New apap with sense awake..driving me crazy!

[desforsleep]

History: been on a cpap for 1 month. Apnea with 115ahi's hourly. They feel I have apnea so severely it has caused some right sided heart failure... o2 sats will drop to 73%, My face is swelling really bad with use of ffm swells less with nasal mask, but sleeping pretty good. My face did not swell before cpap use. So the dme said use this apap and see if the pressure will lower when it can and maybe that will help. My pressure is set at 15. With the regular cpap I had 0 ahi. The first night with the apap i had 2 ahi. I don't like the sense awake.. but there is an option ot turn it off. I can't use my nasal mask with the sense awake because it will not blow hard enough to make it easy to breath thru my nose. I have 55-60 leaks a night with ffm... that did not change with the apap. I have the f & p sleep style 200 auto series model HC254. The mask listed below and the quattro fit small ffm. Right now 2 machines.. and 2 masks.

Question 1: Does anyone swell around their eyes and lower face with the cpap thereapy.

Question 2: Does anyone know why the pressure would make you swell and if it would have anything to do with the right sided heart failure.

Question 3: Is there any hope for less leakage using ffm with 15 pressure. LOL

Question 4: Will the apap compensate for the leaks using ffm?

Questions 5: Can anyone tell me what the cmH2O is and what do I need to do with that button. The manual says it shows humidity in room vs machine. Is this to prevent rainout?

Thanks guys, I appreciate all input!!

[Hephaestus]

For your question #3, I suggest you try a Pad-a-Cheek Mask Liner.

I ordered one for the Quattro FFM and received it yesterday and used it last night. With the liner installed, I found the mask much more comfortable and didn't have a single leak episode the entire night!

[Janknitz]

My eyes swell when air leaks into them all night, but not my lower face. Please check with your doctor and make sure there's no cardiac reason for the face swelling. If not, look at the "Taming the Mirage Quattro" in my signature for some fitting tips that will allow you to not wear the mask so tight. I think the padacheeks liner will help as well. The other question I have is whether or not you might be allergic to the silicone?

You're the first one to answer a question I've had about that Sensawake technology. The idea is that the machine is supposed to recognize when you are awake and lower the pressure to almost nothing. I know I would feel like I'm suffocating if my machine did that--so if it's not something you can turn on and off there's no way I'd ever want a F&P that used that technology. What was the manufacturer thinking?????

[desforsleep]

Thanks Heph and Jank,

I will try it . Jank.. I know.. what are they thinking... with sense awake. I have a nasal mask that needs seating.. I can't do that on sense awake! The first thing I learned to do by digging thru the manual was turn that off!! LOL Also I am already thinking of just keeping the cpap. But I can also turn the apap off to just cpap... so might keep the apap in case i need something different a year from now. (it will cost me a couple hundred dollars more to keep the second one. But I will check with my insurance co before i pay it as someone suggested.)

Thanks for the info peeps!

[Megan]

hmmmm, I kinda like the sense awake - I also have fairly high pressures, so when and if i do wake up during the night, the sense awake drops the pressure back down to my starting pressue. I dont have trouble with facial swelling and I much prefer the apap to the cpap.
I'm using the quattro fx ffm - it took me a while to get the hang of using it so it didn't leak, but I've got it sussed now!

[AHI_Killer]

They feel I have apnea so severely it has caused some right sided heart failure.

Really sorry to hear this, I imagine that for a lot of people on this board, cor pulmonale is a much feared scenario if we don't stick with our therapy. I hope you aggressively pursue your treatment options. You may already know this, but if CPAP and more conservative surgeries fail, a tracheostomy is sometimes used that has a 100% cure rate for OSA. It's unclear how much damage your cardiopulmonary system has taken and how well it can rebound but at least there's an absolute way out for the OSA if nothing else works for you.

Question 1: Does anyone swell around their eyes and lower face with the cpap thereapy.

Question 2: Does anyone know why the pressure would make you swell and if it would have anything to do with the right sided heart failure.

Do you think this is related to your mask? Have you ever had facial swelling before?

Question 3: Is there any hope for less leakage using ffm with 15 pressure. LOL

I had a lot of leaks using the Quattro FFM and the Liberty. I lucked out and the InnoMed Hybrid fit me well and won't leak even at pressures above 15 cmH20. I highly recommend it. If you buy it from CPAP[dot]com, you can even get return insurance and try out a couple FFM's/hybrids if needed.

Question 4: Will the apap compensate for the leaks using ffm?

Yes, to a point. For instance, the DeVillbiss Intellipap will compensate leaks up to around 95 l/min. Beyond that, therapy is impaired because the machine can't read your airway properly and doesn't know whether you're having events so it's supposed to just stay where it's at (I think).

Questions 5: Can anyone tell me what the cmH2O is and what do I need to do with that button. The manual says it shows humidity in room vs machine. Is this to prevent rainout?

cmH20 = a measure of pressure (eg 10 cmH20 is a pretty standard pressure for CPAP'ers)

The humidity/rainout is machine and tubing specific. The S9 has a climate line (heated hose) so you just set the temp you want and the machine will automatically keep the relative humidity to around 80%. Not sure what your setup is.

Thanks guys, I appreciate all input!!

Hope I helped a little. There are a ton of pros on here who know a lot more than I do about this, they'll appear in this thread eventually!!!

[desforsleep]

Thanks AHI killer. I am determined to stick with the therapy. Your reply helped a lot. I have had lower extremity swelling for a long time.. years.. recently developed upper abdominal swelling and discomfort. I have been short of breath all my childhood.. but never facial swelling like this and everything has just got worse the last 8 months or so. I have took a different job to try and help me have less stress and have more days off. I am glad you mentioned the options you did... it is good to know there are options. I am only 48 and becomming afraid my health will make me retire early.. I DO NOT WANT TO DO THAT!!! My doctors just did not listen to me when I said my health was failing , they gave lots of sleep aids and antidepressants. If am going to work (and I am ) I have no option except success!!!

[desforsleep]

OK, so last night I had nasal congestion, still tried my nasal mask and I coughed for two hours. So I put on my ffm with the cpap at 15, and still coughed. While awake disgusted laying there with my mask and cpap off I stopped coughing. I got up and got the apap AND TURNED THE SENSE AWAKE back on.... It worked. I quit coughing so much and went off to sleep. I woke up with 7 AHI this morning, but not sure this is acurate due to coughing and leaks. OH AND MY FACE AND EYES ARE NOT SO SWOLLEN TODAY...!! yeah!!! There might be makeup and vanity after cpap afterall. Not that I will put my makeup on today.. it's saturday.

[Pugsy]

Small victories are still victories.
Good job. Keep plugging along at it and there will be more victories, even if small.