first night w/Hybrid

inacpapfog · Post by **inacpapfog** » Sat Jul 08, 2006 9:00 am

About 10:30, I masked up and went to sleep. After about 15-20 minutes, I detected that tell-tale sound of leaking, so I slipped my PAC's back and tighten the mouthpiece straps. No more leaks, fell asleep around 11:15.
I was awakened at 3:00, once again by leaks from the sides of the mouthpiece. (I noticed that these leaks seem to be happening as a result of my change of head positions. I suppose that is because facial masks can fit fine in one position, but once you turn, gravitational shifts of facial tissue can cause leaks.) I tightened the straps once again and fell asleep. At 6:00am, another leak/adjustment tweak. Woke up at 8:00am.
I felt sleepy upon waking up, not my normal pattern.
Now, I will say that I think I might not have rested as well with this new mask for the simple fact of arousals. Because I'm used to the minimal skin contact with the Swift, the additional facial contact of the Hybrid must be triggering arousals. Awake, I'm fine with the fit and comfort! Guess, my sleeping body just needs time to tolerate this change. The real shocker--- my average pressure for the night--7.0!!!
( Leak- .34 HI- 2.3 AI.2)
Normally my leak rate is .5 or less and my average pressure around 10!
Strange!?! Other than change the mask setting on my apap, I did not change any other settings on my machine. So, I am really shocked at such a low pressure!! Just gonna take additional time and data to see the big picture I guess!
I want to mention here that my biggest obstacle with the Hybrid is the mouthpiece straps staying anchored on the little posts. They came loose several times during the night as I would turn my head ! (Never had this happen with a mask before!) I wish the headpiece had a more secure means of staying placed on the mask! And, like one poster said, if one of those four posts breaks off, the mask shell is useless! Not a good design in my book.
Overall, I'm very pleased with my purchase and will continue tweaking to render this my mask of choice! It is great to sleep free of a chin strap!!!!
It is also nice being able to take a sip or speak during the night, now that I am tapeless! I will be very interested to get the data from my new m series auto when it arrives next week! By then, I should have adjusted more to this new mask.
Bottom line-The Hybrid sure is comfortable!

mousetater · Post by **mousetater** » Sat Jul 08, 2006 9:11 am

inacpapfog,

Make sure when you attach the straps to the mask that you hear the "click". On the first night I thought I had all 4 straps connected correctly, but once I turned on the pressure, 2 of them flew off. Sometimes the straps feel secure, but unless you hear the "click", they probably aren't. I have found that with 3 nights of use, it is easier to attach the straps correctly than it was the first night.

birdiebaby · Post by **birdiebaby** » Sat Jul 08, 2006 9:47 am

Glad you had a good first night with it. I did, too. Does the Auto Spirit have a mask setting like the S8 series does? If so, I think we are going to see higher leak rates. The vent flow on these masks is much higher than the ResMed masks are. I'm going to change my settings each day to see what gives me the best results. My leak rates are usually no more than .06 l/s. Last night mine were .26. My AHI was under 1 for the first time

I think that it make take several days of adjustment to figure out the best fit. I started to have leaks when I first started going to sleep, so I switched out mouth gaskets and nose pillows until I got something that worked. You might want to try a different size tonight to see if that helps. I am a side sleeper and didn't have any problems with leaks.

Hope you have a good 2nd night!

inacpapfog · Post by **inacpapfog** » Sat Jul 08, 2006 9:55 am

Gee!!! Thanks for that pointer, mousetater!
I do not remember hearing any of the four straps/posts click last night when I put it on! ( I think I was so worried about the post breaking, I did not want to tug too hard! )
Anyway, I just went in there and tried again. The straps "clicked" into place beautifully. Seemed to stay put snugly too! That will make a big difference tonight with the leaks!
PTL for CPAP buddies!

maskjkie · Post by **maskjkie** » Sat Jul 08, 2006 10:06 am

inacpapfog wrote:The real shocker--- my average pressure for the night--7.0!!!
( Leak- .34 HI- 2.3 AI.2)
Normally my leak rate is .5 or less and my average pressure around 10!
Strange!?! Other than change the mask setting on my apap, I did not change any other settings on my machine. So, I am really shocked at such a low pressure!! Just gonna take additional time and data to see the big picture I guess!

