S9 Vpap Adapt ASV

Your AHI can and will vary (some times a lot) so don't worry about that.

I can't help with full face mask ideas...never used one and even if I had there's no guarantee that what worked well for me would work well for you.
I use nasal pillow mask...never wanted or needed anything else. If you want ideas about nasal pillow masks...I have tons of those.

The Adapt will do some serious rapid pressure changes that just simply make any mask a challenge to have it fitted for best leak prevention. I see changes from 9 to 20 cm in press in like 20 seconds and that much of a change is simply going to be more of a challenge with any mask and especially with full face masks where there is more surface area touching the skin.
The Simplus may be better able to manage those rapid and large pressure changes...won't know till you try.

Pugsy wrote:Your AHI can and will vary (some times a lot) so don't worry about that.

I can't help with full face mask ideas...never used one and even if I had there's no guarantee that what worked well for me would work well for you.
I use nasal pillow mask...never wanted or needed anything else. If you want ideas about nasal pillow masks...I have tons of those.

The Adapt will do some serious rapid pressure changes that just simply make any mask a challenge to have it fitted for best leak prevention. I see changes from 9 to 20 cm in press in like 20 seconds and that much of a change is simply going to be more of a challenge with any mask and especially with full face masks where there is more surface area touching the skin.
The Simplus may be better able to manage those rapid and large pressure changes...won't know till you try.

Thanks Pugsy. Would you ever recommend a non full face mask to someone that mouth breathes? If so, what would you recommend?

It all depends on why a person mouth breathes...is it habit or is it from a physical need because nose breathing simply won't work due to some sort of physical problem like chronic nasal congestion or really bad deviated septum to the point no air will move.

I thought I was a mouth breather in terms of cpap mask therapy initially because I woke up with sore throat and dry mouth...but it was habit due to gasping for air during the night because of apnea events.
Once I stopped the apnea events I didn't need to mouth breathe.

I usually ask people "can you normally breathe through your nose just fine during the day?" and if they say "yes" then something other than a full face mask is an option. It they can't...then there is no other option.

When mouth breathing is just habit....sometimes that habit is hard to break and that's where chin straps or taping the mouth comes into play.

If you can normally breathe through your nose just fine during the day...try any nasal mask that you want to and don't let someone tell you that you can't use a nasal pillow mask due to high pressures that go along with ASV use.
I see pressures of 20 every single day and I use a nasal pillow mask and sometimes I have an almost flat 0.0 leak line.
My tongue keeps air from entering my mouth...I never get chipmunk cheeks or anything like that. It can be done.

Nasal pillow masks have the least amount of surface area that contacts the skin and thus are IMHO the easiest to get a good seal and keep the good seal. Simply less real estate to have to deal with.
If you want to try a nasal pillow mask...the new ResMed AirFit P10 is super nice (that's what I am using at the moment)..If you want to try a nasal cushion mask....I would suggest the ResMed Swift FX Nano cushion...and that headgear will also work with the Swift FX nasal pillows...so all you would have to buy is the nasal pillow.
The new AirFit P10...super quiet...new way of venting...barely can feel the vented air if you put your hand 1 inch from the vent holes. Definitely worth looking into if it interests you and you can say "yes" to the breathing through the nose during the day question.

Don't let anyone tell you that you can't use nasal or nasal pillow masks because of higher pressure needs...that's an old wives tale started by someone who never used this stuff because maybe someone at sometime had a problem. We have people using pressures over 20 continuously...and using nasal pillows or nasal cushion masks without any problems.
It can be done..not without some challenges but it's not like full face masks don't come with their own challenges.

Juanefny I was reading a few of your old posts and saw you were unsuccessful for some time. Do you have OSA or more complex apnea? I have also been having trouble for years with various PAP machines and am wondering if ASV type machines might be an area to consider if I exhaust all other possibilities. I only have OSA but it seems some people with OSA can benefit as well?

Overflow wrote:Juanefny I was reading a few of your old posts and saw you were unsuccessful for some time. Do you have OSA or more complex apnea? I have also been having trouble for years with various PAP machines and am wondering if ASV type machines might be an area to consider if I exhaust all other possibilities. I only have OSA but it seems some people with OSA can benefit as well?

