The data from my new S9 confuses me?

[frh]

I apologize for the long post. I wasn't sure how to present the data, and don't know how to export the graphs from the ReScan 3.10 software. (but graphs would have made the post even longer.)

My sleep Study in mid March recommended a pressure of 6 with a C-flex setting of 3. I used a Swift FX mask at the study and had 5 or 6 hours of "mask time". I also took a 10 mg Ambien that night (as I usually do). Even though I fell asleep on my side, the sleep study report said I slept in a supine position (I think that means on my back).

I started CPAP on March 29th with a Respironics System One base model (no C-flex or data). The DME supplied a Swift LE mask. When I complained it was hurting my upper gum, they ordered a Swift FX. (I had to give back the LE.) I have a lot of nasal congestion. They let me try a Respironics Full Life mask for 3 days. It tore-up my nose, and I snored in the mask. So I went back to the FX. I also started using Nasonex on April 15th. It helps, but does not completely eliminate the congestion.

My regular MD (who knows very little about Sleep Apnea) agreed to re-write my prescription for APAP. I asked him to write the prescription for a minimum pressure of 5 and a maximum pressure of 10. EPR is set to Full Time with a level of 3. I got my S9 on April 27th. Here's the data for the last week:

April 27. Hours Used: 4:51.
AHI & AI: Apnea Index 2.6, Obstructive 1.2, Central 0.6, Unknown 0.8.
Hyponea Index: 0.0.
AHI: 2.6.
Leak: Median: 0.0, 95th Percentile 21.6, Maximum 93.6.
Pressure Median: 6.9, 95th Percentile: 9.8, Maximum 9.9.

April 28. Hours Used: 6:58.
AHI & AI: Apnea Index 1.2, Obstructive 0.8, Central 0.0, Unknown 0.4.
Hyponea Index: 0.8.
AHI: 2.0.
Leak: Median 0.0, 95th Percentile 15.6, Maximum 78.0.
Pressure: Median 7.2, 95th Percentile 9.3, Maximum 9.9.

April 29. Hours Used: 7.39.
AHI & AI: Apnea Index 1.3, Obstructive 1.1, Central 0.1, Unknown 0.0.
Hyponea Index: 0.0.
AHI: 1.3.
Leak: Median: 2.4, 95th Percentile 16.8, Maximum 33.6.
Pressure Median: 6.3, 95th Percentile: 8.6, Maximum 9.8.

April 30. Hours Used: 8.37. Note: I was pretty congested that night.
AHI & AI: Apnea Index 6.3, Obstructive 4.1, Central 2.2, Unknown 0.0.
Hyponea Index: 0.4.
AHI: 6.7.
Leak: Median: 2.4, 95th Percentile 12.0, Maximum 21.6.
Pressure Median: 8.2, 95th Percentile: 9.7, Maximum 9.9.

May 1. Hours Used: 7.30. Note: I cut the Ambien in half and it took a about an hour to fall asleep.
AHI & AI: Apnea Index 1.6, Obstructive 0.9, Central 0.6, Unknown 0.0.
Hyponea Index: 0.1.
AHI: 1.7.
Leak: Median: 0.0, 95th Percentile 9.6, Maximum 22.8.
Pressure Median: 7.1, 95th Percentile: 9.6, Maximum 9.9.

May 2. Hours Used: 6.12. Note: I cut the Ambien in half again and it took a long time to fall asleep.
AHI & AI: Apnea Index 3.2, Obstructive 1.4, Central 1.7, Unknown 0.0.
Hyponea Index: 0.0.
AHI: 3.2.
Leak: Median: 0.0, 95th Percentile 7.2, Maximum 20.4.
Pressure Median: 7.3, 95th Percentile: 7.2, Maximum 20.4.

May 3. Hours Used: 6.28. Note: I changed my Minimum Pressure to 6.0 and my Maximum Pressure to 12.0. I also cut the Ambien in half and it took a long time to fall asleep again.
AHI & AI: Apnea Index 4.1, Obstructive 1.8, Central 2.3, Unknown 0.0.
Hyponea Index: 0.2.
AHI: 4.3.
Leak: Median: 1.4, 95th Percentile 14.4, Maximum 22.8.
Pressure Median: 8.1, 95th Percentile: 10.6, Maximum 11.7.

My swift FX mask seems to fit OK when I am laying on my back. But I usually fall asleep and wake-up on my side. I have to re-adjust my pillow and the mask to keep it from leaking. Of Course, I have no idea what I do when I am sleeping. But I think leaks in the mask when I roll on my side is causing the inconsistencies from night to night. As soon as I can get enough money, I plan to buy a Swift LE mask.

Any comments?

[Uncle_Bob]

As soon as I can get enough money, I plan to buy a Swift LE mask.

Any comments?

yeah good luck buying a swift LE

have you seen thehttp://www.cpapauaction.com site for low cost masks ?

