Roller coster AHI...

[Sleeprider]

As long as leaks are present with a FFM or nasal therapy, we are not going to get reliable AHI information. Leaks result in a lot of false-positive events. I don't know what model or size of mask you are using, but it clearly isn't working. Read the Mask Primer and Optimizing Therapy links in my signature, they may help. The mask is the beginning, and I don't see any indication either of yours are appropriate. Have you ever tried a Resmed Airfit P10 or different model of FFM? I have no problem with nasal therapy, but you need to get control over the habit of exhaling through your mouth, whether it's a chin strap, soft collar or tape. Oral expiration means EPAP pressure in your airway falls to near zero. Persistent leaks from a FFM means the mask is shifting or simply does not fit, and of course it is disruptive to sleep. At least witht the FFM you did not record a lot of CA events, and that is a clue that the very high AHI of mostly CA events using a nasal interface may be a function of oral breathing while using the nasal mask.

[Aludj]

I have the ResMed AirFit F30i, Mirage Activa LT, and the Philips DreamWear. Long time ego, I did try the nasal pillow, but did not like it, nor did I have much success with it.

Without the SCC, pretty much every night I woke up with the bottom of the FFM seal is in my closed mouth and required moving the mask to reset it. Last night, the bottom of the FFM did not get in to my mouth, the SCC did do what it was supposed to it seems.

Last night, I used the DreamWear FFM (L). After rereading the recommended links, I made some adjustments to the mask, such as to the headgear. There were minor differences between the length of the straps.

The other adjustment was to change the large to medium-wide mask. Last night I've noticed and woke up for, that the corner of my lips were either outside and/or pretty close to the seal and woke up to loud noise of leak. I'll probably moved around the mas 3-4 times. Due to my size, both head and body, I pretty much just went with the large size mask and never used any other sizes.

I'll see tonight, if the adjustments make a difference.

Thanks for your help...

[Ockrocket]

I have the ResMed AirFit F30i, Mirage Activa LT, and the Philips DreamWear. Long time ego, I did try the nasal pillow, but did not like it, nor did I have much success with it.

Without the SCC, pretty much every night I woke up with the bottom of the FFM seal is in my closed mouth and required moving the mask to reset it. Last night, the bottom of the FFM did not get in to my mouth, the SCC did do what it was supposed to it seems.

Last night, I used the DreamWear FFM (L). After rereading the recommended links, I made some adjustments to the mask, such as to the headgear. There were minor differences between the length of the straps.

The other adjustment was to change the large to medium-wide mask. Last night I've noticed and woke up for, that the corner of my lips were either outside and/or pretty close to the seal and woke up to loud noise of leak. I'll probably moved around the mas 3-4 times. Due to my size, both head and body, I pretty much just went with the large size mask and never used any other sizes.

I'll see tonight, if the adjustments make a difference.

Thanks for your help...

The F30i and the Philips Dreamwear are effectively nasal pillows with a mouth covering piece, perhaps they are allowing leaks around the nostrils without it being all that noticeable when you are asleep.

A week ago I switched from the F&P Eson nose mask to an Airfit F20 Medium full face mask, it seems to have overcome the issue of air escaping from my mouth that had developed over recent months, but it is still showing small leaks occasionally from what I can figure out (about to post charts from my last three nights to the page to get opinions).. however my AHI does not seem to have dropped to any extent.  

The upside is that my wife says the new mask is even quieter than the Eson was.  

Keep at it, hopefully one of us will get a solution that might point the other in the right direction for AHI reduction as well. 

[Aludj]

The F30i and the Philips Dreamwear are effectively nasal pillows with a mouth covering piece, perhaps they are allowing leaks around the nostrils without it being all that noticeable when you are asleep.

A week ago I switched from the F&P Eson nose mask to an Airfit F20 Medium full face mask, it seems to have overcome the issue of air escaping from my mouth that had developed over recent months, but it is still showing small leaks occasionally from what I can figure out (about to post charts from my last three nights to the page to get opinions).. however my AHI does not seem to have dropped to any extent.  

