Mirage FX and ResMed S8

[Pugsy]

So sorry....I just can't help it. How many times did I say "check your hose and all connections"
I am laughing with you...not at you.

I hope this resolves the issue and we have all learned a valuable lesson.

Reminds me of a story that I read way back when I was just starting therapy. It was in a medical journal article.
Seems there was this little old lady who was happily going along with her therapy and then things sort of started going south.
So she goes back to the doctor and they try to figure out what is going on and they increase her pressure and that didn't help.
There was no mention as to data in the article as in software reports so there probably wasn't anything available.
So she goes for a few months and still was feeling bad so they did another sleep study and nothing had changed..no pressure changes needed or anything. This went on for several months then one day she decided to change masks and wash the long hose and all the stuff that we sometimes don't do all that often and low and behold the long hose leaked water from tiny little pinholes...courtesy of the household kitty.

[jdm2857]

I was just kidding in my last post.

No offense taken at all.

[Pugsy]

I know...I wasn't put off at all. I knew what you meant. No problem but you have to admit...I do have a reason to chuckle.

I hope that this does resolve your issue mainly because I know it has been bugging the heck out of you because things just didn't compute and we don't like not being able to figure something out. I'm the same way.

[jdm2857]

So I found the leak in my Mirage FX setup, right?

And the Pugster laughed at me, right?

And I changed the setup to eliminate the leak, right?

And I slept with the Mirage FX last night and my leaks now make sense, right?

Wrong.

The leak line is as bad (or worse) than the night before. The graph is too ugly to post (or
maybe I am too lazy to post it.)

For the moment I have to suspend my adventures with the Mirage FX due to a small sore just below my
nasal septum that won't heal. I think the mask is irritating it each night.

So I will switch back to my Swift FX for a while until this thing heals.

When I resume this futile quest, I will post more.

Same bat time, same bat channel.

[Pugsy]

Sorry, I laughed and jinxed you. My bad...I should have known better.

[jdm2857]

SInce my last post, I've been using the Swift FX.

Fortunately, my nose has healed.

Unfortunately, I've been having leak issues with the Swift FX as well.

Here's a typical night. I've had better (almost Aunt Jemima pancake-like), and worse (Cyclone roller coaster, anyone?)



I'm using a PapCap, pulled tight by a team of Clydesdales, and the Swift FX, pulled by just two. (Loose is most definitely not better,
at least for me.)

I want to try to get this nailed down before going back to the Mirage FX. Any thoughts on what to do?

[MS Gray Man]

So just before the 7:00 mark did you wake and adjust something? That 5-7 range is the one that is really bad, the rest were at least short duration leaks...

But something happened to put you back to baseline at that point. Just wondering if you readjusted something or were mouth leaking and closed that off...

[jdm2857]

I well could have adjusted it, but have no recollection of it.

[MS Gray Man]

Well I'm a long way from the resident expert but it looks like that graphs I used to get before switching to FF masks.. I tend to sit at about 14 for pressure.

The up/down nature and then the quick cliff make it look like mouth leakage, it scales up and down depending on how much air is escaping from your lips... then you wake enough that your mouth closes again... I'm sure none of this helps much but -- I had whole nights that looked like your 5-7 period on nasal masks.

[jdm2857]

I have both a Quattro FX and a Liberty Hybrid (no FX ) and have not been able to adjust either one
satisfactoraly enough to try sleeping with either one.

They either inflate my mouth or cause those wonderful vibratory leak noises.

And I have a feeling that I would still need a chinstrap to avoid dislocating the mask by opening my mouth.

[Pugsy]

Looks like mouth breathing to me. The worst of it looks like those 2 chunks between 6 and 7...both not horribly long and not horribly high. The others are so short lived I don't know if I would worry so much about them but you know me...I am good as long as leaks are horrible for a prolonged period of time.

Any difference in how you feel or quality of sleep or any of that usual stuff?

I had something similar last night...was a nice straight line for most of the night right up about an hour before I got up and then things went to hell. Up and down spikes with a few minutes over 24 L/min (though sometimes I have had more than a few minutes) but I sleep right through them and can't tell that it makes any difference in how I feel and that's why I don't do chin straps or tape anymore. They would disturb my sleep more than 20 minutes of big leak would hurt me.

[jdm2857]

I've been dragging a bit for a few weeks now. I'm thinking "I'm tired" during the day, and that was my mantra pre-CPAP. I've
never had any other sleep-related problems.

As for mouth breathing, that's a tough one. The PapCap is about as tight as I can tolerate (or pull the damn strap.) With it,
I can't open my jaw, but I can part the middle of my lips, with effort. My beard rules out taping, or I would try that. I
do have some leftover PolyGrip strips from my little experiment with them years ago, I could try one in the center of my
mouth.

I should also scare up some Velcro for the inside back strap of the Swift FX to ensure it is not sliding up and then my moving
it back in my sleep.

[Pugsy]

I can clench my jaws and teeth shut...vise closed...I can still part my lips and mouth breathe. Not a lot of air will move but it will move and I have woke up in the middle of the night doing pretty much just that.

You know "if" you are mouth breathing it isn't very much...not like half the night spent with a hurricane coming out your mouth...but it may be just enough to maybe disturb your sleep on some lower level that you don't realize.
If you could totally get the leak under control by some means once...and you felt noticeably better..you might have an answer as to why not feeling as good as you would like. More from a sleep disturbance thing maybe and not because the total night was in the toilet from leaks or mouth breathing. 30 minutes of even a huge leak out of 8 hours of sleep is not the end of the world.

[jdm2857]

Take a look at this night from last week:

Figures it was on the sofabed at my parent's house after a Passover (no, not a humidifier) Seder and my share of overly-sweet wine.

It's interesting to note that the one pressure rise is due to a snore spike seen on a graph not in the pic. Since
it's the only snore of the night, I wonder if it is an artifact. The only time I see pressure increases is when leak
is very low and snores happen (A10 algorithm). The flattening index looks improved until the time that the
pressure decayed back to 18 and that next apnea occurred.

I know that I am going off in a million different directions, but should I add increasing my minimum pressure
to my list of things to try.

And now off to Home Depot to buy some mouth epoxy, err, Velcro.

[jdm2857]

I worked with the Swift FX a few more nights with some success reducing the leaks.

Then my nares got a bit sore so I switched back to the Mirage FX. Leak numbers didn't look great.

Today I went to download the data for these days and discovered that the connection between
the S8 and the ResLink module was loose and the graphical data for all of these nights was lost,
so I have no graphs to post.

I have fixed the ResLink issue using a bit of strategically placed tape to snug up the fit. (The
ResLink snaps onto the S8.)

I'll stop back in a few days.