Low CA at sleep lab, high CA at home

[Papit]

" By the way, how did you enter text in the graph?

I use Micrsoft Paint to capture screen shots of my xpap graphs from either ResScan or SleepyHead, including cropped shots for sending to Photobucket (to get .img codes for posting my graphs here). In Paint, I use the Text/Insert Text tool, put my cursur on the graph where I want to add/insert a note and key away. After entering the added note, click Save, copy the .img code link, paste it into a cpaptalk.com outgoing email and voila.

[avi123]

Thanks Papit. Have you arranged an appointment with a Doc? You mentioned before that your Doc told you to lower the pressure b/c you had many central apneas. But the reason for it could be that you have a Central Apnea Syndrome, no? My Doc also told me that if I raise pressure above 13 cm I could then expect more Central Apneas. So I asked for a sleep test repeat. The result was an optimal pressure of 13 cm on CPAP. But I on my own decided to try an APAP mode and it turns out that the machine decided that my optimal pressure is 10.7 cm at 95%th Percentile (even if I set the APAP on 13 max and 9 min, and EPR on 3, full time). The treatment results are great.


I think that I am going to contact John Fisher's Doc whom he mentioned before, if and when I'll have problems with my sleep.

At the moment I am trying your kind of mask and can't be happy with it. I am using the Mid size but the air flow seems to be too low to satisfy my respiration needs. So I feel a bit suffocated. I got this mask on 30 days trial which would cost me $15 for it. I want to find out my events data on it. But after a few hours I change back to the Resmed nasal Mirage SoftGel, and I also need to change the APAP setting for it. Another thing that annoys me about the Swift FX is when I tighten the strap (electrical wires tie strap) over my head it pulls out some of my hair and this makes me even more hairless. It could also be b/c the chinstrap is nearby too.

[JohnBFisher]

... I think that I am going to contact John Fisher's Doc whom he mentioned before, if and when I'll have problems with my sleep. ...

I continue to be highly impressed with him. He started in emergency medicine (so has a very calm demeanor). He can come across as gruff and no nonsense. However, he is a straight shooter and tells you exactly what he can and can not do to help. He also has a sense of humor.

And he actually enjoys having patients that are involved in monitoring their own therapy. For example, for my next appointment he wants me to bring information from my machine so we can review my therapy.

... At the moment I am trying your kind of mask and can't be happy with it. ...

I find that getting a mask that fits reliably is half the battle. For example, I can normally tell when it's about time for a new mask by the amount of leaking I get. The more it leaks the less effective my therapy.

I wish you luck on your search. It can be frustrating until you find just the right one.

[avi123]

John Fisher, for you:

[JohnBFisher]

... John Fisher, for you: ...

Thank you! Yes! I like the philosophy that quote espouses. We all face trials and tribulations. It's not the trials and tribulations that define us. It's our willingness to continue to dance that makes us who we are. Thank you!

[Papit]

Thanks Papit. Have you arranged an appointment with a Doc? You mentioned before that your Doc told you to lower the pressure b/c you had many central apneas. But the reason for it could be that you have a Central Apnea Syndrome, no? My Doc also told me that if I raise pressure above 13 cm I could then expect more Central Apneas. So I asked for a sleep test repeat. The result was an optimal pressure of 13 cm on CPAP. But I on my own decided to try an APAP mode and it turns out that the machine decided that my optimal pressure is 10.7 cm at 95%th Percentile (even if I set the APAP on 13 max and 9 min, and EPR on 3, full time). The treatment results are great."

I did, yes. Will get back to you shortly on that and some new graph results. I wanted to make sure my feedback is not just a one-day result. We decided together to switch the S9 from straight CPAP mode to the Autoset mode at least for a while. EPR is held at 3 in both modes.

[avi123]

Papit, last night I tried your kind of mask, the Swift FX, and got a crazy Leak graph as you have been getting.

See it here:





It seems to me that this type of mask is prone to leaks and does not produce a smooth curve of leaks.

Next time, I'll tighten the back head strap a bit more b/c the mask's straps keep falling on my face. Another issue with this
small mask is that it is not sturdy like the heavier masks and when the air hose keeps pulling on it, the mask gets dislodged.

[Pugsy]

Avi,
The Swift FX doesn't have to be prone to leaks. See my report below.
I don't wear it tight at all but it doesn't slide off my face either. I also don't use a chin strap now nor do I use tape over mouth. I did do both the first couple of months of my therapy in 2009.
The Swift FX might be a little more unstable than the other nasal pillow masks just because there is less stuff to fiddle with. For some people the Swift LT and now the new Aloha might be a better solution because they do offer a little more stability. I have used the Swift LT in the past and I am now trying the Aloha.

[avi123]

Thanks Pug, I sort of gave up on SH. If I want to see my last night's data I then see this:



It refuses to download since March 22nd, and it still fails to upgrade.

With the the Swift LT I still would have problems. Mainly to do with tying my chinstrap that also goes over the head:

[squid13]

You don't have to run the hose over your head, you can just let it hang. Do you use a hose buddy or something like it?

[avi123]

You don't have to run the hose over your head, you can just let it hang. Do you use a hose buddy or something like it?

And for Pugsy too.

I like the hose to hang down between my bed and the night table that supports the APAP. I could tie the hose to my chest with an expandable belt and then the air hose would not tug on the tiny Swift mask.

