Long time reader... first time poster

[Chairman Meow]

Should you end up going to a different type of mask (like a full face mask or a nasal pillow mask) you would need to change the mask setting on the machine.

Is it possible that the RT didn't change the setting from nasal to nasal pillow and that's why I was getting so much blowback on exhale? It just seemed so hard to breathe out - I can't imagine every becoming accustomed to that.

If at my 6 month mask replacement mark, if I decide I want a different mask than whatever I settle on now, can I change or do I have to reorder the same mask if insurance is paying for it?

[robysue]

The mask that she had pulled to give me was the same type of Wisp mask that I used during the Titration part of my sleep study... and I agreed that I hadn't had any trouble with it, but said that I'd really like to try a nasal pillow mask. She said that with my pressure being so high (12) she didn't think I would like it... but she let me try a Swift Fx - and I loved how it felt compared to the Wisp - until she turned the machine on... it was VERY hard for me to exhale, there was a lot of noise on exhale, and a lot of air blown into my eyes are these things normal with nasal pillows?

First, 12cm is not that high for the pressure setting, and plenty of folks use nasal pillows at that pressure or higher.

Second, the Swift FX has a really lousy design for the exhaust vents. I know. I'm still using that mask most of the time instead of my much quieter and much less windy AirFit P10. I'm an outlier, but I find the FX's pillows and headgear more comfortable than the P10's. I don't sleep as well with the P10 because of comfort issues---I wake up a lot more needing to "fiddle" with the P10 as compared to the FX. But I still hate the FX jet engine exhaust vents. The only way I've been able keep using the FX is to add an unauthorized, homemade "diffuser" over the vents. A big no-no, I know. But since my leak line is the same regardless of whether my homemade diffuser is in place, I've decided I have bigger things to worry about in my life.

My point is don't judge all nasal pillows by the Swift FX. Many are less noisy and less windy than the FX. A few have headgear that's even more minimal headgear than the FX.

Third, not everyone likes nasal pillows. When hubby was fitted for his mask a year or so ago, he tried a Pilaro nasal pillows mask. And really disliked the way the airflow felt (at 7cm). And so the tech then had him try on an Eson nasal mask, which didn't bother him at all. (I was just the opposite: Putting a mask over the tip of my nose triggered severe sneezing and an irresistible urge to scratch my nose.) So try some nasal pillows if you get a chance, but if the current mask is comfy, don't feel like you have to try a nasal pillows mask right now.

If at my 6 month mask replacement mark, if I decide I want a different mask than whatever I settle on now, can I change or do I have to reorder the same mask if insurance is paying for it?

You do NOT have to reorder the same mask. You may want to give the DME a heads up a few days before you reorder so that they don't just assume you want another mask of the same sort.

[Pugsy]

No, I doubt that having the machine set to nasal cushion when you tried the nasal pillow mask caused your problems. It really doesn't affect that aspect of things anyway. Having the incorrect setting might impact the leak data a little or mask pressure being sensed and reported but the differences in terms of what it feels like aren't very dramatic between the setting choices.
I suspect if your tech had started out with a low pressure and worked up to the 12 cm pressure that your experience with the nasal pillows wouldn't have seemed to bad. She/he had their mind made up ahead of time that you wouldn't like it because they believed that old wives tale that people with pressures over 10 can't use nasal pillows and thus didn't really give you a suitable introduction into nasal pillow use.

You can always order a different type of mask or change masks whenever you are wanting to use the replacement allowance for your mask per insurance. You aren't tied into any one type or brand.

Find out what your DMEs mask swapping policy is for right now. Typically it's a 30 day thing so if you have available swapping time then by all means use it now while you have it.

[palerider]

The only way I've been able keep using the FX is to add an unauthorized, homemade "diffuser" over the vents. A big no-no, I know.

personally, I think that's a great idea.

I'm hoping, now that F&P has added clip on diffuser pads to some of it's masks, that it'll become a "thing".

the one for the pilairo q that I tried was nothing more than a little mesh pad, like the coarse resmed filter, just something to spread out that hard stream of air. I think I'll make something like it when I have to go back to the quattro.

