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Resmed n20 just does not work for me!
#1
Resmed n20 just does not work for me!
I have ben using CPAP devices for close to 20 years and pretty much have mainly relied on Resmed products.  For most of this time I have used nasal masks culminating with the Mirage Activa which was very successful for me ( sometimes aided by a chin strap of soft neck brace when I was troubled by mouth breathing).  This mask is now of course well gone. So I tried the "replacement" N20.  I have never had any success with this.  Basically as soon as my ramp period is over, the a10 quickly goes to whatever maximum I have it set on and never comes down. This makes for a very unpleasant night's sleep!

I first noticed this issue when I was using a S9 machines and had hopes that moving to an a10 might work better.  But it didn't! So I have now moved to a full face mask, the f20 and this has worked fairly well for me. But there are times I find this claustrophobic, particular when we have very hot weather and I am sweaty - like the present time (I am in Australia).  I would like to fall back onto  nasal mask for a few days, but the N20 just won't fitl the bill!

I wrote in this forum about this problem back when i was trying the n20 with my old S9 and was introduced to OSCAR.  So I now know why I am getting this problem.  From the graphs I can see that what is happening is that I am getting a continuous stream of smallish flow limitations which the autoset algorithm tries to counter by raising the pressure as much as it can. To no avail! I have not seen this issue with Mirage activa or my f20. So the setup is trying to eliminate obstructions caused by the mask itself!

I ham using the large size pillow but it still seems to squeeze my nostrils rather hard so I think that this is what is causing the obstructions. I have tried both the  silicone and foam versions but this makes no difference. 

So I am looking for advice on what I could try next. I did think of obtaining an n30, but this doesn't even have a large size pillow. I would be happy with non-Resmed masks as well.  But I don't want to waste more money buying masks could never work for me (I have lost count of how many masks I have pursed which end up in my bottom draw!  So any advice will be gratefully received.

Elliot
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#2
RE: Resmed n20 just does not work for me!
I didn't have much success with the F20 myself. I found that making it fairly tight lessened the leaks some but made it uncomfortable. And that would last a few nights then it needed adjusting again. I got tired of it. So I was very thankful to be issued a Fisher and Paykel Simplus during a Titration. When I was due a new mask, I actually noticed the newer model Vitera was in stock and got that. Besides a somewhat fussy nasal bridge leak that can be managed by placing the mask closer to the chin than the F20. All while being comfortable and a light tension in the straps. I'd look that Vitera up.

Also probably since you still are using Ramp, I'm guessing you're adjusting the mask while on ramp pressures. That's why it leaks after ramp expires. It does have me wonder why you're using Ramp after 20 years of PAP usage.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Resmed n20 just does not work for me!
(12-30-2021, 10:35 PM)SarcasticDave94 Wrote: Also probably since you still are using Ramp, I'm guessing you're adjusting the mask while on ramp pressures. That's why it leaks after ramp expires. It does have me wonder why you're using Ramp after 20 years of PAP usage.

I feel I need to defend myself here.  I do not adjust the mask during the ramp period. And I don't get leaks when the ramp time expires. The reason why I use one is that it allows my breathing to settle don.  When I first put th mask on I generally have pretty bad  breathing patterns. If I went straight into  a session, the first 10-15 minutes i will normal have multiple apneas (central?) and hypos. And all of this before I have even got to sleep. That is the way my respiratory system responds to a sudden influx of high pressure. Occasionally even a 20 minute ramp time might still result is a cluster of such events before it settles.  Very occasionally! (the actual ramp itself is not very steep - about 2 cm h20.

But thanks for getting back to me!
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#4
RE: Resmed n20 just does not work for me!
"Basically as soon as my ramp period is over, the a10 quickly goes to whatever maximum I have it set on and never comes down. This makes for a very unpleasant night's sleep!"



Either 1 of 3 possible things can be supposed, it's leaking so much that the PAP has to go to higher pressures immediately or you have high flow limits. And it may even be both.

Don't get too defensive, this forum is opinion based. I had to guess from your comments things that might hinder. So that goes to mentioning show data when asking for help.

You can show an OSCAR chart, standard view with Events, Flow Rate, Pressure, Leaks, Flow Limits. It shouldn't be hard to see from there.

On the mask specifically, Fisher and Paykel are much better than ResMed for me. Far more comfortable and better leak control. Whatever pressures you adjust the mask with will count towards success or failure, as you need to test it under therapy pressures while lying back in bed.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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