I believe that the ASV machine is what she got this time around...the S9 VPAP Adapt ASV.
And yes, there are people using it that don't have centrals that are a problem and doing quite well with it. It's typically reserved by people with central issues due to cost but it can be used by OSA patients too. I am doing it myself and I love the Adapt...and I rarely had any centrals at all and certainly not enough to get insurance to cover it. I did this on my own and I love it. Sooooooo much more comfortable and I guess I took to it like a duck to water...never had any issues with it at all.

Juanefny....you might add your machine model to the comments section of your equipment profile so that people can see what you are using. The S9 Adapt choice isn't available in the equipment drown down menu...so you have to manually type it in the comments section and then it will show up with every post you make...see mine for example.

Pugsy wrote:

Overflow wrote:Juanefny I was reading a few of your old posts and saw you were unsuccessful for some time. Do you have OSA or more complex apnea? I have also been having trouble for years with various PAP machines and am wondering if ASV type machines might be an area to consider if I exhaust all other possibilities. I only have OSA but it seems some people with OSA can benefit as well?

I believe that the ASV machine is what she got this time around...the S9 VPAP Adapt ASV.
And yes, there are people using it that don't have centrals that are a problem and doing quite well with it. It's typically reserved by people with central issues due to cost but it can be used by OSA patients too. I am doing it myself and I love the Adapt...and I rarely had any centrals at all and certainly not enough to get insurance to cover it. I did this on my own and I love it. Sooooooo much more comfortable and I guess I took to it like a duck to water...never had any issues with it at all.

Juanefny....you might add your machine model to the comments section of your equipment profile so that people can see what you are using. The S9 Adapt choice isn't available in the equipment drown down menu...so you have to manually type it in the comments section and then it will show up with every post you make...see mine for example.

Yes I get the impression that these ASV machines can be superior. I have only been trying a Resmed S9 Auto for 2 weeks now but find it quite aggressive the way it seems to push the air into the mask which also can inflate my cheeks a bit at times. Is this a Resmed trait throughout their product line or is the Adept ASV a different beast?

Overflow wrote:I have only been trying a Resmed S9 Auto for 2 weeks now but find it quite aggressive the way it seems to push the air into the mask which also can inflate my cheeks a bit at times. Is this a Resmed trait throughout their product line or is the Adept ASV a different beast?

The S9 Adapt would be even more aggressive. I see pressure changes from 9 cm to 20 cm over about 20 seconds. Your AutoSet can't respond that fast.
I suspect your inflated cheeks is more from the air entering your mouth via the backdoor/airway because the tongue is dropping down and opening the "door" allowing the air to enter the mouth from the airway..lips are closed so the only thing left to do is for the cheeks to inflate.
Hopefully with time and experience the tongue will stay in place better and this annoyance will stop or at least be greatly reduced.

It has been said that the S9s will respond a little faster with their pressure increases when compared to your S9 Autoset's equivalent in the Respironics line but I don't know if even that PR S1 model 560 would stop your cheeks from inflating.
I have used both brands and I couldn't really tell any huge different in aggressiveness or how fast the increase happens but then I sleep through changes for 9 cm to 20 cm that occur in 20 seconds...so maybe I can sleep through anything.

You might be better off with a very, very narrow range if using APAP mode (or just try cpap mode) with your Autoset to limit the pressure changes themselves as a potential factor in the cheek inflation thing....and if you still have it then you know the culprit is the tongue not staying in place like it should. We here this complaint often and call it "chipmunk cheeks".
It's not so much the pressure changing but the tongue placement not being optimal.

