Weird grunting on ASV

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
tuzacat
Posts: 313
Joined: Wed Feb 13, 2013 5:52 pm

Weird grunting on ASV

Post by tuzacat » Thu Oct 30, 2014 9:55 am

I am kind of at my wit's end. I have been on ASV therapy for about a month and have a weird problem. When I fall asleep I start to grunt which, of course, wakes me up. It happens with every nasal pillow or cushion mask I own and feels a little like the back of my throat is shutting down. I have tried to pinpoint when it is happening and my best guess it's at the transition between inhalation and exhalation. Just prior to ASV I had ordered an Airfit Nasal cushion mask which I can no longer use. I also used a Nano, Wisp, and, once in a while, the Swift FX, when it didn't congest me. With nasal or cushion masks I have come to wearing a chinstrap and taping because full face masks give me chipmunk cheeks which keeps me awake. The only thing that is working at present is a Hybrid with a chinstrap.Without the chinstrap I get chipmunk cheeks. It is not particularly comfortable but I don't have the gaspy, grunty thing when I wear it. Last night I could barely tolerate it so I tried the Swift FX again with a chin strap and tape - more comfortable but started grunting again - had to switch back to the Hybrid. When I look at my data I have almost no CA's or OA's anymore - most of my AHI is Hypopnea's. I also have nights where I am snoring over the machine. This makes me think that something is not set quite right but I have no idea what. I tried Bi-Flex on different settings and played with the chinstrap to see if somehow I was strangling myself. On Bipap my setting was 13/10 but on ASV it 14/8. I notice most nights the exhalation pressure is 9 or above. It feels too low when I exhale but since the machine is adjusting itself why would it be? Has any one else had this problem; if so how did you resolve it? Is this part of getting used to ASV?

I had an appointment with my doctor on Tuesday and he didn't have anything to offer me. He thinks I am doing well. And I am - sort of - I am sleeping a little longer without waking up and feel a little more rested in the morning. But by the end of the day I'm pretty exhausted. Prior to ASV I'd sleep for a couple of hours and then when my sleep aides wore off I'd wake up. Now I struggle to get to sleep longer but sleep for about 5 hours before I wake up. I do think this might be the right therapy for me once the kinks get worked out.

On Sunday I have an appointment with the tech at the sleep clinic to investigate different masks. I think I'm going to have to get a full face mask but I am guessing if that's the case I'll end up wearing it with a chinstrap to avoid chipmunk cheeks. A while back someone on here mentioned a full face mask which hit them on the face at the right spot so it held their cheeks in. I am going to see if I can find that post again but I would certainly appreciate any suggestions. My issue with the nasal and pillow masks is not leakage - it's the weird grunting that keeps me awake!

Thanks for any input you might have!
Best,
Tuza

User avatar
Sir NoddinOff
Posts: 4190
Joined: Mon May 14, 2012 5:30 pm
Location: California

Re: Weird grunting on ASV

Post by Sir NoddinOff » Thu Oct 30, 2014 11:37 am

I started with nasal pillows and because of the "grunting" you described low down in your throat I had to switch to a full face mask. I'm not sure what was causing the grunting or even small burps but it is hard to sleep thru. For FFMs I first tried the Quattro MIrage, then the Quattro FX and finally I ended up on my current AirFit F10. FFMs are a challenge to get used to, however all that grunting went away once I got the right size F10. Now I'm just dealing with comfort issues and the occasional leak. It's always something I suspect the blow-back from your therapy pressure is the culprit in both your grunting and chipmunk cheeks, that was my case.

_________________
Mask: AirFit™ F10 Full Face Mask with Headgear
Additional Comments: Sleepyhead software v.0.9.8.1 Open GL and Encore Pro v2.2.
I like my ResMed AirFit F10 FFM - reasonably low leaks for my ASV therapy. I'm currently using a PR S1 AutoSV 960P Advanced. I also keep a ResMed S9 Adapt as backup. I use a heated Hibernite hose. Still rockin' with Win 7 by using GWX to stop Win 10.

tuzacat
Posts: 313
Joined: Wed Feb 13, 2013 5:52 pm

Re: Weird grunting on ASV

Post by tuzacat » Thu Oct 30, 2014 1:28 pm

Thanks for your response, Sir NoddinOff, the AirFit F10 was one I was thinking of trying. Someone mentioned in another thread the Flexifit 432 as one that kept them from having chipmunk cheeks but it has a forehead piece so I'm not sure about that for comfort. I am not sure what you mean about the blow-back but I will look it up. It does seem to be always something, doesn't it?

