Hybrid Masks for ASV?

[RationalEntropy]

I am visiting my doctor soon (today), and have considered switching to a hybrid mask. I was wondering about: 1) the feasibility of using a hybrid mask with an ASV unit, 2) if it as position restrictive as a full faced mask, 3) individual experiences with hybrid masks/comfort, 4) how well hybrid masks handle higher pressures.

[JohnBFisher]

I never used the hybrid mask with my ASV. I had used it with my BiLevel unit, but I found it just too difficult (for me) to keep a seal. But others swear by it - rather than at it! Ask your DME if they have a sample you can try.

[neverbetter]

I used one for years.I still have it . I have several, it's a great mask. It beats a full face mask.

[RationalEntropy]

My doctor actually had a few lying around. She fitted me for a liberty mirage, which I left the sleep center with. I was also told that if I like the mask, she can call the script in. So far it seems promising. I will know how it goes after sleeping with it on this evening. I look forward to it.

May have to shave my beard, but that is the price we pay.

I was also given a script for lunesta. Probably don't need the lunesta. May have it filled.

[ozij]

I can't respond to the ASV part or your question - but I can to the hybrid part.
Two companies make them: ResMed, makes a very expensive one called Liberty - Respcare makes the Hybrid - and sells it with all 3 pillow sizes (the Liberty comes with one).
I tried 3 regular FFM's which I couldn't get to seal. Then I tried the Hybrid - and it works for me.

For any mask: read the instructions, view the videos, make your first fitting sessions when you're wide awake, not at bedtime, and initially, expect to spend some time on that. Once you've found the right mask with the right settings, it won't take that long.

Keep in mind that your head pillow, and the way you route your hose may also have a big impact on fitting a mask.

[RationalEntropy]

All in all, I would say that this mask was far more comfortable than my quattro fx. I could also get a nice seal, but my AHI increased dramatically. If I had to guess these numbers changed because of the change in mask, since this is far outside of the normal AHI range (2.0-4.5, with the occasional outlier in the range of 5-6).

The average leak: 41 L/min
AHIApnea / Hypopnea Index: 8.06
HypopneaHypopnea: 7.88
ObstructiveObstructive Apnea: 0.00
Clear AirwayClear Airway Apnea: 0.19
Resp. Effort Related Arousal: 0.00
Flow LimitFlow Limitation: 0.56
VSnoreVibratory Snore: 0.00
PB/CSRPeriodic Breathing: 0.34%


There was FAR more AIRFLOW through my NOSE. That is good, since congestion is now far less of an issue. I'm wondering if the IPAP range can be returned back to the initial settings (9-11 instead of 10-11). The doc does not mind some minor adjustments, as long as I keep records, and as long as my treatment is working (AHI <5, with relatively uninterrupted sleep).

[NateS]

My understanding is that even nasal pillow masks are now approved for use with the latest ASV machines, although formerly they were not.

I have a S9 VPAP Adapt, and right off the bat I was fitted with a Swift FX, and now I am using an Aloha.

Nate

[RationalEntropy]

I pulled up the clinicians menu and found it quite difficult to exhale against an EPAP of 11. I was titrated with an EPAP of 11 (IPAP of 15, and later administered an ASV, but whatever, no time for life story) and a Quattro FX. The better airflow through the nose likely caused this, so now my EPAP is 9 to 10, with a minimum PS of 4 (where only the EPAP was changed).

After my day's activities (studies, work, etc) I took a one hour nap with the new settings. AHI for nap: 1.08. Not sure where the .08 came from, as I saw one short hypopnea, but this is a good sign.

Also, I had no idea that nasal pillows were approved with ASVs, as you said this seems to be a recent development.

I think that I will be happy with this new mask, as that nap ranked high among all of the naps I've ever taken. Tonight is the real test.

~RE

[sickwithapnea17]

so do you feel much better on the hybrid or nasal pillow vs full face?
I had one good night on the fit life mask but the other nights were mixed- it seems better than mirage quattro
there's no ramp on the adapt so the fit life makes it easier to fall asleep it seems. I use the resmed adapt so it may be completely different for the phillips asv

[NateS]

Settings for nasal pillow masks:

http://www.healthcare.philips.com/asset ... ontrol.pdf

Mask Settings for System One Resistance Control - Phillips Respironics

[JohnBFisher]

so do you feel much better on the hybrid or nasal pillow vs full face?
I had one good night on the fit life mask but the other nights were mixed- it seems better than mirage quattro
there's no ramp on the adapt so the fit life makes it easier to fall asleep it seems. I use the resmed adapt so it may be completely different for the phillips asv

As Roster / Rooster used to note ... 9 tenths of success with an xPAP device is getting a mask that works well for you. If the Fit Life mask works, great! Others really like hybrid masks.

Nasal pillows can be used with either of the current ASV models from Resmed or Phillips Respironics. The old Resmed unit (not the one that sickwithapnea17 has, but the larger S7 based ASV units, did not allow the use of nasal pillows. The reason was that they measured the pressure at the mask (via a small, flexible pressure line that ran along (and outside) of the hose. Nasal pillows have a small hose that leads to the nasal pillows that made it impossible for the Resmed ASV unit to measure the pressure accurately. It could not "learn" the breathing circuit.

Interestingly, though the hybrid does include nasal pillows, the old Resmed unit could "learn" the hybrid unit.

But as has been noted, all masks (that work) can be used with the current ASV units. I qualify that because the wild pressure swings on an ASV unit mean some masks might fit and work but are impractical for normal use.

[RationalEntropy]

Now that I've been set up with the hybrid mask and given a few days, I must say that I like it pretty well. I breathe far better and suffer from less congestion during the night. I have fewer night time awakenings, and my AHI is less than 3. So, this isn't too bad.

So far everything is going pretty well. I personally prefer the hybrid.