Different Masks, WAY different results!

How many of you switch back and forth between different types (FFM, Nasal, Hybrid, ect) of masks? Do you notice any major difference in the therapy you receive from one mask to the other?

I switch between a Comfortgel Nasal, and a Quattro FFM. (I change the machine settings for each mask.)

I get "decent" numbers with the Nasal. Average numbers, Leak: 0.4, AHI: 6.5. (leaks from my mouth, NOT the mask)

HOWEVER....when I switch over to the FFM, my numbers go through the roof! Average numbers, Leak: ~0~ AHI: 30.00!!!!!!!!!! WTF!

The pressure stays the same at 16cm, and yes, the machine is set for the mask I'm using at the time.
The only diference I am aware of is that with the FFM, I breathe through my mouth most of the night, and with the Nasal, I'm pretty good at only breathing through my nose.

I originally started my therapy with the nasal. I bought the FFM for two reasons. First, to use when I had severe nasal congestion, and second, to eliminate my mouth leaks from using the Nasal mask. Well, it works fine at eliminating the leaks, but, at the cost of effective therapy!

Has anyone else come across this problem, or am I the only one???

The quattro gives me worse number even if I get the leak the same which is harder for me on the ffm (quattro)than the swift lt.I think sleep is sounder on the quattro for some reason but not convinced enough to use it full time.

INTERESTING! You both have S8 IIs. I have the Resmed VPAP Auto, the January 2008 release, which was kind of a "bridge" between the S8 and the S8 II, I think. Resmed came out w/the VPAP Auto 25, just 6 months later, July 2008, than the release of my VPAP Auto.

I wonder if this has something to do w/the EasyBreathe technology????

I have low AHI, especially AI, w/a nasal cushion mask and chin strap but not all that consistently great a Leak rate.

I have a full face mask I actually like quite well. I get a GREAT Leak rate w/it - BUT - my AHI "ain't" so hot.

I don't change the Mask Selection since both the full face and the nasal cushion's allowed vent rate best mirror the Swift allowed vent rate.

W/o changing the pressure settings at all, the full face mask FEELS like I am getting MORE pressure than w/the nasal cushion mask.

hello slinky,I dont use the easybreathe on my machine and keep it at a constant 8 pressure.I do change the mask setting on the machine when switching mask(when remembered) hope that helps .

My number using the Quattro is 1.7, with a pressure range of 10-17. The graphs show I generally run as high as 15 a couple of times per night (probably when I am on my back).

The only thing I can think of, and it's just a guess, is that a full-face encourages your jaw to pull back, because of the tension on the lower strap. Moving your jaw back pushes your tongue closer to the back of your throat, narrowing your airway and causing more issues. The fix would be to try a higher pressure when using the FF mask, especially if you sleep on your back.

Hi JimIllinois

I changed mask yesterday and I had a terrible night. I was using a MIrage Activa and I tryid the Swift LT. I can't understand that. I changed the mask in the machine settings, I decreased the humidity to 2.5!

One night after the Swift LT: terrible! I woke up 4 times with water inside the mask and with the weird feeling of my chest and forehead trembling and tingling again (it's nor fear don't worry); dizzy, aerophagia again, two hokey sticks marked on the face LOL, and worst still is that my readings went up.

I changed because the Activa botters me the skin around the nose and tryis to drown me LOL. At least the Swift is easy to empty the water, you turn facing the the mattres and the water is out without need to take the mask off.

Readings:
This night Last week
AI 0.9 AI 0.2
HI 4.7 HI 2.8
AHI 5.6 AIH 2.9
no leak no leak

This is discouraging because my readings where not bad, I don't understand.

JimIllinois wrote: The only thing I can think of, and it's just a guess, is that a full-face encourages your jaw to pull back, because of the tension on the lower strap. Moving your jaw back pushes your tongue closer to the back of your throat, narrowing your airway and causing more issues. The fix would be to try a higher pressure when using the FF mask, especially if you sleep on your back.

That makes a LOT of sense to me!
Sitting here at the keyboard, I tried breathing through just my nose as if I was wearing the Nasal mask. Fine. Then, with my mouth slightly open, and things were still fine. THEN, I tried with my mouth full open, and my jaw slightly back, as if I was wearing the FFM. WOW! Wowowowowow!!!! There was a HUGE difference in the amount of air I was able to easily inhale!

I am amazed, totally amazed, that such a small shift in jaw position can cause such drastic difference in my breathing ability. Thank's Jimillinois, I never would have thought of that myself!

John

What was (or is) your breakdown on that 30 AHI number.......AI and HI?

For me, the Quattro didn't seem to have enough Vent Flow (clearing CO2) and if that's the case in YOUR situation, it could be creating more flow limitations and hypopneas.

If you wanted to compare that Quattro to something else, I'd suggest a UMFF. To me, there's a greater perception (at least) of Vent Flow and just a better volume of air, in general, with the UMFF.

Den

PotHoleRepairman, EasyBreathe is not the same thing as the EPR (expiration pressure relief) function.

JimIllinois, I've pretty much come to the same conclusion as you have about the full face pushing the chin and jaw backwards.