[Chairman Meow]

I was so excited all day yesterday to get home and look at my SleepyHead data - but just before I left work I pulled a muscle in my shoulder/upperback and then had to sit in traffic for 1.5 hours to get home (it usually takes me 15 min) and by the time I got home all I wanted was a bath and bed. The pulled muscle was (is) fairly painful, and I was feeling really defeated about how it was going to affect my ability to sleep and so by the time I got around to checking my SleepyHead data I was really down in the dumps. But then!!! (insert fanfare) I discovered that for my first night of CPAP my AHI was a .78!!!! Down from a 124.9!!!!

I had a brief period with a Large Leak (looked to be about 10 minutes or so)- but only a few events and very little snoring. I spent some time reading Pugsy's explanation of the graphs - and I think I have a grasp on it... but I should probably post my data just to make sure I'm not missing something. Figuring out how to do that was just not going to happen last night though - no matter how excited I was by my AHI.

And it turns out that all my worry about my pulled muscle was for naught. I did have a tougher time than usual getting comfortable (between the pain and still adjusting to having something on my face) and falling asleep - but other than that I think I had a pretty good night and according to the S9 my AHI was .8 last night.

I made the following adjustments before bed:

• Turned the humidity up from a 3 to a 4 - liked the extra moisture but still some dryness in my sinuses today, so I'm going to turn it up a little more tonight.
  
  Turned the temperature down from 80 degrees to 75 degrees- I perfer a very cool room when I sleep, but it turns out I don't like a cold nose - I will be turning the temperature back up tonight.
  
  Adjusted the hose to run up over my head - I liked this arrangement better because the exhaust no longer blows in my eyes and the hose doesn't get caught around my neck when I turn over - but I didn't like the way my husband giggled at me when he came to bed
  
  Clipped my hair up while putting the headgear on, keeping my hair from getting bunched under the fabric - worked much better, I wasn't tugging and pushing at the headgear all night trying to straighten out or free my hair.

Still had a few issues with leaks when I would shift my head on the pillow - but with the hose configuration it was much easier to tell the difference between the leak and the exhaust. Also continue to dislike the way the bottom straps ride up and hurt my ears - and if I keep this mask I'm definitely going to have to invest in some covers for the top silicone straps... as a side sleeper I don't like the way they feel pressing into my face.

Pugsy - My RT told me that I had 30 days to exchange the mask - when she called me this morning to see how I was feeling I told her about my issues and that I was thinking of maybe trying a different mask. She told me that they can't get the Swift Fx Nano though and I'm not sure if that means that the local office can't get it, or if the national company doesn't carry it. She said she'd check their stock of nasal masks and get back to me with what they do have so that I can take a look at them online and see if any of them will address the problems I'm having.

Do I have another option at this point? Can I return this mask to American Homepatient and get a mask through another DME, or do I need to get the whole kit and kaboodle from the same place?

Robysue - The main reason I'm so interested in nasal pillows is because it 'seems' like that would be the ideal mask set up for a side sleeper. I have a tiny nose and super small nostrils though, so that really gives me pause when it comes to the suitability of a nasal pillow mask.

[robysue]

Robysue - The main reason I'm so interested in nasal pillows is because it 'seems' like that would be the ideal mask set up for a side sleeper. I have a tiny nose and super small nostrils though, so that really gives me pause when it comes to the suitability of a nasal pillow mask.

I'm a side sleeper and I know exactly what you mean. I strongly prefer nasal pillows---as in I can't imagine trying to sleep with a the nasal mask hubby prefers.

I really do like everything about the Swift FX except for the exhaust vents. I've tried a couple of other nasal pillows masks and did not like them anywhere near as well as the Swift FX, in spite of their having much less obnoxious exhaust vents.

I had exceptionally bad luck with the Pilaro: While the headgear was wonderful, I wound up tearing a gash in the pillows the first night while trying to adjust them in the same way I can adjust the FX pillows. Told the DME about it, they gave me another set of Pilaro pillows to try and the same thing happened again after only a night or two of use. Sadly told the DME that the Pilaro would not work and, since they had quit carrying Resmed masks, that I'd have to find another DME for purchasing my masks from.

On one mask replacement cycle I got the newer Resmed AirFit P10 pillows mask. I've kept the P10 mask and I do use it every now and then. In fact I used it for 3 out of the last 4 nights. A whole lot of former Swift FX users here swear by the P10. And there are good reasons why they like it. The exhaust vents on the P10 are virtually silent and you really can't feel the exhaust flow from more than an inch or two away from the mask. Much more pleasant than the FX's jet plane exhaust flow. And many people find the P10's headgear more comfortable than the FX headgear.