The upside is that my wife says the new mask is even quieter than the Eson was.  

Keep at it, hopefully one of us will get a solution that might point the other in the right direction for AHI reduction as well. 

For me, the F30i/Dreamwear FFMs are just too small for my face. They barely cover the corners of my mouth, fall in to my open mouth and stays in there, when I close it. You could say that I have a big mouth...

Both the F30i and the Dreamware were leaking a lot, the time over leak redline consistently had been 30 - 40% with no SCC; with the SCC, it dropped to mid-20% rate.

After changing to nasal mask, the leak over redline dropped to 15 - 20%; with the SCC, it dropped to zero.

Switching back and forth between different style of masks during the last four days reaffirms this. It's just frustrating, that I cannot consistently have low leak and AHI at the same time...

The Airfit F20 sounds interesting, pretty much a cross between the nasal and full face mask. One could argue, that the F20 is more of a FFM, than the F30i.

How do you like the F20 with memory foam? Is it comfortable, doesn't leave an imprint on the face, etc.

I've seen your other posting; certainly, there will be someone lowering your AHI. Good luck...

[Ockrocket]

The F30i and the Philips Dreamwear are effectively nasal pillows with a mouth covering piece, perhaps they are allowing leaks around the nostrils without it being all that noticeable when you are asleep.

A week ago I switched from the F&P Eson nose mask to an Airfit F20 Medium full face mask, it seems to have overcome the issue of air escaping from my mouth that had developed over recent months, but it is still showing small leaks occasionally from what I can figure out (about to post charts from my last three nights to the page to get opinions).. however my AHI does not seem to have dropped to any extent.  

The upside is that my wife says the new mask is even quieter than the Eson was.  

Keep at it, hopefully one of us will get a solution that might point the other in the right direction for AHI reduction as well. 

For me, the F30i/Dreamwear FFMs are just too small for my face. They barely cover the corners of my mouth, fall in to my open mouth and stays in there, when I close it. You could say that I have a big mouth...

Both the F30i and the Dreamware were leaking a lot, the time over leak redline consistently had been 30 - 40% with no SCC; with the SCC, it dropped to mid-20% rate.

After changing to nasal mask, the leak over redline dropped to 15 - 20%; with the SCC, it dropped to zero.

Switching back and forth between different style of masks during the last four days reaffirms this. It's just frustrating, that I cannot consistently have low leak and AHI at the same time...

The Airfit F20 sounds interesting, pretty much a cross between the nasal and full face mask. One could argue, that the F20 is more of a FFM, than the F30i.

How do you like the F20 with memory foam? Is it comfortable, doesn't leave an imprint on the face, etc.

I've seen your other posting; certainly, there will be someone lowering your AHI. Good luck...

I have the Airfit, not the Airtouch.. mine has the silicone mask, and both versions area a full face mask (covers the nose and mouth as one single covering), the Airtouch is the model with the memory foam.

I chose the silicone one because I found the previous silicone mask on the F&P Eson mask sealed well to the natural shape of my face once the air pressure expanded the thin silicone membrane (and it is also easier to clean, and is surprisingly strong for such thin rubber.. I got four years from a mask that supposedly should be replaced every six months or so).
And the silicone doesn't leave any significant marks on my face, the straps of any mask seem to be what takes the longest to disappear on the face.

A nose mask only covers the nose and leaves the mouth uncovered, which is why leaks became an issue for me... previously I had no problem with just the nose mask and could keep my mouth sealed with my tongue pressed up against the roof of my mouth.
But over the last few months I've tended to relax my mouth more while asleep, and then air escapes at times.

Due to having very thin skin lining the inside of my nostrils I can't tolerate the nasal pillows at all, the irritation is horrendous with the CPAP blasting air directly in at pressure, I'm only able to tolerate it when breathing in naturally.. but with the higher air volume forced by the machine even that is a struggle some nights.

