Any idea why high AHI when using FFM

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flightco
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Any idea why high AHI when using FFM

Post by flightco » Tue Sep 01, 2015 2:24 pm

I am trying to figure out why a FFM is not working for me (I have tried 2, F10 and Simplus plus the Amara View - not sure if it is considered a FF or something else).

I have been using the Wisp but need a chin guard to keep my mouth closed and have been trying to get away from this. I have the same issue with both FFM and the Amara View; my AHI goes from 1-2 with the wisp to 8 to 14 with the FFM . I am trying to figure out why, the masks all seem pretty comfortable and my leak rate is not higher than with the Wisp but...

Any thoughts?

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LSAT
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Re: Any idea why high AHI when using FFM

Post by LSAT » Tue Sep 01, 2015 2:52 pm

Have you looked at a Sleepyhead graph? Please fill in your profile with your equipment. (still sounds like leaks).

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flightco
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Re: Any idea why high AHI when using FFM

Post by flightco » Tue Sep 01, 2015 3:01 pm

LSAT wrote:Have you looked at a Sleepyhead graph? Please fill in your profile with your equipment. (still sounds like leaks).
I have, the last two nights (the nights I went back to a FF mask my leak rate was the lowest ever, doesn't even show on the graph but the AHI went from .55 three nights ago with the Wisp to 8.9 two nights ago and 13.01 last night.

I don't think I can upload graphs yet, correct?

I believe my profile of equipment is listed; I see it, hoping you do too

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Pugsy
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Re: Any idea why high AHI when using FFM

Post by Pugsy » Tue Sep 01, 2015 3:06 pm

How to do screen shots of reports along with examples in this thread
viewtopic/t103468/Need-help-with-screen-shots.html
and more details here ..be sure to read all 3 pages
https://sleep.tnet.com/reference/tips/imgur

What is the AHI primarily made up of on the high AHI nights?
What pressure(s) settings are you using?

Off hand without seeing any reports...if the AHI is primarily OA then I suspect you need more pressure with a full face mask than you do with a nasal mask.
Best to evaluate the reports though.

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cancun
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Re: Any idea why high AHI when using FFM

Post by cancun » Tue Sep 01, 2015 3:09 pm

Pugsy wrote:How to do screen shots of reports along with examples in this thread
viewtopic/t103468/Need-help-with-screen-shots.html
and more details here ..be sure to read all 3 pages
https://sleep.tnet.com/reference/tips/imgur

What is the AHI primarily made up of on the high AHI nights?
What pressure(s) settings are you using?

Off hand without seeing any reports...if the AHI is primarily OA then I suspect you need more pressure with a full face mask than you do with a nasal mask.
Best to evaluate the reports though.
Pugsy, I think you also need to change your mask in the clinical setting to FFM from Nasal mask, don't know if this makes any difference or not with the pressures.

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flightco
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Re: Any idea why high AHI when using FFM

Post by flightco » Tue Sep 01, 2015 3:11 pm

cancun wrote:
Pugsy wrote:How to do screen shots of reports along with examples in this thread
viewtopic/t103468/Need-help-with-screen-shots.html
and more details here ..be sure to read all 3 pages
https://sleep.tnet.com/reference/tips/imgur

What is the AHI primarily made up of on the high AHI nights?
What pressure(s) settings are you using?

Off hand without seeing any reports...if the AHI is primarily OA then I suspect you need more pressure with a full face mask than you do with a nasal mask.
Best to evaluate the reports though.
Pugsy, I think you also need to change your mask in the clinical setting to FFM from Nasal mask, don't know if this makes any difference or not with the pressures.
Light bulb just went off, I completely forgot about that. Will do it now before I forget again.

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: Wisp Nasal CPAP Mask with Headgear - Fit Pack
Additional Comments: Also Sleepyhead, P10, F10 and Amara View

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flightco
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Re: Any idea why high AHI when using FFM

Post by flightco » Tue Sep 01, 2015 3:12 pm

Pugsy wrote:How to do screen shots of reports along with examples in this thread
viewtopic/t103468/Need-help-with-screen-shots.html
and more details here ..be sure to read all 3 pages
https://sleep.tnet.com/reference/tips/imgur

What is the AHI primarily made up of on the high AHI nights?
What pressure(s) settings are you using?

Off hand without seeing any reports...if the AHI is primarily OA then I suspect you need more pressure with a full face mask than you do with a nasal mask.
Best to evaluate the reports though.

Will read these and see if I can upload; I thought you had to have 25 posts or something like that

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Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: Wisp Nasal CPAP Mask with Headgear - Fit Pack
Additional Comments: Also Sleepyhead, P10, F10 and Amara View

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Pugsy
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Re: Any idea why high AHI when using FFM

Post by Pugsy » Tue Sep 01, 2015 3:17 pm

cancun wrote:Pugsy, I think you also need to change your mask in the clinical setting to FFM from Nasal mask, don't know if this makes any difference or not with the pressures.
The mask selection choice in the ResMed machines is primarily for establishing a baseline for figuring excess leaks. To have the incorrect mask choice might hide a little excess leak but it won't hide a lot and unless the leak was marginal to begin with I doubt it makes much difference.
The mask choice does NOT affect pressure though...X amount of pressure is X amount of pressure no matter what the mask choice.

