ASV Quandry - Hyponeas or Snores? -Update

[tuzacat]

Hi, I am still struggling to optimize my ASV usage. I think I am mostly used to the higher pressures but I am having some strange results depending on what mask I wear. For a week or so I had I thought I had the F10 issues worked out. My AHI was under 1 and Patient Triggered breaths were moving up. Then I started having a bunch of snores and when I snored the Patient Triggered Breaths went down. I went back to the Wisp and had a couple of successful days and then my hypopneas went up. I have been working with the F10 and the N10 recently. Last night I started with the N10 with chinstrap and tape. I turned off the Bi-flex and bumped the bottom Epap number to 10.5. I started grunting which keeps me awake. I think the grunt is actually a hypopnea because the back of my throat shuts down and then I grunt. Apparently I am having them when I am awake. So after a couple of hours I switched to the F10. I generally don't grunt with the F10 but even with my mouth taped closed and a chinstrap I snore. When I am having the hyponeas and snores the machine is kicking into action and my Patient Triggered Breaths are scary - like 9. I think my snores are actually pre-hypopneas. With the snores my pressures are not as high when it kicks in. The reason I keep the tape on with the full face mask is to help with the dry mouth.

I am trying to figure out how to get rid of these events. I am thinking this is a pressure issue. My Epap range started out at 8-12 but I adjusted it to 10 because I felt like I was suffocating at 8 especially since when I was on Bi-pap my Epap was 10. I have raised it to 10.5 but I am wondering if I should go up to 11. ASV experts I would appreciate your thoughts on this. Your comments have been invaluable. Even though this is not perfect I am sleeping longer and I put that down to all the help the folks on this forum have offered me! Thank you!

Update ---

Last night I tried bumping the Epap up to 11 but I put the Bi-Flex back on to 1 because it felt a little intense without it. I also tried using a second mask liner that someone else mentioned and it was very comfortable but the leak rate was higher than I like. Here's the weird thing - my AHI was at .1 but my snores were a whopping 37, however, my Patient Triggered Breathes went up to 67%.

I'm going to try again tonight without the second liner and see what happens. Trying to work the problem...







Best,
Tuzacat