Planets Aligned? Good DME Service! Now Some Swift Questions

[Snoozing Gonzo]

Maybe last Friday there was an astrological alignment or something.

At my last appointment my Dr. was mildly concerned that although my apnea occurrences were next to nothing on CPAP, my overall “Snore Index” was high and there were snoring spikes throughout each night. I had woken up snoring (an odd sensation in an Activa) several times recently. On Friday, I went to my DME provider for a follow-up smartcard download (my intended purchase of a reader and software got shifted down in priority to a heated hose which I expect to be delivered soon). After the download and a quick glance, the RT said that the Dr. had written a prescription for a new mask (its too early for a regular replacement to be covered by insurance) if the snoring was still evident. So, even though I think the solution is to kick the pressure up a notch, I ended up with a Swift. I even got some brief instructions and all the parts… good service was not what I had expected!

Except for the stripe on the bridge of my nose I have no complaints about my Activa but I do like the lightness of the Swift and the ability to see the clock without shutting one eye and twisting my head. In just three nights, I may have experienced most of the common complaints; straps riding up, noise, bulging nostrils, leaks due to hose drag, sore nares, and leaks from sleeping on my non-hose side. I have spent a couple hours searching thread archives here and on other sites to find out more about the intricacies of my new mask. Following found advice, I started with the large pillows, Velcro on the straps to prevent riding, new routing of the hose over the headboard, saline gel, etc. However, I haven’t been able to work out the leaks while on my side (I hang the mask over the side of my buckwheat pillow) other than by cranking the straps down pretty tight.

I’ll try the medium pillows and some new barrel angles tonight but other that that, any advice or tricks?

[Snoozin' Bluezzz]

I have been a Swift user for 3+ months and have not solved this. It is why I am experimenting with other interfaces and may be settling on the Headrest with which I seem to be getting the bugs worked out of.

If I sleep in a manner that keeps my head slight rotated up then I don't have any problems but the better my therapy is working the more I relax while sleeping and the deeper and deeper I dig into the bed pillow as I sort of move between side and stomach sleeping. The subsequent leaks wake me up. My only solution has been strap tightening as well and then the nose gets a little sore. It does not seem to matter which side the hose is.

Sorry

SB

[NightHawkeye]

I have been a Swift user for 3+ months and have not solved this. It is why I am experimenting with other interfaces and may be settling on the Headrest with which I seem to be getting the bugs worked out of.

Ditto. I do like the Swift, but it requires constant attention to keep from leaking. I seem to be having a little more success with the ComfortLite 2.

Regards,
Bill

[Snoozing Gonzo]

The medium pillows worked well for side-sleeping last night - also added the recently arrived heated hose and kicked up the humidity a bit. However, the irritation on one nare from the days using the large pillows was a small abrasion this morning. I'll go back to the Activa for a couple nights and try the Swift again. Its not like I have a problem with the Activa, comfortwise anyway.

I've got to say that last night, whether from the Swift or heated hose or a combination, was the deepest I have slept for a long time. I should probably save up and invest in a reader and software so I can track the differences in masks in real time rather than when I can get to the DME.

[Snoozin' Bluezzz]

For me, medium pillows did create a lot more soreness than large and did not seal as well but each of us is different. It seemed like they went into the nostrils too far.

All of my "best" nights so far have been on the Swift but some really difficult nights have been on the same interface with no seeming differences. It seems like I get a little more fatigued on the other interfaces, switch back to my Swift and the first night, or two, is great and then I start battling leaks.

This disorder is can be a royal pain in the patootie!

SB

[Sleepless in St. Louis]

So some more searching and you'll find somewhere a thread about rerouting the hose, using the velcro strap, to the very top of the headgear, instead of attaching to one of the sides. There is even pictures to show how it goes. I did this and it totally solved the tendency of the Swift to leak when I was slide sleeping. The way the hose is situated now, it's impossible for it to touch the pillow, disloding the barrel from a nostril. Data shows my leaks consistenlty lower than before. It's a real easy fix for an annoying and disruptive problem.

[Snoozin' Bluezzz]

I have spent a couple hours searching thread archives here and on other sites to find out more about the intricacies of my new mask. Following found advice, I started with the large pillows, Velcro on the straps to prevent riding, new routing of the hose over the headboard, saline gel, etc.

He says he did that. I know I did that. For me it did not completely solve the problem. I am sort of 1/2 side, 1/2 stomach sleeper when I can which has me digging the side of my face into my pillow. Routing the hose through the tweaked head loop helped but did not solve the problem.

As I said, for me the better the sleep the more likely I am to move into that position and then I get woken up.

Each of us is different, it seems that no one solution works for everyone.

SB

[Guest]

Here are the written instructions thanks to Tridens:

Well, after trying about as many masks as you find at a Halloween party, I finally decided on the Swift, even as a side sleeper. My main complaint (and one I've seen here on the board) is the problem the hose presents, particularly to a side sleeper. Many of us have awakened to find that our "Elvis sideburns" have been joined by an indentation of the hose. Some route the hose downwards to avoid this issue, which creates its own set of problems...I personally like having the hose up and over my headboard so that it doesn't pull on the mask as I roll around.

I found a solution that works great for me. I'll try to explain it as best I can.

The Swift comes with a small Velcro strap that you can use, according to the directions, to secure the hose to one of the ascending straps on the headgear. I've found an alternate location for this strap.

1) Adjust the headgear until the fit is comfortable. This is important, as locating the strap where I'm recommending makes adjusting the top strap more difficult later.

2) Take the headgear off and locate the plastic adjustment buckle on the strap that goes over the TOP of your head.

