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New to the board - few questions hopefully I can get help with - FriedRice - 06-22-2022
Hi everyone,
Started using my Resmed ibreeze about 3 months ago. Initial ramp pressure is set to 7 and final pressure was 15 (lowered it to 13). I have moderate sleep apnea with a AHI of 23 per my sleep study.
I started off with a full face mask due to thinking I was a mouth breather and really struggled due to aerophagia. Doctor agreed to lower it to 13. I recently purchased a new nasal pillow mask (Airfit p10) and prefer this over the full face mask. I believe I now sleep with mouth shut and breathe just through my nose.
My AHI numbers are now consistently below 5 ranging from 1 - 3. However, the last 2 nights for the first time using the nasal pillow mask I experienced aerophagia again. My concern and question is if I am breathing through my mouth while sleeping using the nasal pillow mask, will that skew my numbers? Would I wake up if I was breathing through my mouth while using the nasal pillow? My energy level has never been better since using the nasal pillow mask so my assumption is that it's working. However, I want to make sure my numbers are now skewed.
My thinking is that due to the pressure, if I was breathing through my mouth I'd either wake up or realize it somehow. But I'm not so sure...what I have noticed is that my energy is better than ever during the day now and I sleep consistently without waking up for a solid 5 hours straight. I usually go to bed around 10-11 and I wake up around 4am. At that point I take the mask off and sleep another 2 hours without it only because by that time the mask is uncomforable.
Thank you in advance.
RE: New to the board - few questions hopefully I can get help with - Sleepster - 06-22-2022
(06-22-2022, 09:14 AM)FriedRice Wrote: My concern and question is if I am breathing through my mouth while sleeping using the nasal pillow mask, will that skew my numbers?
Yes.
Quote:Would I wake up if I was breathing through my mouth while using the nasal pillow?
No way to tell. If you do wake up you may not have a memory of it.
If your machine is supported by OSCAR, I recommend you use this free software to look at your leak rate graph. If you see large chunks of time where the leak rate is elevated that's a sign that you're mouth-leaking.
Quote:At that point I take the mask off and sleep another 2 hours without it only because by that time the mask is uncomforable.
Try to just accept the discomfort and fall back asleep. Sleeping without the machine hampers your adaptation to it. If the aerophagia persists try a soft cervical collar to keep your airway aligned, that may help. You can also try lowering the pressure to 12 and see if that helps.
RE: New to the board - few questions hopefully I can get help with - FriedRice - 06-22-2022
Thank you, I appreciate the feedback. Now I'm debating on whether I should go back to the full face mask as that would ideally be better in situations where I breathe through my mouth.
RE: New to the board - few questions hopefully I can get help with - Sleeprider - 06-22-2022
The iBreeze is a relative newcomer to the CPAP market and is manufactured by Resvent (not Resmed) of Shenzhen, China. This company sells both a CPAP and an Auto CPAP version, so it will help to know what your model is. IBreeze has a software that can provide you with some data, but the machines are not yet compatible with OSCAR. We're working on it.
The iBreeze machines offer a number of features that can help you with comfort and aerophagia. While Resmed uses EPR (exhale pressure relief), the iBreeze calls this feature IPR (Intelligence Pressure Release). Turning this feature on, and setting to 1, 2 or 3 will provide from 1 to 3 cm of pressure release during exhale. This tends to be very helpful for people with aerophagia and you just have to fine-tune pressure or IPR to ensure continued efficacy, keeping your event rate (AHI) in a good place. We encourage patients to make these kinds of changes to their machines to find out what provides the best quality sleep and therapy. If your doctor is willing to dispense a Chinese machine to you, I am less inclined to accept his insistence on rigid prescription numbers. Most of us are self-titrated and use the machine data and how we feel to make decision on which direction to take therapy.
RE: New to the board - few questions hopefully I can get help with - FriedRice - 06-22-2022
Good to know. My machine is an ibreeze 20A. IPR is set to 3.
I'm now considering moving to my full-face mask knowing that my numbers could be skewed. Or should I just stick with the nasal pillow? Kind of frustrating. My respiratory therapist was of little help and didn't seem to know much, so I'll have to be taking more of this on myself. Well that's disappointing to know. I feel better without a doubt but I want more accurate data. I have an appointment in July with my doctor.
RE: New to the board - few questions hopefully I can get help with - Sleeprider - 06-22-2022
If you can access the iBreeze software, you might get a better picture of how bad the leak is in terms of flow and duration. Most machines can pickup an apnea event, even with a leak. All of us have leaks from time to time, and even awaken to a dry mouth, but if just need a little "persuasion" to help with leaks, I find that just pulling the corner of my pillow between the shoulder and jaw can keep me from leaking as I get into deeper sleep.
RE: New to the board - few questions hopefully I can get help with - FriedRice - 06-22-2022
The leak data I have shows: Leak (L/min) Median 1.9 95%: 45.8. Not sure what that means exactly.
RE: New to the board - few questions hopefully I can get help with - Crimson Nape - 06-22-2022
Unlike the average, the Median is the value that is exactly in the middle of all data collected after arranging the values according to size, either ascending or descending order. Example: If you had 5 values, 1, 11, 2, 8, and 3. After arranging them in order of size (or magnitude) you would have, 1, 2, 3, 8, and 11. The average will be calculated as 1+2+3+8+11=25. 25/5= 5. The median will be 3, because it is exactly in the middle of all recorded values. In your case, you were at or below 1.9 L/min for half the night. Median is the same as the 50%-tile (percentile). The 95%-tile value means that all your recorded values were at or below this number 95% of the time, 45.8 L/min in your case.
- Red
RE: New to the board - few questions hopefully I can get help with - FriedRice - 06-22-2022
Excellent, thank you.
RE: New to the board - few questions hopefully I can get help with - AZGuy - 06-22-2022
This would be a curiosity observation.
With an initial AHI of 26 for Moderate sleep apnea, it seems to me that a CPAP setting of 13 would appear to be a little high.
MY initial AHI was 95 for severe sleep apnea and my machine is set at 14.
If your pressure is too high, that could be causing an issue.
Maybe there's something else going on. Just an observation.