Need Help with Settings - AHI in the 20s

[BigEd]

This has been an ongoing issue for me and I'm embarrassed to say that after 3 years in CPAP therapy, I'm still confused by my numbers and what they really mean. (Other than a high leak rate and high AHI is bad.) My equipment listed below is current. I had been mouth breathing and finally got a handle on that with taping, but then I started to get leaks at my nares whenever the pressure would work its way up. I tried a combination of taping and Lansinoh creme to try to prevent nasal leaks. All that's left at this point is a bubble helmet.

I have a difficult time getting a good seal on a FF mask and really like the comfort of the Swift II nasal pillows. I just can't seem to get my leaks and AHI under control. I'm wondering if my settings need to be adjusted. The machine settings are the same ones I was using with my first machine - a Respironics BiPAP Auto with Bi-Flex.

I've provided a link to my readings from last night (detailed) and the overall readings from the last few weeks. Any setting suggestions, interpretation of my charts or other recommendations would be greatly appreciated. http://www.emeraldsquarelimo.com/images/cpap/cpap.htm

PS: Is there a link somewhere for "Resmed Readings for Dummies"? That might help me better interpret what is happening too.

Thanks.

[ScrappinMom]

Hi BigEd! I know next to nothing about bilevels, but I do know this...you've got to get that leak rate under control first thing. If you're sure the mouth leaks are taken care of, it's time to tackle the mask. Are you certain you have the right size pillows? Are they tilted properly? When using the Lanisoh, use just the tiniest amount. Too much will make them more slippery.

Until the leaks are controlled, I don't think it will do you much good to be changing any settings. All you therapy air is going somewhere other than into your airway.

I'm sure other more experience users will have more ideas for you.

[tattooyu]

I would try a bigger nasal pillow. It may be uncomfortable at first, but when I switched from a small to a medium for my Swift LT, it made all the difference!

[BigEd]

The mask is only a few weeks old and I'm using the large pillows. They fit better than the medium. But maybe I should try the medium again. I just started using the Lanisoh, so perhaps less creame would be worth a try also. Thanks.

[ScrappinMom]

I just started using the Lanisoh, so perhaps less creame would be worth a try also. Thanks.

Yes, just the very tiniest amount you can get out, and sometimes even that's too much. I know it sounds crazy. I put my finger on the tube opening, and squeeze just as little out as possible. Don't try to squeeze it out onto your finger as you'll have WAY too much. Hope that makes sense.

[BigEd]

Yes it does. Thanks. I'll try that tonight.