FFM was a bust.

wrote:obsolete

I think you guys are using the term "obsolete" when it is actually "discontinued".

ChicagoGranny wrote:

wrote:obsolete

I think you guys are using the term "obsolete" when it is actually "discontinued".

Good point, thanks for the distinction.

Hi guys,
Sorry for the delay replying! The mask is an AirFit F10. It was fitted, with a scale. It has quick release, and looks awesome.
What I'm finding is pretty much everything related to CPAP takes getting used to, and I apologize if I sounded overly dismissive. I was hoping that the mask would solve my problems, but it introduced new ones. With time I could learn and adapt but right now I'm only 25 days in. I've had one glorious night where everything worked perfectly but am otherwise still struggling. I think I need to stick to one plan and really hammer out all the kinks. So I'm going to stick with the nasal pillows for now because I know they worked at least once.

Tonight was not great. The nocturia was in full effect and I was getting up once an hour. I had a late meal and a glass of wine, perhaps that hurt. It's spring and my nasal passages aren't completely clear, so that's a possibility. My AHI tonight was 0.4 so unless there were leaks I don't have any apnea to point to. I'm about to go download the data right now.

I visited the urologist again and he had nothing for me. He hadn't heard of the apnea/nocturia connection so that was a bummer. He suggested maybe trying pot, and that prostate cancer was extremely unlikely (nocturia would not be intermittent, and I've had a complete exam). It seems like effective CPAP treatment stops it in its tracks and indeed on my one good night I only got up once. So something about my treatment is not effective. I'm hanging on to the FFM and may come back to it, but I think I got to work on other things first and do everything I can to optimize the current mask. I won't be able to tell what's working and what's not if I am changing the plan all the time.

glowradar wrote:I visited the urologist again and he had nothing for me. He hadn't heard of the apnea/nocturia connection

It continues to be amazing how ignorant doctors are about some things.

BTW, it could be that a nasal interface is not sufficient for your condition.

Do you know when a FFM is required and when a nasal interface is acceptable?

Yes (I mean I'm not an expert, but I could see the leaks on the nasal). This is why I decided to try the FFM. But I think I'm causing a secondary problem: it takes time to get used to things, and by not giving myself time I'm careening. I think O need to slow down and focus. Right now my plan is to work on my nasal passages: saline and/or steroid spray and a nighttime shower to reduce the effect of any irritants on my nasal passages. And then give that approach a week or two before trying something else.

glowradar wrote:saline and/or steroid spray and a nighttime shower

Good plan.

The ideal order is neti pot (or spray) saline rinse, warm shower/bath, steroid spray.

The idea is to get everything cleared out of the nostrils so that the steroid spray is more readily absorbed by the mucous membranes.

Do be aware that people who are very sensitive to corticosteroids may experience insomnia from the spray.

My Gramps is sensitive and can only use the spray first thing in the morning. A few days of regular use of corticosteroid nasal sprays and they are just as effective for nighttime relief of congestion and irritation regardless of whether they are used in the morning or evening.

glowradar wrote:Hi guys,
Sorry for the delay replying! The mask is an AirFit F10. It was fitted, with a scale. It has quick release, and looks awesome.

Cant really help with the peeing, but can advise on the mask -- if you have the F10 and are getting pressure sores then something is absolutely wrong -- it was either sized wrong or is being adjusted wrong. The Quattro cushions are generally very good on the nasal bridge unless severely overtightened or if you have, well, a larger nose at the top. The older Quattro with the adjustment dial is one of the better ones to try because it makes adjustments so easy and precisely. The new ones without a forehead bar take more practice.

But above all remember -- if the mask is not working and you cannot get it to work right FOR WHATEVER REASON, then RETURN IT WITHIN 30 DAYS!!!!! Don't hold onto an expensive mask that doesn't work with your anatomy and/or u cant get to work right. Most all DMEs allow free returns within 30 days. So if you have that option to return it, then do so before the 30 days and try another mask. There are plenty of good FFMs out there to try instead, like the plain Quattro or the Simplus.

If you can use a NP mask then that's awesome. Just know it takes skill and the ability to keep your mouth closed completely while asleep. My good friend just got fitted for a bipap. He really liked the looks of the P10 and wanted it. The DME hooks him up and he starts inhaling through nose and exhaling through mouth... I'm like, um, that's not how its done... When he tried the right way he realized he really needed a FFM to start so he got the QFX and paid extra to also get the P10 for when he eventually could use it.