The most common cause for higher AHI (that is made up of OAs and hyponeas) when comparing a nasal mask to a FFM is that the FFM needs a little more pressure to do the same job. Don't know why because in theory X amount of pressure should yield the same results no matter which mask but in real life the theory doesn't hold up. Now it might have something to do with the lower straps of some FFM maybe affecting the jaw position...that's a maybe.

All I know is that I have seen lots and lots of reports where people need different pressures to get the same job done between nasal masks and FFmasks...and full face is always needing the higher.

Now if the higher AHI is made up of mainly centrals...we have a different discussion.

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Pugsy
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Re: Any idea why high AHI when using FFM

Post by Pugsy » Tue Sep 01, 2015 3:20 pm

Full face masks typically have a little higher vent rate. If by chance the ResMed machine thinks you are still using a nasal mask it is not going to make the leak report all that different but if anything it will over estimate the excess leak because it would be still working under the assumption a nasal mask was being used which would have a lower vent rate to start with.

Incorrect mask choice would be very unlikely to be the cause of the higher AHI...at worst the leak rate might be off a little but that's about it.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
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I may have to RISE but I refuse to SHINE.

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flightco
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Re: Any idea why high AHI when using FFM

Post by flightco » Tue Sep 01, 2015 3:26 pm

Pugsy wrote:
cancun wrote:Pugsy, I think you also need to change your mask in the clinical setting to FFM from Nasal mask, don't know if this makes any difference or not with the pressures.
Now if the higher AHI is made up of mainly centrals...we have a different discussion.
Will upload when I get home tonight but here is the makeup of last night
CA 6.99
Unclassified 0.00
OA 3.37
H 2.65
RERA 3.37
Large Leak .004%

For reference, my last night on Wisp (3 nights ago)
CA .37
Unclassified 0.00
OA .18
H 0.00
RERA 0.00
Large Leak 2.78%

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Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
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Re: Any idea why high AHI when using FFM

Post by Pugsy » Tue Sep 01, 2015 3:27 pm

Posting of images or links to images (or anything else for that matter) is NOT tied to post count.
All you have to be is logged in under your member ID.

People who post and are not logged in are the ones who can't post links to anything.

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Re: Any idea why high AHI when using FFM

Post by Pugsy » Tue Sep 01, 2015 3:31 pm

flightco wrote: Will upload when I get home tonight but here is the makeup of last night
CA 6.99
Unclassified 0.00
OA 3.37
H 2.65
RERA 3.37
Large Leak .004%

For reference, my last night on Wisp (3 nights ago)
CA .37
Unclassified 0.00
OA .18
H 0.00
RERA 0.00
Large Leak 2.78%
The CAs are Clear Airway events or Centrals and we don't treat those with more pressure because the airway is already open.

The increase in CAs along with the increase in RERAs makes me wonder if the CAs are related to arousals or wake ups.

Now are those potential wake ups related to the also increase in OAs.....that's a million dollar question.
Need to see exactly when those increased events are happening in relation to the sleep time line.

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Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
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I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

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flightco
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Re: Any idea why high AHI when using FFM

Post by flightco » Tue Sep 01, 2015 3:35 pm

Need to see exactly when those increased events are happening in relation to the sleep time line.[/quote]

Will get those uploaded this evening.

After you spoke about higher pressures with a FF mask, I looked and saw that my 95% pressure was 15 which is the max I have it set for; could that be the problem?

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Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: Wisp Nasal CPAP Mask with Headgear - Fit Pack
Additional Comments: Also Sleepyhead, P10, F10 and Amara View

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cancun
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Re: Any idea why high AHI when using FFM

Post by cancun » Tue Sep 01, 2015 3:44 pm

Pugsy wrote:
cancun wrote:Pugsy, I think you also need to change your mask in the clinical setting to FFM from Nasal mask, don't know if this makes any difference or not with the pressures.
The mask selection choice in the ResMed machines is primarily for establishing a baseline for figuring excess leaks. To have the incorrect mask choice might hide a little excess leak but it won't hide a lot and unless the leak was marginal to begin with I doubt it makes much difference.
The mask choice does NOT affect pressure though...X amount of pressure is X amount of pressure no matter what the mask choice.

The most common cause for higher AHI (that is made up of OAs and hyponeas) when comparing a nasal mask to a FFM is that the FFM needs a little more pressure to do the same job. Don't know why because in theory X amount of pressure should yield the same results no matter which mask but in real life the theory doesn't hold up. Now it might have something to do with the lower straps of some FFM maybe affecting the jaw position...that's a maybe.

All I know is that I have seen lots and lots of reports where people need different pressures to get the same job done between nasal masks and FFmasks...and full face is always needing the higher.

Now if the higher AHI is made up of mainly centrals...we have a different discussion.
Thanks Pugsy, of course my DME didn't tell me to change my mask when I got the pillow I had just remembered seeing it when I went in to the clinical menu. I couldn't deal with the pillow and went back to the FFM.

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ F10 Full Face Mask with Headgear
Additional Comments: FlexiFit HC431 FFM with Headgear

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flightco
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Re: Any idea why high AHI when using FFM

Post by flightco » Tue Sep 01, 2015 3:55 pm

seeing if I can post image. This is not the best example because I woke up with low blood sugar and fell asleep in a chair without the mask while I was waiting for it to be corrected. Would you like to see the previous night or a night with the Wisp

Image

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Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: Wisp Nasal CPAP Mask with Headgear - Fit Pack
Additional Comments: Also Sleepyhead, P10, F10 and Amara View