[frh]

yeah good luck buying a swift LE

have you seen thehttp://www.cpapauaction.com site for low cost masks ?

I'm a little confused about http://www.cpapauction.com/. I wish they had a "Buy Now" price. I hate waiting for stuff. Having to wait to see if you got the bid adds insult to injury. I might consider paying the DME $200 for a full face or hybrid mask so I can return it if it doesn't work for me. But there's no way I am going to pay them that much for something I know will work, and I can get online for less than $80.

I was hoping for is some informed opinions about the inconsistency in my data. So far CPAP seems to be a roller coaster ride. No two nights are the same. Can anybody explain why?

[Uncle_Bob]

yeah good luck buying a swift LE

have you seen thehttp://www.cpapauaction.com site for low cost masks ?

I'm a little confused about http://www.cpapauction.com/. I wish they had a "Buy Now" price. I hate waiting for stuff. Having to wait to see if you got the bid adds insult to injury. I might consider paying the DME $200 for a full face or hybrid mask so I can return it if it doesn't work for me. But there's no way I am going to pay them that much for something I know will work, and I can get online for less than $80.

I was hoping for is some informed opinions about the inconsistency in my data. So far CPAP seems to be a roller coaster ride. No two nights are the same. Can anybody explain why?

I seem to remember being told that if your 95 th percentile leak is not below 5 then the machine cannot accurately score the AHI.

I suggest working on your leak first, its a common hurdle to overcome. I agree its frustrating to wait for CPAP supplies but on the other hand making changes too quickly can sometimes be non productive. I had no luck with the Switch FX at all, the pillows collapse easily and do not fit up my nose at the right angle. Thats why i love the Swift LT it has a pivot adjustment at the pillows so i can get the right angle so they fit up my nose and stay there.

There is also the possibility that you could be leaking from your mouth. Many nasal mask users find they end up leaking air out of their mouth. Have you tried a chin strap? Or you could try taping your mouth shut. Search on mouth taping to find out what others are doing. If you decide to try a chin strap then the best one IMO is the PapCap

http://www.pur-sleep.com/products/produ ... category=6

Good luck with finding the right mask for you. Personally I have 10 masks at home that i have tried

[frh]

Uncle Bob, it would be difficult to tape my mouth unless I shaved off my mustache. But I don't think I am leaking from my mouth with the nasal mask.

The Swift LE bothered my upper lip / gum, but it never felt like it was leaking when I rolled over on my side. So I will buy one online next week and put up with the discomfort.

It will be another two months before the insurance will pay for another mask. I think I'll wait till then to experiment with unknown masks.

In the meantime, should I put the pressure back to 5 and 10?

[Uncle_Bob]

Uncle Bob, it would be difficult to tape my mouth unless I shaved off my mustache. But I don't think I am leaking from my mouth with the nasal mask.

The Swift LE bothered my upper lip / gum, but it never felt like it was leaking when I rolled over on my side. So I will buy one online next week and put up with the discomfort.

It will be another two months before the insurance will pay for another mask. I think I'll wait till then to experiment with unknown masks.

In the meantime, should I put the pressure back to 5 and 10?

So i assume when you were recommended a pressure of 6cm that was your titrated pressure? If so and based on the results above i would say a auto pressure of 5 to 10 would be OK.

Or if you think you are getting bothered or sleep aroused from the machine increasing the pressure on you to compensate for the leaks then you might want to try straight CPAP set to 6cm, and set to work on your leaks.

I've never heard of a Swift LE mask or do you mean Swift LT?

If you do have an issue with the Swift LT then i can relate as i used to get leaks with that mask especially when moving. I noticed the back strap would slide up the back of my head and lessen tension on the pillows so they would come off slightly causing leaks.A great idea for getting the Swift LT to stay put is the PapCap with the side straps that come around the back of your head, around by your checks and faster to the mask straps. I used to have a photo of me doing this but i can't find it. I will check at home.

Now i don't have to use the side straps as i find the PapCap helps stop the mask straps from sliding around. But it was a relief to go from annoying leaks to zero the first time i slept with the papcap.

[frh]

...Or if you think you are getting bothered or sleep aroused from the machine increasing the pressure on you to compensate for the leaks then you might want to try straight CPAP set to 6cm, and set to work on your leaks.

I've never heard of a Swift LE mask or do you mean Swift LT?

If you do have an issue with the Swift LT then i can relate as i used to get leaks with that mask especially when moving. I noticed the back strap would slide up the back of my head and lessen tension on the pillows so they would come off slightly causing leaks.A great idea for getting the Swift LT to stay put is the PapCap with the side straps that come around the back of your head, around by your checks and faster to the mask straps. I used to have a photo of me doing this but i can't find it. I will check at home.

