How low are you numbers with swift lt? Help me improve!

[jayjp04]

hi,

I posted a little over a week ago about numbers for "normals" and looking for ways to improve my numbers. With an average AI of ~1, and an average HI of about 5-6, and an average leak rate of 0.3L/sec with a swift LT, regular chin strap, on a resmed elite II and H3i humidifier, I decided to tackle leak rate first. I got a new nasal pillow, and again, it fits fantastically. With the machine on, I get absolutely zero leaking out of my nose; these are always able to form a great seal for me. Then, I purchased the papcap. Thumbs up to Brett who made it, I have a smaller head than most and it fits comfortably, is easy to put on, and i noticed after lying down that it truly does do a good job of keeping my mouth closed....I think. I was unable to get leaks out of my mouth with relaxing my jaw in all positions, so I was hoping this would be reflected in my numbers.

Excuse my french.....but damnit I am disappointed! I am a little upset this morning as my numbers are IDENTICAL as they have been for months, and showed no improvement. AI 0.6, HI 5.7, AHI 6.3, leak rate 0.3L/sec as shown on my resmed elite II clinical menu under "results" and "day"

what is going on???? I cannot seem to ever get my AI below 0.5, my HI below 5, and my leak is NEVER below 0.3...(okay maybe some days 0.27.) But seriously, I don't know what to do to improve my therapy. Is anyone using a swift LT able to get better numbers....if so, let me know what they are (especially if you are using a resmed machine). I have been trying everything!!!!! Tape, chinstrap, sports headband chinstrap, papcap.....

oh and when I hit the mask fit button on my machine, its always the max number of stars, perfect fit. I am telling you, I would have a tough time believing that it EVER leaks out my nose....the seal is fantastic....

[sleeplessinaz]

Hi there--sorry you are having so much trouble with your leak rates. I am using the same machine with the Swift Lt for her. I have leak rates of 0.00--almost every night. Maybe you need to use a different pillow? I am a side sleeper and my husband used to say--"you bought another pillow!!???" Now I found my perfect pillow--it is a goose down filled one from Costco --it works perfectly as I can form it around my head and neck and leave room for my tubing etc. Take a look at what pillow you are using and see if maybe you need a change?

[jayjp04]

That is an idea, and I have thought about it....have not tried a different one yet. I was so hellbent on getting this therapy perfect because I am 23 years old and refuse to let this impact my life if I am at all able to solve it, that after side and stomach sleeping for 22 years, I learned to sleep on my back after starting therapy (about a year ago). My apnea is position independent, as I was having it in sidesleeping and stomach sleeping as well, so sleeping on my back should not make it worse (it didn't during my sleep study). I really do not know where the leak is coming from....and as I said, the pillows fit perfectly. I am using size medium, and as soon as the air flow starts, the pillows seal right up against my nares.

[Hawthorne]

One of the big problems I have with the SwiftLT is the top straps. That little "lock" thing is always slipping. The teeth are supposed to grab it but for me, it doesn't hold and for me, it has to make just the right fit under my nose. Maybe if you route the short tubing over your head it may hold with that little hose attacher. I don't like using it that way.

I am no "seamstress" so I velcroed the 2 sides for a while, when I had it adjusted to fit me.

The velcro has started loosening now so yesterday I got out needle and thread and sewed the top straps down. Last night was good - no slipping - no real leaking and good data. I also have the back strap pulled well down on the back of my head.

It works for me - may work for you!

[jayjp04]

I actually do route the hose over my head using the hose attachment-I find that done right, it positions the pillows for a perfect seal while keeping the pressure off your upper lip and teeth. I route my cpap tubing over the top of a light fixture as well, so it is coming at me from higher up. still no luck with stopping the leak....

[BrianR4743]

We've got the same equipment, and I've been struggling with the same issues. A couple of ideas that might help out:

1) A good face washing to remove as much oil from the face, especially around the nose, upper lip and around the mouth.

2) I deal with mouth leaks at times, and have resorted to using 2 strips of 8" long paper surgical tape to keep my trap shut. I know there's some controversy about this practice, but it works well for me as the FFM didn't work out well. Just make sure to leave about 1/2" folded over at one end for quick, easy removal (I've never experienced a loss of pressure that would require it, but a good precaution). Every once and awhile I have a "blowout" which throws my numbers off.

3) My most recent addition is incorporating Rested Gals idea of a strap made with tights just under the pillows and over the top of the head. Two nights of trying it, two nights of zero leaks. Must be something to it.

Even with zero leaks, I'm at about .4 AI and 4-5 HI regularly. Will be chatting with the sleep doc about pressure adjustments next week.

Good luck!

[Scarlet834]

I actually do route the hose over my head using the hose attachment-I find that done right, it positions the pillows for a perfect seal while keeping the pressure off your upper lip and teeth. I route my cpap tubing over the top of a light fixture as well, so it is coming at me from higher up. still no luck with stopping the leak....

I'm going to offer my experience, in case it makes a difference for you. I fight mouth leaks, and have had my best luck with the papcap and with an eye mask used as a chin strap (go figure). My favored hose position turns out not to be routed over the head. The hose is pointed down, then kind of coiled under the covers beside me. It's arranged so that there is a bit of pressure upward from the coil of hose--it's not dragging downward on my nose.

Later in therapy I tried fixing the hose over the head a couple of nights and found that my large leaks escalated. After some analysis it seems like the weight of the hose over my head tips the balance in my head pulling backward and my jaw opening. I went back to my old hose positioning.

My body dynamics might be completely different from yours, but maybe experimenting with other hose routings would help. Good luck!

[jayjp04]

looks like I may have to try that. When I first started therapy, I used to arrange the hose almost identically to what you describe. I will report back tomorrow....

[sleeplessinaz]

Same here---I don't put the hose over my head either--I am a side sleeper and I have the hose pointed down, then kind of coiled under the covers beside me--like the posted above said earlier. I have a nice fleece cover made by Karen at PADACHEEKS too so it is nice and snuggly --so you might want to try not hiking the hose up over your head.

Carrie

[rosiefrosie]

I started using the EPR on my machine and found that it decreased my leak rate to the lowest it's ever been. My other numbers increased but they are still well under 5.

rosie

[Autopapdude]

I have better results with the Swift II than the LT. My numbers are better (AHI around 1 as opposed to 2 with the LT), and a better quality of sleep overall. The LT does have the swivel that allows the hose to rotate, but I find the Swift II fits my nose with a better seal. In addition, the pillows for the II seem to last far longer. My suggestion would be to get a Swift II, and try that for a while. I am one of the few that does not find the LT to be at all an improvement over the Swift II. In fact, I am going to buy another II soon, to make sure I have another backup, in case it is discontinued.