ASV machine, different numbers with different masks?

[tomma]

So, I've been using a Mirage FX nasal mask for around 4-5 months, but really started to hate it because I also have to wear a chin strap and and have something covering my mouth. Just getting to be to uncomfortable. My AHI has been good, usually anywhere between 1 and 3.

A couple nights ago I decided to go back and try my Mirage Quattro full face mask again. It's really hard to stop the leaks as my pressure can get up to around 23 or 24 at times (I'm on an ASV). Somehow I managed to get it to work, but, my AHI is higher than it's been in months, last night was 6.9. The only thing that's changed is the mask. Is it possible that I just need some time to adjust, or, is there a difference in the way the different mask types deliver the pressure and maybe I need a change in my settings?

Also noticed that most of the difference is coming from a group of centrals that occur an hour or 2 before waking, never had that with the nasal mask.

Thanks!

[tomma]

Anyone?

Last night was the same thing, 6.7, killer headache this morning too. This time the events were pretty much spread throughout the night as opposed to being grouped together.

[Pugsy]

How about adding "ASV" in your subject line like "different ASV numbers with different masks" to get the attention of the ASV users who frequent the forum. We don't have a lot but we do have a few.

I know that there are several people who have different pressure needs when going from nasal to full face as in needing a bit more pressure with the FFM but I have no idea how that might translate into ASV usage. They are battling obstructive apneas where more pressure is commonly needed but you have a different battle.
Could you also maybe post the detailed report for last night so we can see the AHI breakdown?
That way the guys who do use your type of machine and know which or what adjustment do whatever can offer their input.

[tomma]

Good idea. I just edited the subject to include ASV and here's some screen shots and more info...

The first screen cap is from a few nights ago, when using my nasal mask. It's pretty representative of what I normally get.



This next one is from last night, using the full face mask:



For the last couple months my settings have been:
EPAP min/max = 14
PS min = 5
PS max = 10
BPM = auto

Trying to determine if the difference in AHI when going from the nasal to the full face is just needing time to adjust, or if I need to tweak my settings. Any ASV experts (or anyone) have any ideas?

Thanks

[Pugsy]

You know that one time with that ugly cluster.....maybe REM sleep related? Or sleeping position?
Other than the cluster...the slight variations in the reports are within what would normally be considered night to night standard deviation.

Any chance that the straps for the full face mask are maybe causing extra tension and causing headaches?
When you wake up with the headache does it go away slowly or quick or not at all?

[tomma]

Headache is not going away at all, even now after being awake for 8 hours or so and countless tylenol and motrin.

You might be on to something, position. For whatever reason, with the nasal mask I'm not able to sleep on my back, the mask leaks to much. With the full face I can, (well, kind of anyway) so I wonder, maybe I'm rolling onto my back and that's when I'm getting those nasty clusters.

Might be time to break out the shirt I used to have to wear with the ball in the back and see if there's a difference.

[JohnBFisher]

Sorry, I had not realized this was an ASV related thread until you changed the title.

I would not be surprised that you have different numbers with different masks. If we were only talking about 10 to 15cm H2O then they would probably perform the same. Additionally, as you note, going onto your back may increase your obstructive apneas.

Why would they perform differently? Well, some masks hold up better to the high pressure than others. Full Face Masks have a lot more area to cover, thus can be more prone to leaks than nasal masks.

However, like you, a nasal mask was no longer working for me. Add to that the high pressure and even a chin strap did not help.

I find the original Quattro Full Face Mask harder to keep a seal than the Quattro FX full face mask. However, I needed the LARGE Quattro FX Full Face Mask when I only needed the medium Quattro Full Face Mask. The difference is that when my mouth hangs open the Quattro FX tends to ride up my nose and lower part of the mask rides up into my mouth. Talk about large leaks!!

I've tried / used the following full face masks:

• Quattro
• Quattro FX
• FullLife
• Hybrid

My favorite is the Quattro FX. I hope that helps.

[tomma]

Last night I tried wearing a shirt I made months and months ago, with a ball stitched into the back, to keep me from sleeping supine. AHI was 2.5, a little bit high, but back in the normal range for me anyway.

Seems like that might be the answer. Thanks everyone.

[JohnBFisher]

... AHI was 2.5, a little bit high, but back in the normal range for me anyway. ...

Dude, that's not "a bit high" .. That's GREAT!!

Folks, an AHI of ZERO is not always attainable. And sometimes like the OP, you need to work around known issues. Sleeping on his back drove his AHI sky high .. Well, he tried something to help keep him off his back. He probably aroused a few times due to that trick. And that may have led to some sleep state transition apneas. Who cares?!! He slept better. THAT is all that matters.

So, to tomma .. Good for you for working it through. Hope you have many more nights of good sleep.

[djhall]

... AHI was 2.5, a little bit high, but back in the normal range for me anyway. ...

Dude, that's not "a bit high" .. That's GREAT!!

