Please help me with interpreting Encore Viewer results

[soverytired2]

Hello Everyone, I finally uploaded my encore viewer software and looked at what's been happening. I'm not sure I understand what alot of it means and will do some searching but am hoping everyone here can give me feedback or suggestions on what to do next. I've been on therapy since end of april.

My apap machine was set for 4-18 but I couldn't breathe and changed it to 10-18. When I originally titrated I was set on cpap at 12.

Currently I'm trying to get used to the Hybrid mask as I am definitely a mouth breather. However I find myself waking up middle of the night trying to keep the pillows in place to no avail and switch masks to the comfort gel nasal. I've tried head gear adjustments, rubber bands, head bands, tights, and even tape to keep the pillows in place. This first image is when I started with the Hybrid and switched to the nasal. It seems like I'm hitting the top pressure setting, would you bump it up if these were your numbers? It looks like with the hybrid the machine uses higher pressures than with the nasal, although on some of the other dates with the nasal mask I had somewhat high pressures too.



Last night I used only the comfort gel nasal. I don't remember waking up with the leak. Also, is the vibratory snore usually that high? My thoughts with this one is that even though I think I'm getting pretty good sleep, the mouth leak is the reason I'm still having headaches some nights. I do use a chinstrap and can't bring myself to tape which is why I'm trying the hybrid.

Please share your thoughts with these two representative results. I'm off to try to find posts that will help me understand what I'm seeing.
Thank you! Paula

[Wulfman]

You're actually having very few Apnea/Hypopnea events. Also, your snore index isn't all that bad (pretty low, actually). It's your leaks, snores and flow limitations that are driving your pressure upwards.
I think if you set your machine in CPAP mode at a pressure of somewhere between 10 and 12, you would probably get a better night's sleep.......maybe fewer headaches.

Have you tried taping (mouth)? I haven't heard that many success stories with chinstraps.


Den

[Hawthorne]

Actually your data shows pretty good results from your therapy with the nasal mask. If I were you, I would use the nasal mask for several nights, since things were better with it, except for that large leak. I had a large leak last night as well (I rarely have that) and it did not wake me either. I did have some trouble with my mask but the data showed a large leak.

I use nasal pillows and do not mouth breathe a lot. I am able to get by with one strip of 1" medical tape placed vertically across the centre of my lips and place my tongue just behind my top teeth. I seem to just need a small "reminder to keep my mouth shut. It may work for you. If you try my approach, remember to put chapstick on your lips to prevent the tape from causing problems there.

You probably need a few nights more of data to come to any firm conclusions about changing anything.

If you post, say 3 more nights of data, with the nasal mask, some suggestions for possible changes might be possible. I would need to see more nights to suggest anything.

[soverytired2]

I'm glad I asked because I couldnt see which was the worse mask for me with this small amount of data. While I hate even the thought of taping, maybe just a small strip won't be so bad especially if I don't put it all the way across my lips. I'll try that tonight. I'll also give the suggestion to just sleep with the nasal at least 3 full nights a chance and see how it goes, and then perhaps a night or two with the hybrid if the small amount of taping doesnt do the trick. In looking thru the data I do have less AHI events and Hypopneas when I use the nasal mask, but the leaking is pretty consistent too. The chinstrap for sure has not helped the leak rate. Not too sure about going straight cpap again, because I felt much worse then, than I have with the apap. The M series plus which didnt have data but I could check the screen generally showed 10-15 AHI every day. I will consider it though, because now I'll have data and be able to monitor.

Thanks Wulfman and Hawthorne! I appreciate you sharing your thoughts.
Paula

[Hawthorne]

You are doing great in analysing and seeing what you can do to optimize your therapy!

You are thinking things through (planning to keep the same mask and pressures for a while -trying minimal taping - you know a chin strap doesn't work for you - then planning on trying the Hybrid again). You already know that you feel better on APAP so you are planning to stay with that for now.

Follow through, giving each change several nights (3 or 4) and then, change something else if things have not improved enough.

Post the data from your next 3 nights! I'd be really inerested to see it!

You will get there!