megabill - Apnea Therapy

[Sleeprider]

I agree with that. Revisiting your last set of charts, I just want to draw your attention to the apnea events. You can see the machine doing its best to provide backup breaths with absolutely no effect on your respiratory flow rate. That is how we know for certain this is obstructive along with the obvious increasing flow limitation leading to the apnea. I am certain with the right collar fit, things will change for the better.

[megabill]

The smaller of the 2 collars showed up and it was too small.  The other is coming today.
Meanwhile, I changed EPAP/IPAP to 7.4/13.2   and last night's AHI was 8.23.  Unfortunately, last night saw a use time of only 3 hours.  Over the decades, my wife has never yelled in her sleep- until last night.  Gave me a huge adrenaline rush and made it hard to get back to sleep.  Spent about an hour walking it off and drinking herbal tea.  When I finally hit the bed, I fell asleep before I got the mask back on.
Tonight I hopefully will have a collar to improve things.   I posted a snip from last nights readings.   Interestingly, I think Oscar had some sort of rush too because today it would hang when told to read data.  This happened regardless of whether pointed directly to the card or a copy on a local folder.  I had to remove Oscar and re-install to fix this.

[Sleeprider]

I assume you earned the yell by snoring. I wish you luck and better comfort.

[megabill]

Oscar says I did not snore while wearing the mask and hooked up.  If I happened to snore during the time I fell alseep without the mask,  in my HUMBLE opinion, the snore was a result of the unexpected wakeup yell and subsequent adrenaline rush.  Therefore SHE deserved the SNORE.

[megabill]

so far no luck with collars. I have tried 4 and they either are too constricting or are too high.  This weekend my task is to customize one to fit better.

Meanwhile, I am experimenting with masks.  The first attachment is an overview to show my segmented sleep.  I then am posting a zoom in of section 1,  section 3 and section 4.

For the first 3 segments I am using a resmed F30.  For the final segent a resmed airtouch f20 which has the memory foam edges.

I had a huge problem early with the f30 getting enough airflow to the nose.  I have mostly solved that by removing the flap separating the two nostril holes using small precision scissors.  This makes the airflow acceptable.  The problem I continue to have with the f30 is sealing around the edges.   I am awakened often by maskfarts when using this mask.  However, on days when I get the fit right (randomly - unable to arrive at something that works all the time) I feel more rested on waking and have a lower AHI than I normally get with the f20.   

I wonder if my observations are borne out by the data, and what else this data might say.

My thanks in advance.

---

Here is the sect 4 capture from Oscar

[Sleeprider]

The obstruction is pretty obvious and we can see both flow limits and inspiration times rise together, while tidal volume and minute vent are reduced. Which collars and sizes have your tried? How would you feel about using some higher pressures to see if that can open things up? What has been your experience with higher pressrue?

[megabill]

I have tried higher pressures, but when I have the AHI has not shown any real improvement.  Higher pressures have resulted in more maskfarts-additional difficulty in achieving a seal.  AND has resulted not only in more severe cotton mouth as well as  significant nasal irritation.  I would awake with the feeling that a goose feather had been embedded in my nasal passages.

I think you were spot on about the obstruction being position related.  I have seen fewer events since I replaced my pillow with a much thinner one.  I sleep in an adjustable bed  because my back does not like it when I try to sleep flat.  I generally sleep in  what the bed mfr calls "zero g" position, and sometimes need to elevate the head a bit more to alleviate both back pain and to keep sinus drainage flowing rather than pooling and blocking the airway.

I have a futuro collar that I am going to use K-tape on to tweak the height, and a piece of velcro 'one-wrap' to lengthen the fastener to make it easier to put on and take off.  I hope this helps.


I think the data looks better while I was using the f30 mask rather than the f20.  I would like to learn how to get a better fit/seal without cranking on the straps so hard that I gouge permanent lines in my face.  I wish I could use  nasal pillows, but I tried that  and  it so irritated the passages that I had to NOT use the machine for 2 nights. I also just acquired a phillips dreamwear hybrid mask that I will try.  Hopefully the pressure will not blow the mask right off my face.

[Sleeprider]

i think working on your positional issues will help more than pressure. You're on the right track, and just need to think-through the problems that cause your head to fall forward in your zero-G sleep position. There are a number of helpful reviews on collars in the reviews forum area that might be useful. Many members have also had to work through these issues and the inclined sleep position has been challenging.

[megabill]

Thank you Sleeprider

Iwonder if you (or anyone) can offer mask insights.  I use the large cushion for the f20.  Airtouch works better than airfit.  The cushion partly compresses the airway where it sits on the bridge of my nose - smaller cushion blocks it completely.

F30 has issues.  Out of the box, the cushion design makes it very difficult to line up the holes in the nasal interface with nostrils.  Cutting out the separator with precision scissors helps but is not perfect. The most serious problem isgetting a fit that seals, or one that at least does not produce maskfarts.  Those make sleep difficult.

Tried the Phillips dreamware.  Have so far not been able to get situated so that it  both seals and nasal breathing works.  I may have the wrong cushion size.  I should have gotten a fit pack but did not.

Have also tried F&Pvitera.  It also has sealing issues plus the clips on the straps are especially a PITA to navigate at night when groggy.  By the time Iget them clipped I am wide awake, frustrated and have difficulty getting back to sleep.

[Sleeprider]

You may wish to split your mask questions into a separate thread with that specific question. I have basically used nasal pillows since 2008. I was originally given a Respironics nasal mask that soon gave way to a progression of pillows. An option for you may be to trial more masks. Supplier 1 has a program where they will allow a mask to be tried for up to 30 days and they will exchange. Maybe the Inomed/Respcare Hybrid full face mask or Mirage Liberty will work better. All have design nuances that make a better fit and comfort possible. You might be well served to trial a few of these to see if you can find one that works.