Same story with this:



BUT ALL THESE MASKS' STRAPS ARE IN THE WAY OF CHINSTRAPs (ON THE CHEECKS)

This kind of nasal mask can take a chinstrap going over its headgear straps easily, and give excellent leaks avoidance:

[Pugsy]

Avi,
Sorry SleepyHead is acting up. The update thing..that isn't why it won't import the data..that update was a minor bug fix. If SH won't import...I don't know why it won't unless it is trying to find the files in the wrong spot. If you will uninstall SleepyHead...reinstall with the "run as administrator" thing from the install...the update will not be a problem though.

Regardless of which software you want to use though...the leak line doesn't change. I still have times with minimal leaks with the Swift FX. It can be done...I didn't say it was easy.

Chin strap and mask side straps...yeah they do get in the way for some people. Each person has to decide which way to do things either under or over the mask straps.

Hey...if sleeping with the mask was so easy and no one ever had any problems there wouldn't be a forum like this one.

[Papit]

"Avi, The Swift FX doesn't have to be prone to leaks. . . .
"I don't wear it tight at all but it doesn't slide off my face either. I also don't use a chin strap now nor do I use tape over mouth. . . .
"The Swift FX might be a little more unstable than the other nasal pillow masks just because there is less stuff to fiddle with. . ."

Avi, My experience with the FX is exactly like Pugsy's; once you've made the usual little tweaks and adjustments that she mentions. You're exactly right that the weight of the short hose can disturb the pillows. Not a problem though if you figure out a satisfactory means for hose management. Some people clip it to their chest or collar as you suggested. I've had outstanding sealing results by using a hose hanger, one that drops the hose a few inches over my chest, another that drops it a few inches behind the top of my head. The latter is my favorite because it keeps the hose out of my way. For that, like Squid says, it's best to just lay the hose over your shoulder. Not over the side of the bed where it may pull on the mask.

(If you want to play with it, as I like to do, you could route the hose over-head and connect it to the little buckle on the silicone upper crown strap. I've been using that for a while. It's not easy to connect it up there. I use a wire through the buckle. It requires some patience as it takes a knack to mask up because it's all so flimsy. But then that lightness is the beauty of the FX design. I like it a lot.)

The Aloha sounds terrific, but it takes an entirely different design approach. I'm not sure that I will like it when/if I try it because it's a substantial mask with a fair amount of stuff on it. So it's weight and "presence" on my face may have it losing the contest to the venerable Swift FX, with me anyway. It might work for you, though, since you may be used to a more substantial mask.

[squid13]

If I use a chinstrap I put the chinstrap on first then put on the mask.

[Papit]

"Thanks Papit. Have you arranged an appointment with a Doc? You mentioned before that your Doc told you to lower the pressure b/c you had many central apneas. But the reason for it could be that you have a Central Apnea Syndrome, no?"

Yes, I saw my sleep doc last week and have since been collecting and averaging my data. With OA well taken care of by straight cpap, he's focused on my centrals. He was agreeable with trying the Auto mode and we decided together on a Low pressure setting at 7 cm, High setting at 10 and continuing with EPR at 3. Who knows why, but the centrals immediately took a dive, leak went up as expected but remains well controlled and below ResMeds 24 L/min benchmark. OA remains low.
My averaged numbers for the four days that I’ve been using the S9 Autoset in Auto mode, and the stats for the past 10 days, are shown below along with CMS-50 pulse ox data (lowest desat reading and total time spent at 90% desat level and below) which have also improved. Below the stats are last night’s screen shots produced by both ResScan and Sleepyhead. I use them both. Hopefully, this four-day trend is real and will hold.

April 19 to 22 Averaged CA: 5.3, OA: 0.7, 95%LK: 9.8, AHI: 6.3 , Oxd: 87.3; T<90: 1.3 min.
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April 22, 2012 Night 136 CA: 3.0, OA: 0.0, 95%LK: 10.0, AHI: 3.6 , Oxd: 88; T<90: 0.4
April 21, 2012 Night 135 CA: 5.5, OA: 1.2, 95%LK: 9.6, AHI: 7.1, Oxd: 87; T<90: 2.2
April 20, 2012 Night 134 CA: 7.1, OA: 2.2, 95%LK: 10.0, AHI: 9.8, Oxd: 87; T<90: 2.1
April 19, 2012 Night 133 CA: 5.0, OA: 0.2, 95%LK: 9.6, AHI: 5.4
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April 18, 2012 Night 132 CA: 11.9, OA: 0.1, 95%LK: 2.4, AHI: 12.9, Oxd: 83; T<90: 0.4
April 17, 2012 Night 131 skipped cpap Oxd: 75; T<90: 24.1
April 16, 2012 Night 130 CA: 17.8, OA: 1.3, 95%LK: 0.0, AHI: 20.4, Oxd: 80;
April 15, 2012 Night 129 CA: 6.6, OA: 0.0, 95%LK: 0.0, AHI: 6.9, Oxd: 86; T<90: 1.6
April 14, 2012 Night 128 CA: 8.4, OA: 2.5, 95%LK: 3.6, AHI: 10.9, Oxd: 83; T<90: 4.8
April 13, 2012 Night 127 CA: 3.3, OA: 0.2, 95%LK: 2.4, AHI: 3.8