Multiple Masks & Leaks

[AcedDublB]

I have tried at least 6 different masks over the past 3 weeks trying to find one that has minimal leaks.

The last one was the Quattro Air and it was very comfortable and I never heard any leaks but the DreamStation Mask Fit was very low around 25%. I had one AHI night around 8.

I started using RemZzzs mask liners with the Quattro Air but little difference in Mask Fit.

Last night I went back to my Amara View using the RemZzzs mask liner for the first time. I was astonished this morning to see Mask Fit 100% but my AHI was very, very high at 41.8, Yikes.

I have turned down my pressure on my Auto BiPAP to 18.0 and 13.0 with PS of 4.0 in order to try and get leaks under control but I should be at 25.0 and 15.0 where I was a few weeks ago when I started testing various masks.

Given that I was able to get an amazing 100% Mask Fit last night but very high AHI, I am going to stay with Amara View and start progressively boosting pressures by 1.5 cm every few days to see if I can get AHI down to 5 or thereabouts.

This last 6 weeks has been so disappointing waking up every morning with numbers all over the map.

The good thing is that I am sleeping well, never wake up during night and get at least 8 therapy hours sometimes 9.

I have absolutely no issue with wearing mask, high pressures, etc., just extremely upset and can't get the numbers I need.

I do want to try a RespCare/Innomed Hybrid mask when I travel to The US next week as they are not available here. Are they suitable for high pressure.

Any advice is certainly appreciated.

[JDS74]

What is the AHI composed of? Are you still getting OSA events or is it mainly composed of Hypopneas?
When the MaskFit number is low, what was the reported leak rate?

High leaks sometimes mask apnea events because the machine has greater difficulty in discerning when and what type of events are happening.

Congratulations on adapting so well to wearing the mask and using the machine. That part is often a big hurdle for new apnea patients.

[AcedDublB]

Last night I had another 100% Mask Fit night albeit for only 5 hours.

The AHI was 64.6

My 90% pressures were 20 and 16 as I am bumping my settings back to higher numbers.

That is 2 consecutive nights with 100% Mask Fit and extremely high AHI.

When I had the Quattro Air FFM I was getting Mask Fit of only 25% but had much lower AHI, including last day at 8

I am now totally confused as to what I should be doing.

Thank you for your advise.

[JDS74]

Use Encore to look at your data and then post the breakdown of the AHI number.
For example, here are my number for last night:

% of Night in PB 2.8
CA: 1.4
OA: 0.0
H: 4.2
FL: 0.6
VS: 0.0
AHI: 5.6

You are concentrating on the summary AHI number but what to do depends on the rest of them.

[robysue]

Last night I had another 100% Mask Fit night albeit for only 5 hours.

The AHI was 64.6

Because of the 100% Mask Fit, these are probably accurate numbers

My 90% pressures were 20 and 16 as I am bumping my settings back to higher numbers.

Given that your script is for (max?) IPAP 25 and (min?) EPAP 15, it could be that you really do need an IPAP much closer to 25 to properly control things.

That is 2 consecutive nights with 100% Mask Fit and extremely high AHI.

When I had the Quattro Air FFM I was getting Mask Fit of only 25% but had much lower AHI, including last day at 8

I am now totally confused as to what I should be doing.

When the mask fit is down at 25% that means that you are in official Large Leak territory for 75% of the night. When the leaks are in Large Leak territory for extended periods of time, the machine can have a very difficult time tracking your breathing accurately. When the breathing is not accurately tracked, the machine can, and sometimes does miss lots of events. That's what I would expect in your case.

But to confirm that's what's going on, you'd need to see the flow rate date, and you'd need to zoom in on it to the point where you can see the breathing on a breath-by-breath basis. Encore can't do this (easily) because Encore only downloads the flow rate data for only the last night on the sd care, or sometimes the last two nights. Encore Basic wipes out the previously stored flow rate data each time you download; Encore Pro does not do that, but it's a pita to download into Encore Pro every single day.

The 1.0-beta version of SH can read the DreamStation data, but it's still in "testing" and because of the nasty situation discussed in viewtopic.php?f=1&t=111056&st=0&sk=t&sd=a, which is JediMark's latest thread. JediMark's last response on the thread indicates that a new link for 1.0 will be available soon

If you don't have SH 1.0 and you would like someone to scroll through your data, I'd be willing to do that for you. You'd have to zip the SD card's contents together and email them to me. PM me if you are interested and I'll let you know where to send it.

[SewTired]

Just as a random recommendation, my brother had a lot of problems with mask fit. He uses a Walgreens brand sleep mask (bright blue) to help hold his mask to his face and achieves 98-100% mask fit all the time now (and that's with a beard). It's quite stretchy but adds just that little extra hold at his higher pressures. They are about $8 (our local Walgreens has a senior 20% off day once a month for anything but prescriptions).

[AcedDublB]

Thank you all for your comments.

I just left home this morning and heading south to Tennessee for a week then a couple of weeks in Florida.

Over the next few days I will increase my settings up to the 25 and 16 level then get a few days before I send off the zip file.

My copy of Encore Pro 2 decided yesterday that it would not function anymore so I will likely delete that program and download again.

I used the Sleepyhead software for about a month until getting the Dreamastation.

I will try the Sleepyhead Beta version once I have time to download it.

I like the idea of a supplemental strap for the face mask so will check out Walgreens on Saturday or Sunday before we get to Fairfield Glade TN.

I will not give up on this journey despite a few too many setbacks and I certainly appreciate your care and advice.

Brian

[Mr Nifty]

I know the frustration of masks and leaks. Check out my signature. The only mask I have been able to use with no leakage is the ResMed Mirage Quattro. Once I added Remzzz's liners and a padacheek anti leak strap. Just got the Dreamwear in the mail today. can't wait to try it out.

[AcedDublB]

Are you a high pressure person?

What DreamWear model are you trying.

Can the RespCare/Innomed Hybrid handle pressures at the high end?

[AcedDublB]

Freezing ice here in New Dundee, Ontario last night and I woke up with pump not working as power went out.

Not a nice sensation waking up with a mask not pumping air.