Need advice as to what to try next

I have been on CPAP for over six months. I started with nose pillows, but because I am a mouth breather found that did not work. I switched to a Quattro Air FFM and found that AHI was high when sleeping on back, but quite good when on side (average about 2.5 AHI//hr at pressure eight). After six months I got tendinitis in both shoulders. Diagnosis was that the cause was sleeping on shoulders every night. Because of this I again began sleeping on my back. Now, AHI varies between 8 - 15 at a pressure of 12. However, at the pressure of 12 I get lots of bubbling leaks at the mask edges which wakes me and I do not sleep well and I am not happy with the situation.
Any constructive suggestions would be greatly appreciated.
Thanks in advance for any advice.
RM

RonMatson wrote:I have been on CPAP for over six months. I started with nose pillows, but because I am a mouth breather found that did not work. I switched to a Quattro Air FFM and found that AHI was high when sleeping on back, but quite good when on side (average about 2.5 AHI//hr at pressure eight). After six months I got tendinitis in both shoulders. Diagnosis was that the cause was sleeping on shoulders every night. Because of this I again began sleeping on my back. Now, AHI varies between 8 - 15 at a pressure of 12. However, at the pressure of 12 I get lots of bubbling leaks at the mask edges which wakes me and I do not sleep well and I am not happy with the situation.
Any constructive suggestions would be greatly appreciated.
Thanks in advance for any advice.
RM

Reply,

Yes Ron, first thing take the S9 Escape™ CPAP and return it to whoever gave it to you. Instead, ask for an S9 Elite (which works in CPAP mode only) or even better get an S9 Autoset which can be switched from CPAP to APAP mode. Do the exchange even if you have to pay some cash. These is b/c these machines have data output of your treatment, while the Escape does not (it is a "brick"). Next, I would never suffer by lying on my sides just b/c the AHIs were 15 or even 20. When I started CPAPing 4 years ago my AHIs were between 15 and 25 for 6 months, so what? Over time I improved a lot of things like correct pressures, and ETF, the set up on my machine, masks, chinstrap, etc, and my AHIs became steady below 5 for the last two years. See here a recent ResScan Stats of my treatment for a full year. About mask leaking, the only chance you have is to try more and more masks. Take advantage of the 30 days free trials offered by provider on the Internet. BTW, I use pressure similar to your and it does a good job for me.

My one year recent results of my Stats:

OP does not have the Escape -- he knows his AHI. He's listed the wrong machine.

Hi Ron -- I think we can best help you if you could post a typical night's data (screenshot) for us to examine more closely. That should also tell us which machine you are using, because it's not the Escape that you have listed (the Escape does not record AHI). If you need help with obtaining the free software and posting screenshots, let us know and we'll help you with that, too. I also see that the humidifier you've listed would not work with the machine you have listed -- two different manufacturers.

Does your machine look like this, and if so, does it say Elite, Autoset or Escape Auto by the Start/Stop button? Or something else?



Because you need to sleep on your back, something about your therapy needs to be adjusted so you can get down out of the 8-15 AHI range. First we need to see if leaks are bad enough to be skewing the AHI data that your machine is reporting. I know you said leaks are disrupting your sleep so the leaks need to be dealt with one way or another, but if leaks are not skewing the AHI numbers then your therapy also needs adjustments so you can sleep on your back and still get effective therapy.

Some screenshots of typical nights may show us what's going on during the night and hopefully (unless you have the Escape Auto) will also tell us about the event breakdown of your AHI -- obstructive, hypopnea, and central (clear airway). Adjustments to your therapy (especially pressure settings) will depend on what kind of events are primarily responsible for the high AHI numbers you're seeing.

Re leak control -- a lot of people report that mask liners help with leaks. You may also need to re-fit the mask for sleeping on your back at your current pressure. Video on sizing and fitting the Quattro Air Full Face Mask: http://www.youtube.com/watch?v=Hdh60seM0Z4 . Do the mask fitting while you're actually on your back with your machine on at your max pressure setting because as you've discovered, a good seal at a lower starting pressure can become a bad seal at higher pressures.

I hope this helps -- let us know if you need tips on software and how to post screenshots.

Hi Ron,
Welcome to the forum.
Listen to Kaisagram and do as she asked as she knows her stuff.
Also check your private message box as I sent you a PM with information on how to get and use ResScan software (hopefully you have a Windows computer and not a Mac because it won't work on a Mac).
Be sure to watch the video link I sent too. While for older ResScan the basics are still the same.
If you are seeing AHI on the LCD screen you have some sort of data available. Even the almost brick Escape Auto has AHI and pressure data available. So you at least have that data available. Hopefully you have either the Elite or AutoSet and then you will have even more data available. Sleepyhead won't work with the Escape Auto but ResScan will.

Don't know how to post the data? We talked about it here
Screen shot thread viewtopic.php?f=1&t=81072&p=737779#p737779

See here that only the S9 Escape Auto shows AHIs but not the regular S9 Escape:

http://www.resmed.com/ap/products/produ ... c=patients

avi123 wrote:See here that only the S9 Escape Auto shows AHIs but not the regular S9 Escape:

http://www.resmed.com/ap/products/produ ... c=patients

If Ron really has an Escape Auto he should try to get it swapped out as you suggested.

I wonder how much difference the margin is for the DME to sell/rent him a S9 Escape Auto vs a S9 Autoset or Elite?

Hi Ron,
I am a side sleeper, and have neck problems from cervical stenosis which causes discomfort in my back and shoulder when I'm on my right side. I can't sleep on my back at all, and I toss and turn from side to side a lot. I have a Tempurpedic pillow (memory foam) that greatly alleviates the discomfort - it fills in the space between my head and shoulder and gives my neck some support - it also molds around my FF mask to keep it stable during the night. You might want to try this.