Good luck whatever you choose, but definitely consider returning that mask asap.

ChicagoGranny - thanks for that sequence. I'm going to do that, in that order.

I just reviewed the sleepyhead data for the entire month, and sure enough there's almost always a large sustained leak or sustained break (without mask [in the first week they were intentional, later they were simply being too sleepy to remember to put the mask back on]) before almost every episode of nocturia. The nights with less nocturia simply have less air leaks.

Despite this I'm getting low AHI scores: last night was 0.36.

Sleepyhead is pretty blunt about all this: on the welcome screen it says "Your mask is leaking way too much". The AirSense screen is absolutely useless: happy face.

Without this message board I would be absolutely screwed, so I'm going to pause for a second and thank all of you, from the bottom of my heart for being so active and responsive.

There are other interesting clues in the data. For example my one "perfect" night (last Wed), was damn good, but not as perfect as I thought. I got lucky with the first leak: it wasn't as intense as one of my typical events, hovering around 30 for half an hour before I woke up. Apparently it did not result in the severe tachychardia and/or ANP buildup, because it looks like I made a quick 30 second bathroom break and was asleep within a minute of my head hitting the pillow. It's possible I didn't go to the bathroom and just turned off the machine for a little bit, as I have no recollection of this at all.

The next leak was more typical, but had an unusual outcome: I slept through it! I must have been so exhausted I just never woke up. The leak rate hovered around 52 for 17 minutes, and then it spontaneously resolved, followed by a series of roughly 10 clear airway events for five minutes afterwards. Again there's no apnea event recorded. In fact it is a rare night that I have any OA or UA events at all.

The night with the FFM was a mixed bag from a leak perspective: there were a large number of leaks in rapid series, but most of the time the leak rate was within or close to the machine's ability to compensate: roughly 26 or so. But I was having a different problem: the pressure was maxed out at 14 almost continuously, and I was having an unusual number of hyponea events. I woke up and the pressure was so intense the air was escaping around the mask, and it scared the living daylights out of me in my sleepy state. My mouth was the dryest had ever been, so clearly my nose was stopped up. The anxiety I encountered waking up in this state pretty much ruined the rest of the night. So I think it may be worth revisiting the FFM, but only after I have become more used to this process.

My path forward is now obvious: I have to figure out these leaks, one way or another.

Be aware that the cpap machine will give you a happy face in terms of leak unless you spend more than 30 % of the night in large leak. So if you spent 29% of the night above 24 L/min you will get a happy face for mask fit. It takes a lot of large leak to get Mr Frowny face.

SleepyHead's "nag" screen that might say "you had significant leaks last night" can sometimes make things out like they are worse than they are.
Like the other night the "nag" screen said "you had periods of significant leak" and when I looked it was 2 short spikes that maybe lasted 5 minutes and went to 30 L/min. In other words SleepyHead's idea of "significant" and my idea of "significant" weren't on the same page.

I know you are having some leak issues...just understand how bad it really is instead of how bad it might initially appear.
Time in large leak is a factor but how far we go above 24 L/min is a factor and how long to we stay up there is also a factor.
You have recently made a mask change....let's give it some time to see what seems to be the overall trend/pattern with the leaks you are experiencing before getting too far ahead of yourself.

If you never go above 30 L/min in LL territory...that's not nearly as bad as going above 35 L/min....and 10 minutes isn't nearly as bad as 45 minutes.

glowradar wrote:Sleepyhead is pretty blunt about all this:

well, if there's one thing my friend jedimark is, it's blunt. *lol*

the whole 'brokenGL/OpenGL' thing is more properly "old versionGL/new versionGL", as one other example.

glowradar wrote:My mouth was the dryest had ever been, so clearly my nose was stopped up.

Yes and no.

People can have a perfectly clear nasal airway and still mouthbreathe using CPAP.

As you know, you need to take steps to deal with the mouthbreathing. I prefer a FFM so that there are no worries if air escapes from my mouth - CPAP will still maintain the pressure and I continue to breathe and sleep.

Sounds like you are in problem-solving mode and that is exactly what you need to be successful with CPAP.