Hello,
Sooo I wanted to update everyone on my progress. First of all, I wanted to thank everyone for all their help and advise. After looking further into the graphs very few of my leaks have been over the 30 "number" and my AHI has consistently been below 2, usually below 1 so I am not as concerned with the leaks.
I'm feeling much, much better than before treatment. In fact, it's almost 3:30 pm and before I started treatment I felt like i was dragging by this time, and it's only been about a week of treatment. I can't wait to continue getting better.
Today my Simplus mask should arrive and I'm looking forward to trying that mask and seeing if I have less leaks... after all I seemed to have less leaks at the sleep test than I have with the Quattro Air. That said, I feel like my leaks are better now after watching the Quattro Air fitting video more closely and making sure both sides are tightened the same.
I have ordered a new pillow and I'm looking forward to sleeping with that and seeing if that helps reduce leaks even further.
I plan on getting the mask liners to ensure that it doesn't sound like a dying dolphin when I have the occasional leak. I'm hoping it will also help reduce some of the redness on my face.

Anyway, that's the update so far... things are getting better and the few issues I've had (like leaks and the whole SD card problem I talked about on another thread) have been caused by me and I've easily found ways to get them rectified thanks to this board and all your support and expertise.
PS. I LOVE my machine. So glad that I found Dr. Krakow and that he took the time to diagnose me properly and put me on this treatment. I feel much better than I ever did with the CPAP I was prescribed five years ago... That time I don't think I stuck to the treatment for even a month. I was beyond frustrated and the treatment really wasn't working.

I didn't know you had seen Dr Krakow. I have read a lot about him and by him. He used to stop by this forum on occasion a long time ago.

So glad you are feeling somewhat better. It will get even better with time. Heck, most people are still adjusting to the ASV varying pressures at a week into therapy. The mask thing is the most difficult I think....between leaks and comfort and plain old personal preference it just makes for quite a challenge finding the right one that covers all our basic needs and wants.
Leaks are a war we never totally win but sometimes we win our share of battles and sometimes the mask wins.

Pugsy wrote:I didn't know you had seen Dr Krakow. I have read a lot about him and by him. He used to stop by this forum on occasion a long time ago.

So glad you are feeling somewhat better. It will get even better with time. Heck, most people are still adjusting to the ASV varying pressures at a week into therapy. The mask thing is the most difficult I think....between leaks and comfort and plain old personal preference it just makes for quite a challenge finding the right one that covers all our basic needs and wants.
Leaks are a war we never totally win but sometimes we win our share of battles and sometimes the mask wins.

Yup, I did. It's all somewhat funny... My insurance company also has hospitals and I had gone to their sleep study five years ago and after an inconclusive (at best) sleep test, they shoved me into CPAP, although my AHI was still over 20 at the prescribed pressures. So after a month of trying a ton of masks and such, I never felt nearly as good as I do today and just quit treatment for about four years.
Then I went to the DNC (I also attended the RNC) and the Huffington Post was hosting an "Oasis" that featured doctors in well being topics. So there was a sleep doctor there who advised me to get a second opinion. He also proceeded to scare me telling me all the bad things that could happen to me when OSA is not treated.

Ironically, four months later or so I was on a flight from Dallas to ABQ and was seated next to a doctor. I got to talking to him and he revealed he was a sleep doctor. I then told him about the whole dilemma and about how I was unhappy with my prescription and such. He told me that it sounded to him like I was not on the right treatment and he gave me his card and said that he would more than gladly give me a second opinion. I realized his office and sleep center is down the street from my house.

But I procrastinated for another year... and my sleep apnea got so bad that I gave in and made an appointment. Even his sleep technicians are incredibly more knowledgeable than the ones at Presbyterian. I'm very very glad I came across Dr. Krakow. I know some of his writings may differ from what other doctors believe, but at least for me what he prescribed seems to be doing wonders.
On your ASV point, to be honest, I have adapted much better and quicker to it than to CPAP. After all, at this time five years ago I was getting the mask off my face in the middle of the night in frustration.

I can tell you this. If I hadn't done well with my therapy I would have done my darndest to go see Dr Krakow.
I know some of his ideas don't follow the mainstream but when mainstream isn't working then I am all for trying the other stuff.
He's willing to think outside the box and for a lot of people that's what it takes. I am glad you got to see him.

It's great that you fell into step with your machine's ASV algorithm right away, it took me a lot longer and some nights can still be tough with weird leaks and whatnot. Like someone above said, it seems to come down to how you naturally adapt to different breathing patterns and the overall experience of ASV.