User avatar
M'ohms
Posts: 516
Joined: Fri Aug 09, 2013 2:44 pm
Location: Georgetown, Indiana

Re: Weird grunting on ASV

Post by M'ohms » Thu Oct 30, 2014 3:26 pm

Like Sir Nod, I went through the same 3 masks. I grunted for about a week (don't remember which mask), but then it just went away. I don't what caused it to start or stop; I didn't change anything.

_________________
Mask: Quattro™ FX Full Face CPAP Mask with Headgear
Additional Comments: Supplemental oxygen at 2.5 lpm
AutoSV 960 with heated hose. Settings: EPAP Min-12, EPAP Max-17, PS Min-5.5, PS Max-13, Max Pressure-25, Rate-Auto, Rise Time 1. Use Sleepyhead and Encore Pro.

tuzacat
Posts: 313
Joined: Wed Feb 13, 2013 5:52 pm

Re: Weird grunting on ASV

Post by tuzacat » Thu Oct 30, 2014 3:40 pm

Well, M'ohms, I've been wondering if I need to be more patient - someone on here said three months of adjustment - but since I'm still working I absolutely need to get some real sleep at night. The chinstrap with the Hybrid is not exactly comfortable but it beats grunting all night long and keeping myself awake. Thanks for commenting because the Dr. even though he's a cpap user himself had no idea what I was talking about.

User avatar
M'ohms
Posts: 516
Joined: Fri Aug 09, 2013 2:44 pm
Location: Georgetown, Indiana

Re: Weird grunting on ASV

Post by M'ohms » Thu Oct 30, 2014 4:00 pm

I forgot to mention that I also use the Hybrid mask sometimes. I do not like chin straps, so I wear a cervical collar when I'm having trouble with jaw drop. That works a lot better for me. Patience is definitely something you need with this therapy. It took me about a year and a half before I started feeling normal again. Most people have success much earlier than that, but for some, it just takes more time.

_________________
Mask: Quattro™ FX Full Face CPAP Mask with Headgear
Additional Comments: Supplemental oxygen at 2.5 lpm
AutoSV 960 with heated hose. Settings: EPAP Min-12, EPAP Max-17, PS Min-5.5, PS Max-13, Max Pressure-25, Rate-Auto, Rise Time 1. Use Sleepyhead and Encore Pro.

User avatar
Sir NoddinOff
Posts: 4190
Joined: Mon May 14, 2012 5:30 pm
Location: California

Re: Weird grunting on ASV

Post by Sir NoddinOff » Fri Oct 31, 2014 3:52 pm

M'ohms wrote:I forgot to mention that I also use the Hybrid mask sometimes. I do not like chin straps, so I wear a cervical collar when I'm having trouble with jaw drop. That works a lot better for me. Patience is definitely something you need with this therapy. It took me about a year and a half before I started feeling normal again. Most people have success much earlier than that, but for some, it just takes more time.
Hi M'ohms. Hmmm. I might try a cervical collar if it was ventilated with holes or something like that, my bedroom tends to get warm all year round. M'olms... do you have any light weight recommendations in that department

I don't like chin straps so I use an old bike cuff strap looped thru my bottom straps to keep my chin up and to help keep the mask from riding up. Here's a link to that write up I did awhile ago, It's a neat option to a full on chinstrap and is certainly less restrictive. Photo included:

viewtopic.php?f=1&t=96560&p=894169&hili ... ff#p894169

If you enter the link, also go down a few replies and I zero in on how I got it to work.

_________________
Mask: AirFit™ F10 Full Face Mask with Headgear
Additional Comments: Sleepyhead software v.0.9.8.1 Open GL and Encore Pro v2.2.
I like my ResMed AirFit F10 FFM - reasonably low leaks for my ASV therapy. I'm currently using a PR S1 AutoSV 960P Advanced. I also keep a ResMed S9 Adapt as backup. I use a heated Hibernite hose. Still rockin' with Win 7 by using GWX to stop Win 10.