DreamStation AmaraView: Mask Fit numbers are bad

[bryanschmiedeler]

I got a Dream Station a few weeks ago. I tried using the nasal pillows, which would have been great, but I have bad allergies and my AHI numbers were in the 50s. No good.

So I got the Amara View, and things are better, but my mask fit percentages are not good - 17 percent, 50 percent, 1 percent.

I cannot see anything inherently wrong with the mask when I wear it. I went to Apria and checked and they said that I am wearing it correctly.

Any hints or thoughts on what could possibly be wrong? And are my AHI numbers accurate even with a bad mask fit? Last night my mask fit was 17% but my AHI was 5.

I have made another appointment with Apria, but it is not until next Tuesday.

Any suggestions would be greatly appreciated.

Bryan

[Pugsy]

And are my AHI numbers accurate even with a bad mask fit? Last night my mask fit was 17% but my AHI was 5.

That 17% is off the machine's LCD screen???? If so that's bad, bad. It means only 17% of the time you weren't in large leak. That's really, really bad.
How accurate the AHI might be depends on how deep you went into large leak territory. I little over probably isn't that big of a deal but a lot over could mean the machine didn't have a clue what was happening.

Do you know about the available software so you can see just how far you went into large leak territory?

As to why the poor fit...
Couple things come to mind...do you have facial hair?
and at what pressure are you fitting the mask at initially and what pressure is the machine actually using the bulk of the night?
Have you used the mask fit feature available on your machine?
So what are your pressure settings?

Now if you are using SleepyHead and the 17% is the statistic for time above red line threshold then that's a different story and not that bad and especially after we change the leak threshold to something more in line with a Respironics machine (it defaults to a ResMed machine leak threshold which won't work well for Respironics machines).

[bryanschmiedeler]

Pugsy,

Thanks so much for the quick and helpful reply.

I should have made clear that the 17% and other percents came from the DreamStation iOS App.

>>Do you know about the available software so you can see just how far you went into large leak territory?

I know of DreamStation but not other software; you mentioned SleepyHead? I found the website. What does it do?

I do have facial hair. I currently have a beard, but it is very very short. I am more attached to my sleep than my whiskers, so if it needs to go so be it.

By pressure, I start my ramp (30 minutes) at 4 and at end it is 13.

Not aware at all of the mask fit feature. I have all my documentation in electronic form I will certainly look at that.

Thanks for responding!

Bryan

Bryan

[Doublev]

Shave the beard

I guess with the beard you dont feel the air swirling around your head and not waking up? lol .. guess that is one benefit of a beard. A tiny pinhole leak and i wake up

If you have a short/short beard meaning it takes a week to grow, then you dont lose much shaving it, right? Now if that is a month of growth or more, then i am pretty sure this is the source of your leak. But I guess it depends on the person... i have a 5 o'clock shadow around noon time.

There are solutions for people with beards on this forum, but if you dont care to lose it, shave it. Then get your mask dialed in... and then grow your beard again and see what the impact is day by day

When I use a full face mask, I found shaving before i slept resulted in less leaks and movement.. I did not need the mask as tight.. and i shave every day, it was just what time of day or adding a second shave at night to get it real smooth.. now I felt it was more the oils on my face and hair than the actual growth, but it definitely helped

[Pugsy]

Examples of what you can see with SleepyHead...actually there's a lot more but these are the basics we look at when evaluating a person's therapy.
viewtopic/t103468/Need-help-with-screen-shots.html

You might want to also take a look at RobySue's tutorial
http://www.apneaboard.com/wiki/index.ph ... SleepyHead

and my tutorial at the top of the Announcements section.

By pressure, I start my ramp (30 minutes) at 4 and at end it is 13.

This may be part of your problem. When you initially fit the mask at the beginning of the night you fit it at 4 cm pressure and that fitting doesn't work so well at 13. Use the mask fit feature (explained in your manual) and it will deliver 13 cm pressure (if that is what your setting is) for you to do the fitting and it should work better. This would be a problem even if you didn't have the beard adding to the problem.

Might not need to shave the beard. Worth trying before you resort to shaving unless you just want to shave. People do use full face masks with beards successfully..not without additional challenges but it certainly can be done. I know one guy with a great big Santa Clause beard who uses a full face mask and his leak graphs are pretty than mine.

If your manual doesn't explain the mask fit feature or it isn't turned on for you...go here and request the clinical/provider manual for your machine and it will explain things.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

[bryanschmiedeler]

Excellent advice. I will shave tonight and see if my numbers improve.

I know my wife at least will be happy. She hates the beard.

