11-28-2016 07:35 AM
Last Post: jimscott3
Angry [Treatment] Dry Mouth Question Turborob2005 5 297 11-15-2016 10:30 PM
Last Post: Sleeprider
  Mouth Breathing mcsheltie 31 1,013 11-15-2016 08:25 PM
Last Post: chill
Question Dry mouth djamiem 7 304 11-14-2016 08:58 AM
Last Post: Sleep2Snore
Thumbsup [CPAP] Mouth Leak? Saskie 5 327 11-13-2016 07:01 PM
Last Post: Saskie
  Not mouth breathing but air leaking between lips Roy289 20 645 11-11-2016 07:19 PM
Last Post: Sleeprider

Forum Jump:

Who's Online (Complete List)