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Need Help With Dreamstation Full Face Mask - Printable Version

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Need Help With Dreamstation Full Face Mask - RWhipkey - 04-21-2018

I’ll begin with a note on my history.  I started CPAP with a Resperonics  Dreamstation APAP and nasal cushion last January and found this forum shortly thereafter.   Not having any guidance from a sleep physician or much from my DME, this forum and its wonderful folks guided me along to very good success with my treatment by dialing my machine in.  Along the way I found that I needed a tight chinstrap and tape over my mouth to achieve good numbers since apparently I am a mouth breather.   Last May, I tried a Simplus FFM, but could not get comfortable with it, so I returned to the chinstrap and tape.  I had even a little better success with the Dreamstation nasal gel cushion when it came out.  I picked up a Dreamstation FFM three nights ago with the hope that I could ditch the chinstrap and tape (I have to wear the strap tightly; it’s hot and I also have some jaw discomfort).  Lastly, I often have upper airway nasal congestion and, I guess as a result, frequent high Flow Limitations as recorded by the Dreamstation.

Here are the results over the last year after dialing in:
1.    Pressure Range 8-12, 239 days, AHI .75, RDI 1.70, FL .46
2.    Pressure Range 8.5-11, 21 days, AHI .75, RDI 1.73, FL .56
3.    Fixed Pressure at 8.5, 47 days, AHI .55, RDI 2.06, FL 1.05
 
My best sleep subjectively has been with the 8.5 fixed pressure.  My hope with the FFM was to be more comfortable (no hot tight chinstrap, tape) and, perhaps to reduce the flow limitations somewhat (the DME respiratory therapist said that I should achieve that as a result as well).  The therapist also recommended a small frame (I always wore a medium before).  I didn’t know that she also gave me a small cushion as well until after the first night (it has an S on the one side where the frame plugs in).
 
The first two nights were spent tweaking the mask adjustments.   I had only fair results.  I ditched the small frame for a medium after the first night.  The mask is very comfortable with the medium frame but, perhaps, the small cushion is too small even though it “feels” OK.
 
Last night had three main sessions and I have posted them below.   I was cautioned by the DME rep not to tighten the straps on the FFM too tight; to wear it rather loosely.  The Resperonics FFM manual says this as well.  So, I began with a comfortable, but loose fit.  The first session was a disaster as far as numbers go (7.76 AHI, 8.62 RDI, .86 FL) and I only slept a little over 2 hours.  After a brief second attempt in which I could not go back to sleep, I put my nasal gel pillow, chinstrap and tape back on and slept for 4 more hours comfortably.  Voila!  .48 AHI, 1.44 RDI, .48 FL.  Feeling rested, I decided to put the FFM back on and strap it on rather tightly.  This 2 hour session had an AHI of 0.00, RDI of 2.66, FL of 2.13 and RERA of .53.  It was too short to reasonably evaluate sleep comfort or refreshment.
 
Again, here are the posts from last night.  I would appreciate your insights as to how to proceed.  Thanks in advance.  (The small sessions after the last major session were me trying humidity levels and strap adjustments while awake).
 
Thanks
Rick


RE: Need Help With Dreamstation Full Face Mask - Sleeprider - 04-21-2018

Your night is broken into three sessions with most of the events occurring early. If you plan to used fixed pressure, then I would try 0.5 cm higher to avoid some OA and H events, or use auto pressure at 8.5-10.0. Results seem to be okay, except for the gaps. The obstructive events from 00:20 to 00:40 could be positional, so an alternative to a chinstrap and tape might be a soft cervical collar.


RE: Need Help With Dreamstation Full Face Mask - RWhipkey - 06-06-2018

I gave the Dreamwear Full Face Mask another try starting on May 20 and implemented Sleeprider’s suggestions.  I settled on a pressure range of 9.5 – 12.5 and wore a soft cervical collar loosely.  Look at these results!

May 20 – June 5 (17 nights)  AHI .27, RDI .64 , FL .22

And, I am much more comfortable havind ditched the chinstrap and mouth taping. 

Thanks Sleeprider for all your help from day 1!


RE: Need Help With Dreamstation Full Face Mask - Sleeprider - 06-07-2018

like
Glad to hear all is well in the Allegheny foothills.