Now i don't have to use the side straps as i find the PapCap helps stop the mask straps from sliding around. But it was a relief to go from annoying leaks to zero the first time i slept with the papcap.

Sorry Bob, I meant the swift LT. I changed the lower pressure from 5 to 6 because most of the graphs indicated my pressure got above 6 pretty quick, and did not fall below 6 all night long. I changed it from 10 to 12 because the graphs showed it topped out at 9.9 frequently. Perhaps I should have worked on the leaks before I changed the numbers.

I don't think I have a problem with the swift FX leaking, except when I roll over on my side. I think it is more hose management than anything else. The weight of that swivel puls it out of my nares. I tried fixing it to the left side with a couple of strips of velcro. It seemed to work pretty well, but prevented me from rolling over to the left. I tried using a rubber band to fix it to the top of my head like the Swift LT, but the swivel still flopped around a lot. I thought about trying to disable the swivel with another rubber band, but have not tried that yet.

The Swift LT was rock-solid on my face, an didn't feel like it leaked. It was just uncomfortable pressing on my gums (just above my teeth). The other thing about the LT is I woke-up with the left nare sore most mornings. That doesn't happen with the Swift FX.

I'm not sure if something like the PapCap could be rigged to work with the Swift FX?

[Uncle_Bob]

I have tried the FX with the PapCap but i leaked like crazy because the when i move the weight of the hose dislodges the pillows. I like to have the hose go up over my head and over my bed head. Thats another reason i like the Sift LT as it has a clip to manage the hose.

It sounds to me like you have your LT on too tight. Those pillows should almost feel like they are floating or just resting under your nose.

I used to put the LT on very gently then used the mask fit feature on the machine. I would move around in bed and see if i was leaking and needed to tighten any straps or adjust the angle of the pillows. Thats how i got the most comfortable fit with no leaks.

[Craig P]

Uncle Bob, it would be difficult to tape my mouth unless I shaved off my mustache. But I don't think I am leaking from my mouth with the nasal mask.

The Swift LE bothered my upper lip / gum, but it never felt like it was leaking when I rolled over on my side. So I will buy one online next week and put up with the discomfort.

It will be another two months before the insurance will pay for another mask. I think I'll wait till then to experiment with unknown masks.

In the meantime, should I put the pressure back to 5 and 10?

I also have a moustache, use a Swift FX and tape my mouth closed. even though the tape goes over my moustache I put a strap over my mouth also which seals everything up nice and tight.
See my strap in this thread:

viewtopic.php?f=1&t=49212&st=0&sk=t&sd=a&start=45

[frh]

Craig, I looked at your strap. It looks like a great way to solve the problem. Although I am a mouth breather during the day, I don't think I am leaking out of my mouth at night.

Bob, I think my FX is adjusted properly and is not too tight. Compared to the Swift LT it's incredibly comfortable. I found a couple simple ways to secure the hose / swivel so it doesn't pull the pillows away from my nares. (I think I described those in an earlier post.) But I don't think that is the problem.

I was fooling around with the mask earlier last night. I noticed the back strap moved whenever I started to roll over. It seemed like that was all it took for it to start leaking at my nares. The mask works best when loose, but loose straps make it move easier when I move my head on the pillow.

I have never seen a PapCap, but if it would help secure the FX without making it too tight, I would like to try it.

On the other hand it might be time to get another Swift LT and find a way to make it more comfortable to wear. Do you think the PapCap might help make the LT put less pressure on my upper lip / gums?

Last night was kind of strange:

May 4. Hours Used: 2.50.
AHI & AI: Apnea Index 1.7, Obstructive 1.4, Central 0.3, Unknown 0.0.
Hyponea Index: 0.0.
AHI: 1.7.
Leak: Median: 0.0, 95th Percentile 88.8, Maximum 27.6.
Pressure Median: 7.3, 95th Percentile: 11.5, Maximum 11.9.

I cut the Ambien in half again. About 1/2 hour after I took the first half, I was not getting drowsy so I took the other half. Five minutes later I put the mask on and fell right to sleep. Three obstructive apneas occurred about 5 minutes later. Another obstructive and a central happened about 20 minutes after that.

The weird thing is, the leak timeline does not line-up with the apnea timeline. The first leak occcured when I put the mask on and lasted for less than a minute. Another minor leak occurred about 15 minutes later between the two apnea events. Then another minor leak occurred about 10 minutes after the obstructive and central apneas. Then I slept for about 2 hours without leaks or apneas. I had a major leak for about 5 minutes before I woke around 1:30 am to find my wife turned the TV on.

I woke again at 6:30 am and found the CPAP mask hanging on the headboard instead of my face. That's the first time I recall taking it off in the middle of the night and not putting it back on.

I think the design of the Swift FX is part of the problem. It's comfortable, but I think moves when I am sleeping. But I can't re-adjust it to stop leaks every time I move my head when I'm sleeping.