You may find a proper full face mask works better for you than the hybrid models... and most brands of FFM should come with a wide version I think, I know the Airfit does.. since starting using it I've had 100% seal every night, but my AHI hasn't improved much as yet because I need to reassess my pressure setting to find what works best for the FFM (they need a bit more pressure than a nose mask, which in turn needs a little more than nasal pillows do - as a general rule of thumb)

[Aludj]

As long as leaks are present with a FFM or nasal therapy, we are not going to get reliable AHI information.  Leaks result in a lot of false-positive events.  I don't know what model or size of mask you are using, but it clearly isn't working.  Read the Mask Primer and Optimizing  Therapy links in my signature, they may help. The mask is the beginning, and I don't see any indication either of yours are appropriate.  Have you ever tried a Resmed Airfit P10 or different model of FFM?  I have no problem with nasal therapy, but you need to get control over the habit of exhaling through your mouth, whether it's a chin strap, soft collar or tape. Oral expiration means EPAP pressure in your airway falls to near zero. Persistent leaks from a FFM means the mask is shifting or simply does not fit, and of course it is disruptive to sleep.  At least witht the FFM you did not record a lot of CA events, and that is a clue that the very high AHI of mostly CA events using a nasal interface may be a function of oral breathing while using the nasal mask.

I cannot stop the FFM, F30i and Dreamwear, from leaking, even with the SCC. In both cases, the leak over the redline ranges from 20 - 30%. Neither of the FFMs are large/wide enough for my mouth.

With the Mirage Activa LT and the SCC, the over the redline is less than one percent all of the times:

   

The roller coaster AHI did not return during the last 8 days using the Activa LT. That's the longest time period without high AHI results.

I did make a change, lowered the minimum pressure from 8.00 to 6.00 cmH20. Could this be the reason for no high AHI?

Also, would lowering the current EPR level from 3 to 2 cmH2O be beneficial?

I've ordered the AirFit F20 FFM, that might be better, than the Activa LT; it should arrive tomorrow

[Sleeprider]

.
Those results look pretty good, although we would prefer to see a daily details chart than the summary data. I don't understand why you want to get a full face mask when you apparently get good results from nasal therapy. What am I missing?

[Aludj]

I've been using CPAP machines for the last decade, or so; the S9 and now the AS10 for two month. The last two month, I've actually learned about CPAP machines, masks and evaluating the results, thanks to this forum. I didn't know that there's such a wide selections of masks, sleeping aids, etc. I am trying to get the most comfortable mask, that provides the best results.

Certainly, the Activa LT is the best so far and the only mask used with the S9, but it does block my vision to watch TV, prior to falling asleep. The bottom seal rest between the nose and the upper lip; it is a more sensitive area, than resting the seal between the chin and the lower lip. The AirFit F20 seems like a mask, that would address both of these minor issues.

The last three days are pretty good samples of the AHI fluctuations:

               

While there's still a minor "roller coaster AHI", it's far from the 2-30 AHI that existed previously. I'd prefer to minimize this minor  fluctuation, but that may not be possible.

I did notice that the current fluctuation might be impacted by activities, diet, etc. For example, the 0.49 AHI came after having a Yoga class and after trail biking last week, the AHI was 1.49. Couple of days doing nothing and eating more than usual generally result in higher AHI 3-4.x. The sample data is not a lot, nine days so far, maybe this is just coincidence, but certainly will pay attention to it.

My gym opened up and will go back swimming next week. I usually swim between a half to one mile, looking forward to the AHI value for the night.

[Sleeprider]

Would you consider trying a Resmed Airfit P10 nasal pillows mask? No vision block, no pressure on sinus or nose bridge, great, quiet nasal therapy.

[Aludj]

@Sleeprider...

I did try the nasal pillow mask back in 2008, or 2009 and didn't like it at that time. The technology probably got better since then, but...

My initial search shows number of issues with the P10. One is that head-strap has no adjustment and with time, the stretchable fabric loosens up and won't hold the pillow mask in place. The other is the "one size fits all" head-strap, that is too tight for people  with head size above of 7 1/2". I have a bigger melon than that and as such, the P10 does not look like a mask I'd try...

I did get my AirFit F20 FFM today and the initial fit looks very promising. Come on Sun, go down by now, I have a mask to try...