[Pugsy]

I know my wife at least will be happy. She hates the beard.

Ahhh...You know what they say about a happy wife...happy life.

As you wish...but do remember to fit at the higher pressure. Fitting at 4 cm might work well enough if you only went to 8 or 9 but it won't work well for 13.
My husband has a goatee...I love it and wouldn't want him to shave if he didn't want to but I know other women don't care for facial hair...so each to their own.

[Pugsy]

Oh...just a reminder if you do decide to use SleepyHead be sure and make the correction for the red line threshold I mentioned above.
Otherwise SleepyHead is likely to tell you that you had "massive leaks going on" when maybe they aren't really all that bad (once you get the better fit at the 13 pressure dialed in). I have both a Respironics and a ResMed machine. I used the Resmed primarily so I leave it at the 24 L/min but every time I use the Respironics SleepyHead tells me that I am leaking like crazy and I look over at the Events graph and there isn't one large leak flag there...so there were no large leaks but it's enough to scare the devil out of someone if they don't know that SH is basing the threshold on incorrect numbers.

I wish the author of SH hadn't used the ResMed defaults because it causes panic with some Respironics users and they go trying all sorts of things to fix a problem that doesn't exist. Just more added stress and this therapy is stressful enough without adding unneeded stress.

[cands]

I have been using the Amara View for over a year now.
My time above the leak rate threshold (24l/min) was 15% or more at the beginning.

I had a beard. I was wearing it too tight. I didn't have a clue on how to adjust it to reduce leaks!

First thing I did was lose the beard. Now I shave at night before I go to bed.
I stopped wearing it so tight. This had the added benefit of not making my lower teeth ache! (Goodness knows what other damage that might have done).
Then came the really hard part: Adjusting the mask. There are lots of good tips in various threads about this. The best one was to only make tiny adjustments to the tightness at a time. The reference is 1/8 inch at a time. I don't really know what that is, but I adjust by a mm or two! . (I have also used a permanent pen to mark the 'sweet' spot on each strap. This really helps as a reference point if the velcro comes undone)
The placement of the crown strap is really important for me. It needs to be pulled right back - it almost seems too low, but it stops the mask from riding up. I had a lot of initial problems with my lower lip dropping out of the mask. The top straps should just clear the ears.
Another thing that worked was to have a smaller range of pressure. A mask that fits fine at 7cm can leak like crazy at 17!
So now I work with a smaller pressure range - from 12.4 to 17.2 cm. Most of the night the pressure is around 13 (my prescribed pressure).
My average time over the leak rate threshold for the last 30 days is 0.5% and my AHI is 0.33 I am happy with that.

[seatest]

My Maskfit numbers dropped off from near 100% to as low as 2%. Yes I have a beard, and it worked for months with my beard.

Changed insert, tried a foam insert, changed the hose, changed the head gear, tried three different masks. Percentages all over the place. Had the machine check by vendor.

Something in the software or way it calculates maskfit?

Why did my maskfit numbers change under the same conditions?

[klm49]

Pugsy,

Thanks so much for the quick and helpful reply.

I should have made clear that the 17% and other percents came from the DreamStation iOS App.

>>Do you know about the available software so you can see just how far you went into large leak territory?

I know of DreamStation but not other software; you mentioned SleepyHead? I found the website. What does it do?

I do have facial hair. I currently have a beard, but it is very very short. I am more attached to my sleep than my whiskers, so if it needs to go so be it.

By pressure, I start my ramp (30 minutes) at 4 and at end it is 13.

Not aware at all of the mask fit feature. I have all my documentation in electronic form I will certainly look at that.

Thanks for responding!

Bryan

Bryan

If I don't shave for 3 or 4 days I have a hard time keeping a good seal on my Amara View.

[Chris8243]

For what it's worth - I'm female - no facial hair - and I still have trouble with leaks using my Amara View full-face mask. Wakes me up when I hear and feel the leaks. It's a daily struggle.

So it may have nothing to do with your beard? I dunno. Just my two cents.

[bryanschmiedeler]

Chris,

Thanks for the information. Actually my wife does not want me to cutoff my beard, and I keep it trimmed very short. If you have no facial hair (and that is good thing if you a woman) and still have had these problems, it is most likely the mask. I picked up a new one a few days ago and am going to give it a try.

Thx

>by Chris8243 » Fri Nov 30, 2018 1:44 pm
>
>For what it's worth - I'm female - no facial hair - and I still have trouble with leaks using my Amara View full-face mask. Wakes me up when I hear and feel the leaks. It's a daily struggle.
>
>So it may have nothing to do with your beard? I dunno. Just my two cents.