This quote makes me feel so much better. I commented recently that a 0.7 was "doing great" for a new user that was only something like two weeks into treatment and thinking about adjusting their pressure. Later I read in another thread a comment from an established member saying someone had recently advised that a 0.7 was great, but they have a 0.2 to 0.3 and would be screaming for help from Pugsy if they had a 0.7! I was really discouraged after seeing that and thinking I was just an idiot.

[racprops]

I have the same problem flat on my back and sky high apneas..

Now for me I use a long body pillow and it keeps me from getting FLAT on my back... and it is not painful and does not wake me up...

Sadly some times I do slip down and get flat, but 90% of the time it works...

My 2 cents worth.

Rich

[JohnBFisher]

... AHI was 2.5, a little bit high, but back in the normal range for me anyway. ...

Dude, that's not "a bit high" .. That's GREAT!!

This quote makes me feel so much better. ... they ... would be screaming for help from Pugsy if they had a 0.7! I was really discouraged after seeing that and thinking I was just an idiot.

Nope. You are NOT an idiot. Way too many people here recently have been pushing for unrealistic numbers. Remember, we want to sleep well. We don't need to try to hit some mythical number. As long as I awaken feeling refreshed, I really don't give a tinkers damn what my AHI number is. It's when I don't feel as refreshed that I start to try to figure out why I am not sleeping as well. THEN the AHI is a good indicator of issues. But until then, WHO CARES!!! And not every night will be a good night. Again, it's VERY UNREALISTIC to think that every night will be good. Sometimes life sucks. No way around it. Trying to avoid a bad night that happens every now and then is just wrong. It's not that you sometimes "fall". We all do. It's that you keep on dancing and enjoying life!! So, be happy, keep on dancing and know that you are on the right track.

[Pugsy]

Nope. You are NOT an idiot. Way too many people here recently have been pushing for unrealistic numbers. Remember, we want to sleep well. We don't need to try to hit some mythical number. As long as I awaken feeling refreshed, I really don't give a tinkers damn what my AHI number is. It's when I don't feel as refreshed that I start to try to figure out why I am not sleeping as well. THEN the AHI is a good indicator of issues. But until then, WHO CARES!!! And not every night will be a good night. Again, it's VERY UNREALISTIC to think that every night will be good. Sometimes life sucks. No way around it. Trying to avoid a bad night that happens every now and then is just wrong. It's not that you sometimes "fall". We all do. It's that you keep on dancing and enjoying life!! So, be happy, keep on dancing and know that you are on the right track.

I think everyone knows that I totally agree with John....the goal is to get good sleep and feel better and not make some nice perfect score on a math test. Some people just HAVE to see low numbers as some sort of validation though and go chasing that elusive 0.0 AHI because they saw on the forum where someone else got it. It's extremely elusive for me if I have more than 4 hours of sleep.
I think I can count on one hand the number of times I lucked into a 0.0 AHI...pure luck and probably 5 or 6 hours of sleep barely.
I remember a few years back when a newbie started therapy and got an AHI of around 1.2 and felt great after the first night ...I know it was really low on the first night of therapy and immediately started increasing pressure trying to get the AHI lower and all that happened was aerophagia reared its ugly head making that person totally miserable and quality of sleep went straight down the toilet. That person spent nearly 2 weeks working on the AHI with more pressure and getting blown up like a puffer fish because they reduced the pressure back down to the starting point. I sat here just shaking my head watching that train wreck unfold.

So just for fun I sat down just now and did a quick tally for my AHI for the last month. Part of the time I was using my 750 in auto mode and the past 10 days my 660 in fixed mode.
This is how it played out.

AHI..had no 0.0 nights
AHI less than 1...2 nights and interestingly...last night and the night before..
AHI 1 to 2....11 nights
AHI 2 to 3....9 nights
AHI 3 to 4....8 nights
AHI 4 to 5....1 night
AHI over 5...none in the past month but a while back I had a 6 AHI and an 8 AHI mostly CAs if I remember right...bad nights of sleep due to back pain.

There was no pattern...numbers jumped around no matter which machine I used.

I had a couple of nights where hours of sleep were much less than my normal...and those days I didn't feel so good..and one of them my AHI was 1.11...for me it isn't the AHI that dictates how I feel...it's how many hours of good sleep I got.

[49er]

At the risk of sounding too negative, the other night I had an AHI of .37 for 1 hour and 47 minutes of sleep on the machine. I took an ambien to get back to sleep which got me an additional hour which resulted in a Zero AHI. Heck, I would be happy with a 25 AHI if I could get 5 hours on the machine. Of course, that isn't my ultimate goal but for now, it would suffice. Anyway, I just wanted to gently remind folks that having a super low AHI isn't everything.

49er

[Stormynights]

A couple of nights ago I had my second night of 0.0. I felt like crap all day long. I didn't turn my oxygen on.