Dazed and Confused

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
grifho

Dazed and Confused

Post by grifho » Wed Feb 10, 2016 7:36 pm

I'm new to this CPAP thing, having been on it almost 4 weeks. I have a Resmed Airsense 10 with a Mirage FX Nasal Mask. I've spoken to to a Sleep Doctor and CPAP supplies person, but can't seem to get a satisfactory answer to some of my questions. My questions revolve around mask leak I've been getting, as well as not-great total apnea events per hour (about 5-8). Let me try here--thanks!

1) My best mask leak scores have been when I've tightened the mask to the point where it's a little uncomfortable. Yet I've heard it should be comfortable, but not tight. But if it's not tight, I get mask seal scores of 10L/min or higher, and then get an email from Resmed saying that my mask leak seem to be continuing. Should I just try another mask? I've tried pulling it off my face while it's attached, and gently placing it back on, as I read somewhere that it will keep the silicone more directly on the skin rather than "folding under", or something like that.

2) The apnea events recorded are the ones that occur despite the CPAP, right?

3) The sleep doctor said that the mask leak may be leading to the apnea events being higher than they should be. She said that ideally I'd have 2 or fewer events/hour. Does that mean that the CPAP can't really address and correct all the events that occur? Just wondering, because if the mask leak is preventing the events from being corrected, then I would think fixing the leak would allow it to correct all of them.

4) Mouth breathing is not a good think with a nasal mask, yet that's what I'm doing. So I ordered a chin strap. Would mouth breathing raise the mask leak scores by itself? And would mouth breathing reduce the ability to record apnea events and/or correct apnea events?


OK, that's it for now. Sorry I'm a bit obsessive/analytical about it, but that's the way I am, and I also want to do this right. Thanks for any feedback!

Mudrock63
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Re: Dazed and Confused

Post by Mudrock63 » Wed Feb 10, 2016 7:49 pm

How high are your pressures set on the machine? Mine are pretty high, so I have to keep my mask rather tight to prevent leaks. Got used to it after a while. I've had best results with a full-face mask as far as leaks are concerned.

Yes, the events recorded are those that occur while you are being treated. Some of them can be false alerts, especially if you are awake with the machine on.

I think you NEED to be analytical to help you manage this condition. 5-8 AHI routinely is not good enough. Now the trick is to figure out whether that is caused by leaks, pressure settings that aren't quite right for you, or several waking events during the night. Your present machine probably CAN treat you, with the proper settings, and getting a comfortable mask that doesn't leak like a fire hose.

Probably going to need some more info and reports for the experts to be able to advise you on here. They should be along shortly.

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grifho

Re: Dazed and Confused

Post by grifho » Wed Feb 10, 2016 9:01 pm

Thanks for the response, Mudrock. The pressure is now from 6-13, although it was higher a week ago. I told the sleep doctor that I would be awake and the pressure was too high, so she had it lowered to 6-13. I'm not sure if that will prove to be a good thing or not. You mentioned leaks, pressure settings, and waking events, and those are probably all things I should look at closely. I do wake up at least a couple of times to go to the bathroom, but I do go right back to sleep usually pretty fast. Anyway, I'll be trying the chin strap too for the mouth breathing, although I may have the full face mask in my future if that helps the best with leaks and mouth breathing. So, this is food for thought...thanks.

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LSAT
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Re: Dazed and Confused

Post by LSAT » Wed Feb 10, 2016 9:04 pm

Mouth breathing is a leak. Large leaks will cause a higher AHI. Very often a chinstrap will hold the jaw closed, but air can still leak out your lips. (Try it). You may need a Full Face Mask which will still stop events even if you breath or exhale through your mouth.

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otrpu
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Re: Dazed and Confused

Post by otrpu » Wed Feb 10, 2016 9:32 pm

Hi grifho,
When I have problems keeping mask seal I switch to my Hybrid FFM. Has all three sizes of nasal pillows, and a much smaller mouth area to seal. Also, has a chin flap, so no chin strap is needed. Might be worth a look. Link is in my equip list below. Hope you find what works for you.
Cheers,
otrpu

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Julie
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Re: Dazed and Confused

Post by Julie » Wed Feb 10, 2016 10:10 pm

Hi - if you have to overtighten to get a good seal, either it's just the wrong mask for you, or wrong size or wrong advice on getting fitted - it's important with a FF mask to try it lying down because your face changes a lot then. And most of us have gone through any number of masks before finding the right one, so keep at it til you're satisfied. Higher low pressures (the top one almost doesn't matter, though left higher is better than not) can make mouth breathing worse from the pressure, so again let the cushion inflate once you've loosened whatever mask you have, but don't feel a higher low pressure is necessary... less may even be better, but you need to experiment. Good luck.