But the P10's pillows attach to a somewhat rigid platform, which I dislike: It seems like the P10 just doesn't "squish" around as well when I'm moving around while awake. That platform catches on my bed pillow in some fashion and that tends to push the pillows out of place for me. I also find the P10 pillows much harder to "reset" for some reason---the gentle "tug them away from the nose and let go to allow them to settle" that works so well for my FX pillows just doesn't seem to do the trick for me on the P10.

And while most people around here seem to prefer the P10's headgear, I don't like it as well as my FX's headgear combined with a custom mask pad from Padacheek. I've got a small head, and it took me a long time to figure out how to arrange the P10's headgear so that it was loose enough for me to tolerate. Yep---I've got a tiny head, but I wish the P10's strap were longer rather than shorter. I also find that the top half of the split strap gets tangled in my hair something awful and that makes it harder to pull the bottom half of the split strap down far enough on the back of my head for the pillows to be at the correct angle. If I can get those split strap halves to go to the correct place on my head, the headgear is a bit more comfortable than the FX's. (But the P10 pillows themselves are not as comfortable as the FX pillows according to my nose.) But I have to work pretty hard some nights to get the P10's straps where I want them, and I can get the FX's straps arranged without any effort and without thinking about them. Which is important to me because it means I don't have to wake myself up to put the mask on at the beginning of the night.

[Chairman Meow]

Graph from last night... does anything look hinky?

[Pugsy]

One brief large leak flagged at around 3:30.
Otherwise not real remarkable.
From the looks of the pattern around that LL I would suspect a little mouth breathing. If it was mouth breathing it didn't last long and didn't go all that far into large leak territory and I doubt there was any impact on therapy or the events recorded ...meaning we can trust the data shown.
Large leak territory for the ResMed machines begin at 24 L/min.
If it didn't wake you up...I would dwell on it.

Your increase in the flow limitation graph activity seems to roughly correlate with what might be REM stage sleep.
Typically first REM stage will happen about 90 minutes after sleep onset and as the night goes on the REM stages come more frequently and last longer with the greatest amount of REM sleep usually happening in those wee hours of the morning before we wake up.

It might also be related to sleeping position if you happened to be on your back during those times where you see the flow limitations increase.

My OSA is much worse in REM sleep (documented on the sleep study) so I am quite familiar with the patterns...and my gut tells me that yours seem to go with REM sleep stage. You likely need a little more pressure during REM (it's quite common) if you wanted to reduce those FLs (assuming they are a problem). Not all FL activity means that there is a problem that needs to be fixed though. If you are sleeping well and feeling decent then there may not be any urgent need to do anything about those FLs.

[Chairman Meow]

Three week update.

I've been using my CPAP for three weeks today - with the exception of a major issue I had with my first mask (a Wisp) leaking being displaced during sleep, I feel like I was made for CPAPing. I haven't had any trouble with chipmunk cheeks (I naturally keep my tongue glued to the top of my mouth, even during the day) I don't have any trouble adjusting to the mask (I try to put it on to read, but once the air starts blowing up my nose it's like my brain thinks that's the 'go to sleep' signal and I can barely keep my eyes open) and with my A10 I don't even have issues with marks on my face or a sore nose . I look forward to going to bed now, I sleep through the night, I wake up most mornings before the alarm goes off feeling refreshed and ready to go.

I'm so grateful to everyone on this board for sharing their experiences and offering advice. When I first got the OSA diagnoses I was actually relieved to finally have an answer for my epic EDS. Then I started doing research and discovered this forum and found out how little I actually knew about how my life was about to change. Without the resources and information I received from this forum, I doubt that the CPAP experience would have been nearly as postive as it has been.

I'm planning to stick around and hopefully I'll be able to offer the same kind of help I've received to some other hapless newbie in the future.

Thanks to you all!

[Pugsy]

Glad to hear that you are doing well and BTW Happy Birthday.

[Chairman Meow]

Thanks!!! It's the big 4-0. Thankfully, due to CPAP, I don't feel a day over 39.