Just when I thought I was getting there...

[HanzT]

I have been working to get my AHI down and I got it down from 7.3 to 4.1 by raising the pressure a bit from 6.0 to 7.5 while wearing a nasal pillow mask. One of my problems is my nose is so stuffy at night the only way to get it clear is to use Affrin. That was bringing my sinus and throat, and considering my issue with opening my mouth, I thought I would try a hybrid mask. I got this one https://www.cpap.com/productpage/RespCa ... -Mask.html from Respcare. I like the mask, although it has some issues with noise, etc. However, now my AHI is 9.4 with a huge increase in OA's (although my previous issue with RERA and Hypopnea did seem to decrease). I upped the pressure to 8.0 but only a minor change. Does a full face mask change the pressure needed? I don't see any large leaks on my report. Help!!! would be appreciated. So frustrating. It's like a game that no one gave me the rule book too.

With nasal pillow mask:

With hybrid mask:

[HanzT]

It should say "burning" when I mentioned the Affrin...

[Pugsy]

How would you rate your overall sleep using the Hybrid? Do you remember some awakenings during the night?
I see 2 breaks in therapy line so I know at least those 2 major breaks (discounted the first couple which are obviously brief and you were likely awake fiddling with mask).

Some people have reported having to use a little more pressure with FFM...so wouldn't be unheard of but if your sleep was highly fragmented a lot of what you see could be awake/semi awake junk clutter. So you should eliminate that possibility first.

What is the vent rate your each of your masks at your pressure? While the line itself is fairly stable the overall number is a bit high for your pressure. Example...my Swift FX vent rate is around 33 L/min at 10 cm pressure.
Still well below large leak territory though so unlikely to be negatively impacting therapy pressure.

Vent rate charts here
http://www.resmed.com/us/assets/documen ... sa_eng.pdf

[HanzT]

Hi Pugsy,
I wake up 2-3 times. Once I turned off the machine and took a bathroom/water break. My mouth gets pretty dry with the mask. Overall, I am happy with the mask because it solves my nose and open mouth issues. It is pretty loud. I have the two small extra vents open. I try closing those and reading about vent rates, and keep updating. I was pretty shocked in the OA increase though.

[woodworkerjunkie]

Hi Pugsy,
I wake up 2-3 times. Once I turned off the machine and took a bathroom/water break. My mouth gets pretty dry with the mask. Overall, I am happy with the mask because it solves my nose and open mouth issues. It is pretty loud. I have the two small extra vents open. I try closing those and reading about vent rates, and keep updating. I was pretty shocked in the OA increase though.

Those small extra vents are supposed to stay capped off. They will cause additional leaks and will cause the mask to make more noise. That would mean you are loosing some of the effectiveness of the pressure and could cause your events to spike somewhat.

[chunkyfrog]

The two capped holes are oxygen ports.
They are not to be opened unless you are attaching an oxygen line.

[HanzT]

That's good to know. I was trying to prevent re-breathing. I'll cap them and give it a try tonight. THANKS!!!!!

[squid13]

You need to update your mask in your profile, your showing a Swift FX.

[MobyTheMinnow]

I use the Afrin as well. I may switch to Neti pot soon because Afrin has to be used nightly. Just something to think on.

[HanzT]

The Neti pot only lasted a short while for me, and sometimes didn't do almost anything. But I would certainly try it if you have not. I am also starting allergy shots to see how that goes.

[HanzT]

I tried the suggestion to close the small side vents used for ox tubes. I don't think that is reason why, but my AHI increased to 10.8! AHH! WTF? My leaks are down but the sleep is getting worse. Other then upping the pressure I don't know what to do. It doesn't make sense to me that this mask would yield such a bad result. Is the mouth a worse way to use CPAP somehow? Any thoughts on nose vs mouth results?

[Pugsy]

You may be one of those people who simply need a little more pressure with a FFM. You wouldn't be the first.
In theory..it shouldn't matter but in real life I have seen too many reports that prove it can happen to say that the theory is infallible.
There are some in the medical community that say that nasal cpap therapy is "better" than oral therapy but I haven't seen cold hard facts. Obviously FFM therapy is something that serious mouth breathers have to do though. If someone can't keep their mouth shut they have to use a FFM mask or risk seriously impacted therapy. They make it work.

It sure looks like if you want to use a FFM you are going to need more pressure than you would need with a nasal interface mask. Why? I have no idea. Some people do need more pressure and yet others go back and forth between nasal and FFM without any change in pressure at all. Just another one of the many things that with CPAP therapy comes with the YMMV sticker.

[HanzT]

Best night yet! I learned a pretty significant lesson. Don't take anything for granted. I was using my dental apnea appliance with my hybrid mask thinking it would keep my airway open better than not using it. As soon as I tried a night without it, my AHI dropped in half. See the report from last night. Pretty cool! Never give up and you will make progress.

[Slartybartfast]

Afrin (oxymetazoline)* can be a real problem. Initially it works fine, but after a few days' use, if you stop using it, you'll get rebound congestion until your system stabilizes. Have you tried using a saline nasal spray? It's just salt water in a nasal spray bottle. That's worked for me, so long as I use it every night before retiring. You have to squirt the stuff into each nostril while inhaling. Use it until you can taste the salt water running down the back of your throat. Then mask up and see if that works for you. My pulmonologist said it has been his experience that if patients would simply do that every night they wouldn't have problems with congestion, outside of the occasional cold or allergy attack.

*also found in Afrin Nasal Sinus, Allerest 12 Hour Nasal Spray, Duramist Plus, Duration, Four-Way Nasal Spray, Genasal, Neo-Synephrine 12 Hour, Nostrilla, NRS Nasal, NTZ Long Acting Nasal, Oxyfrin, Oxymeta-12, Sinarest Nasal, Sinex Long-Acting, Twice-A-Day)

[HanzT]

Thanks, I appreciate the advice. I use saline twice a day and it does make a difference. It's more complicated for me than just seasonal allergies. But I hear what you are saying and everyone should give it a shot to see if it solves their issues.