I know I found early on that positioning the angle of a chin strap when using my nasal cushion mask made a difference which is why I ended up preferring the Respironics Basic White chin strap. Very little to it. Comfortable, silky chin "saddle" and 4 small velcro squares allowing me to position the chin strap straps to my mask headgear to reduce the tendency of a chin strap to push my chin and jaw back that I encountered w/a couple of other chin straps. Plus the other chin straps irritated the skin of my chin.

The thing tho is that it FEELS like I am getting a LOT more pressure w/the full face than I am w/the nasal cushion and chin strap.

Yet the data indicates higher leak rate and lower AHI w/the nasal cushion and chin strap and the lower leak rate and higher AHI w/the full face.

When I went from the nasal cushion and chin strap to the Swift LT for Her I didn't feel any change in the sensation of pressure.

When I went from the nasal cushion and chin strap to the OptiLife nasal cradle I felt a DEFINITE sensation of INCREASED pressure.

And, yup, I made the proper Mask Selection adjustments.

Wulfman wrote:What was (or is) your breakdown on that 30 AHI number.......AI and HI?

For me, the Quattro didn't seem to have enough Vent Flow (clearing CO2) and if that's the case in YOUR situation, it could be creating more flow limitations and hypopneas.

If you wanted to compare that Quattro to something else, I'd suggest a UMFF. To me, there's a greater perception (at least) of Vent Flow and just a better volume of air, in general, with the UMFF.

Den

Den, er I mean power poster - congrats by the way and THANKS for your contributions : ) Do you think something to consider would be that each mask has a different leak rate too? The leak rate on the FFM would be higher.

gasp wrote:

Wulfman wrote:What was (or is) your breakdown on that 30 AHI number.......AI and HI?

For me, the Quattro didn't seem to have enough Vent Flow (clearing CO2) and if that's the case in YOUR situation, it could be creating more flow limitations and hypopneas.

If you wanted to compare that Quattro to something else, I'd suggest a UMFF. To me, there's a greater perception (at least) of Vent Flow and just a better volume of air, in general, with the UMFF.

Den

Den, er I mean power poster - congrats by the way and THANKS for your contributions : ) Do you think something to consider would be that each mask has a different leak rate too? The leak rate on the FFM would be higher.

According to the charts, the UMFF and the Quattro have virtually identical Vent Flow Rates. However, I experienced slightly lower leak rates (in my reports) when using the Quattro (particularly after I fixed the leaking elbow).

But, yes, different styles of masks have different Vent Flow Rates......full face masks typically have higher rates.

http://www.internetage.com/cpapinfo/leak-rates-1.html


Den

Given a lot info to digest, now I know that I need to go to the next step and monitor my AHI rate. I was comfortable knowing that wearing my FF (FORMA) with a 0 leak rate that I was doing great and getting alot out of my treatment. I have my epr set on 3 and able to handle my straight pressure of 10 quite easily. I hav found though that I get better therapy and sleep when I do NOT sleep on my flat bed. When I sleep in a zero gravity position I get much better therapy. I think having at least one's head elevated is a way of opening up the air passages. (its what doctors recommend for those suffering from GERD --acid reflex is lowered with the elevation) It would als makes sense for those who cannot break the habit of sleeping on their back because again it will help open up the air passageway.

I really get alot out of these threads and as a newbie it means alot. I am going on six months with 100% compliance only because of this forum.

rise&shiner wrote:Given a lot info to digest, now I know that I need to go to the next step and monitor my AHI rate. I was comfortable knowing that wearing my FF (FORMA) with a 0 leak rate that I was doing great and getting alot out of my treatment. I have my epr set on 3 and able to handle my straight pressure of 10 quite easily. I hav found though that I get better therapy and sleep when I do NOT sleep on my flat bed. When I sleep in a zero gravity position I get much better therapy. I think having at least one's head elevated is a way of opening up the air passages. (its what doctors recommend for those suffering from GERD --acid reflex is lowered with the elevation) It would als makes sense for those who cannot break the habit of sleeping on their back because again it will help open up the air passageway.

I really get alot out of these threads and as a newbie it means alot. I am going on six months with 100% compliance only because of this forum.

If you didn't know, the "0" leak rate is because the mask selector in your machine takes into consideration the approximate leak rates of various masks. So, ZERO is "good" when using a ResMed machine.

And, as you mentioned, for acid reflux/GERD, elevating the head of the bed (like with 2x4's under the corners) and/or sleeping on one's left side are better for that condition.


Den

I have posted extensive data on this phenomenon:

viewtopic.php?f=1&t=37954
and
viewtopic.php?f=1&t=42646
for which I still owe a final data update; hopefully coming soon.

See also the fairly recent discussion:
Re: Different masks = Different numbers ??
viewtopic.php?f=1&t=47167

Thanks a lot for the links Velbor.

I completelly agree with the fact the smaller diameter of the Swift LT hose compared to the Activa mask hose is the responsible of the increasing on my HAI. The cpap pressure sensor is located inside the machine, so the machine should be seeing all the way the same pressure but we at the end of the mask we are receiving a lesser pressure not able to keep our air ways opened enough so we FEEL and LIVE the difference.

It could be too that part of the air is going into my stomach instead of my lungs, today I had again air in my stomach. I used to have that problem with the Activa but it had stoped.

Now I need to convince the md to make something with my pressure :0(, but I will need to suffer a couple of days to have the prove.

Rosacer