3) Take the Velcro strap and, from the underside of the buckle, route both ends of the strap through the slits in the buckle so that both ends of the Velcro strap are sticking out of the top side of the buckle.

4) Connect your Swift's hose to your main tubing. Place the tubing on top of the buckle and secure with the Velcro strap. Make sure you route the tubing the correct direction...the Swift's tubing should be forward of the buckle.

You can decide for yourself what part of the tubing assembly is secured directly under the velcro strap. I find that it works best if you use the rubber connector of the larger tubing. Securing the tubing itself (either the Swift's or the main tubing) causes the tubing to slide through the connector.

5) Strap on and go!

You'll find that this arrangement keeps the Swift's tubing both forward and off to the side of your face, so that if you lay on your side it's completely out of the way. This arrangement also doesn't interfere with changing which side the Swift's tubing is connected to, which is great for people like me who frequently switch sides during the night. Lastly, securing the tubing to the top of your head in this way allows you to route the main tubing over your headboard or attached to the wall above, so it doesn't pull on your mask, and keeps you from rolling over onto it as happens when the Swift's tubing is routed downwards.

Tridens

Click on this link to bring you to the three photos:

viewtopic.php?p=35069#35069

[roztom]

I found the Swift really difficult to deal with but other than getting it just right for theleaks it just caused too much pain which I couldn't overcome.

It was very light and unobtrusive but I have slotted nares and on one swide of my septum it continually caused sores - no matter how much AYR gel or incantations I used.

I've considered taking my Swift on a one way ride to a land-fill in New Jersey.

Seriously, I wish it worked for me. The hose over the head helped relieve pressure and leaks - though it is a finicky interface. IMHO.

Tom

[Sleepless in St. Louis]

I guess I'm lucky then. The overhead trick worked and my sore nose as Tom described stopped being sore after a while. I guess I got used to it. One key for me is to not overtighten the headgear. My DME first gave me a large, which really hurt, and when I switched to a medium (on my own of course) it still hurt a little, but like I said it went away. I will still occasionaly spring a leak, but my leak rate numbers have been tending downward. Now if I could just get my snore index to near zero. One step a time.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): DME

[Snoozing Gonzo]

Thanks for quoting the Tridens procedure. I did go ahead and do that even though I rarely roll to my left side. (Too many years of getting a shove or push for snoring into my wife's face. But apparently I'm trainable). It does create a more stable system. My leaks seem to occur on my non-hose side even when the barrel mask itself isn't on the pillow. Its just from smooshing the side of my face a bit into the pillow. I'll double check my hose routing and keep after it, thanks again.

The snore index thing is weird. I've even woken up with the old "snore thoat" a couple of times. I wonder if its something a fine-tune of pressure could allieviate, if it were possible. That is if you could set an 8.2cm for example. I'm trying to remember my position when I wake up snoring to see if thre is some pattern there.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): hose

[rested gal]

Now if I could just get my snore index to near zero. One step a time.

I see from the picture of the machine you use, you have a Respironics machine. Unless you have a bed partner who is noting that you're snoring in your sleep, I wouldn't worry unduly about "snores" appearing on your Encore Pro data.

Maybe you're snoring, maybe not. Both Respironics REMstars I used tallied up a lot of snores that were just not really happening. When I use my Puritan Bennett 420E autopap, there is rarely a snore tick mark at all (PB calls it "acoustical vibrations".) That's with same configuration of everything for both manufacturers' machines - same mask, same heated hose, same pressure range, and with the REMstar's C-Flex turned off when I was experimenting to see how the two machines compared on "snores".

I even used the same humidifier. I use a stand-alone humidifier, the Fisher & Paykel HC 150, so that I can use it with any machine and not have the added expense of a different integrated humidifier for each machine. Plus, the HC 150 works extremely well.

Always the Respironics machines would register many snores. The PB machine, rarely - often none. The Respironics machine seems to note "something" as snores that doesn't seem to really be happening for me. I finally just ignored the snore index with the Respironics machines.

If it were me, I think I'd raise the lower pressure a notch or two on your Respironics machine just to see if that reduces the snores; but if that doesn't make a very appreciable difference in the snore index, then I'd drop it back to where you had it and forget trying to reduce it, much less trying to get none. What's registering as snores with your REMstar might not be meaningful at all.

[Anatha]

I used my Swift for the first time last night. I used Ayr, put in some netting, routed the hose up and used larger pillows than the DME thought I should. These were all suggestions from this website and I will tell you that I slept much better than I did with the Activa, which was very poorly. 1-3 hours with Activa = nearly 5 hours with Swift.

I didn't have any soreness this morning and my nares feel normal. It did take quite a bit of fiddling to get it right, but I had to fiddle with the Activa too. Once I got it on right, it didn't leak at all.

Thank you everyone for your input on this mask, it has given me at least one good night now (hopefully more!).

[Sleepless in St. Louis]

Always the Respironics machines would register many snores. The PB machine, rarely - often none. The Respironics machine seems to note "something" as snores that doesn't seem to really be happening for me. I finally just ignored the snore index with the Respironics machines.

Thanks rested gal. I sort of suspected this was the case. I have to jump through a few hoops to be able to breathe enough volume of air through my nose to make this work, and it is. I'm talking irrigating, Flonase, etc. I tend to have some sort of restriction in my nose, don't really know why. So I'm wondering if the Remstar is "hearing" the air move through my nose in a less than optimal way and calling that a snore. I really don't see how I could be snoring much since I tape my mouth every night. I have not been able to prove it yet with a witness that can talk but I hope to try to gather that evidence in the near future, but that's another whole story that I'm sure most don't want to hear about .