grifho

Re: Dazed and Confused

Post by grifho » Thu Feb 11, 2016 7:14 pm

thanks LSAT! I guess large leaks mean that the CPAP can't do it's thing
and stop apnea events. I'm certainly keeping an open mind about the full face mask.

otrpu, I had never heard of such a mask, with the combination of nasal pillows and smaller mouth
area being sealed. And a built-in chin flap. Very interesting. I like the sound of it. Thanks for
responding!


Julie, I will try adjusting it lying down. It makes sense. I recently had my pressure
numbers, including the lower one, lowered. But I think the mouth breathing is still about
the same. Yeah, I guess I have to try several different masks. At first I thought I better
choose correctly for my first mask, but now I know it's a process, so it doesn't matter much
if I choose wrong at first. Yes, guess I need to experiment on the pressure as well. Thank you!

Mudrock63
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Re: Dazed and Confused

Post by Mudrock63 » Thu Feb 11, 2016 11:16 pm

You are turning the machine off when you get up to use the bathroom, right?

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grifho
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Re: Dazed and Confused

Post by grifho » Fri Feb 12, 2016 8:22 am

Hi Mudrock. I just responded, but inadvertently saved the post as a "draft" instead of submitting it. But now I can't find the draft to resubmit it. Ah well, drafts, leaks, they are all problematic. I guess leaks sometimes feel like drafts. But I digress. Anyway, yes I am shutting the machine off when going to the bathroom. At first I'd leave it on, thinking that I'd need to do so to have a continuous set of data for the evening. But I read somewhere that it doesn't matter if it's shut off for getting the numbers the next day. It didn't seem to affect the leak numbers, but I prefer to shut it off anyway. It's a factor for me as I have to get up 2-3 times to go to the bathroom every night. Thanks for inquiring about that

Mudrock63
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Re: Dazed and Confused

Post by Mudrock63 » Fri Feb 12, 2016 6:06 pm

Hey Grifho: When you get a chance, upload your machine type and the mask you are using to your profile. If your machine works with the Sleepyhead software, you should download that and then post some screenshots so the experts here can take a look and provide suggestions that might lower your AHI. There are tutorials here to help you if you need them.

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grifho
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Re: Dazed and Confused

Post by grifho » Fri Feb 12, 2016 6:52 pm

Hi mudrock. I've got an Airsense 10 Autoset, which I'm now displaying. It's got a built-in modem that sends data to the cloud, which then displays on the resmed.com site. So I don't think I have the ability to download any software on the machine itself. Thanks for the idea,though.

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OkyDoky
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Re: Dazed and Confused

Post by OkyDoky » Fri Feb 12, 2016 7:03 pm

Yes you can take out your SD card and down load your own information. Sleepyhead has much more info than the screen or app will give you. Here is a copy of your Clinical Manual. https://sleep.tnet.com/home/files/resme ... -guide.pdf
Here is where you can learn how to download Sleepyhead. https://sleep.tnet.com/resources/sleepyhead
If for some reason the DME removed your SD card, look in the slot indicated in the manual, you can buy any 4GB SD card and use it.
ResMed Aircurve 10 VAUTO EPAP 11 IPAP 15 / P10 pillows mask / Sleepyhead Software / Back up & travel machine Respironics 760

Mudrock63
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Re: Dazed and Confused

Post by Mudrock63 » Fri Feb 12, 2016 9:39 pm

Yeah, Sleepyhead is going to give you a lot more detailed info than you can get from the other app. You can also post the results here and the folks here may be able to suggest tweaks that will get that AHI down to the lowest level possible. They certainly helped me.

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grifho
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Re: Dazed and Confused

Post by grifho » Sat Feb 13, 2016 10:46 am

Thanks mudrock and okydoky. I'll download that Sleepyhead so I won't belabor others with my ill-informed ramblings and speculation I would never know this stuff without going on cpaptalk, so I'm glad I jumped in.

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palerider
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Re: Dazed and Confused

Post by palerider » Sat Feb 13, 2016 6:15 pm

nothing to see here, move along

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Last edited by palerider on Wed Feb 17, 2016 7:06 pm, edited 1 time in total.
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