Inacpapfog,

I assume that you are using a chin strap with the Swift. If so, due to the upward force that the chin strap applies, the upper airway actually narrows and the resistance to flow increases. So a higher pressure is needed to overcome that. The lower pressure witn the Hybrid does seem intuitive because the soft chin flap doesn't do that. I would also guess that the pressure with Hybrid will be lower than other FF masks because it has far less deadspace and hence less resistance.

I'm going to ask my doctor to request some of our other FF mask and Swift w/chin strap patients to come back for re-titration with the Hybrid so that I can confirm my theory that the pressure will be lower with the Hybrid. I'll post my findings.

oldgearhead · Post by **oldgearhead** » Sat Jul 08, 2006 10:22 am

I believe the Hybrid holds the record for CO2 flush holes. At almost 50 L/Min at 10 cm/H2O.

inacpapfog · Post by **inacpapfog** » Sat Jul 08, 2006 10:29 am

Interesting information, mousetater!
Yes, I use a chin strap (Duluxe) and mouthtape when I sleep with my Swift. The added resistance causing an increase need of pressure would explain why my pressure last night with the Hybid was so much lower than normal! It will be interesting to see what the next few weeks will show!

inacpapfog · Post by **inacpapfog** » Sun Jul 09, 2006 6:45 am

Maskjkie, my second night sure supports your explanation about why my pressure needs with the Hybrid are lower than my pressure needs were with the Swift, chinstrap and tape. Last night pressure was 7.2.
(leak.35, HI 2.3, AI .1) I slept more soundly and feel normal this morning. I only remember waking up once to readjust for leaks! (mousetater's hint!) Also, didn't seem to have arousals due to the "newness" of the mask fit, like I did on the first night. I continue to notice my leakage being high and will keep tweaking to lower that aspect. (BTW My earlier reported leakage with the Swift should have been a .05 not .5 sorry for the mix-up! )

maskjkie · Post by **maskjkie** » Sun Jul 09, 2006 11:54 am

inacpapfog wrote:Maskjkie, my second night sure supports your explanation about why my pressure needs with the Hybrid are lower than my pressure needs were with the Swift, chinstrap and tape. Last night pressure was 7.2.
(leak.35, HI 2.3, AI .1) I slept more soundly and feel normal this morning. I only remember waking up once to readjust for leaks! (mousetater's hint!) Also, didn't seem to have arousals due to the "newness" of the mask fit, like I did on the first night. I continue to notice my leakage being high and will keep tweaking to lower that aspect. (BTW My earlier reported leakage with the Swift should have been a .05 not .5 sorry for the mix-up! )

Inacpapfog,

I'm happy that you are validating my theory. I hope a few others on the forum will find the same thing. I also believe that the generous CO2 washout that the mask provides will also improve your SatO2 and you will start feeling more energetic. Please let me know if you start experiencing that after using the Hybrid for another week or so.

tooly125 · Post by **tooly125** » Sun Jul 09, 2006 8:28 pm

oldgearhead wrote:I believe the Hybrid holds the record for CO2 flush holes. At almost 50 L/Min at 10 cm/H2O.

I wonder why The flush on the hybrid is so much higher than the ultra mirage FF.
They both have six vent holes, the holes are the same size (within .005")
of course the positioning is different.

maskjkie · Post by **maskjkie** » Sun Jul 09, 2006 8:44 pm

tooly125 wrote: I wonder why The flush on the hybrid is so much higher than the ultra mirage FF.
They both have six vent holes, the holes are the same size (within .005")
of course the positioning is different.

Tooly125,
I'm not sure that the flush/flow from exhaust ports on the Hybrid is that much more than the Ultra Mirage FF. I put on both the UMFF and the Hybrid, made sure I had almost no leaks from the sides (I could not eliminate the side leaks on the UMFF but I think I did it with the Hybrid) . Then I measured the leak rate. The Hybrid had only a 2 lpm higher leak rate than the UMFF at 12 cm and that in my opinion is too close to call either way.

But the Hybrid definitely has a higher exhaust flow than the Swift.

first night w/Hybrid

first night w/Hybrid

Re: first night w/Hybrid