Hybrid Users. What is your pressure setting?

[Sleepless in St. Louis]

I'm asking because of the problems I was having last night, my first try with the hybrid. I have my auto, which I recently got, on a rather wide setting of 11-20. The hybrid did fine until my auto started doing its thing and then voila, leaks all over the place. With the swift, my 90% sometimes goes as high as 18 with mean being about 16. (Believe it or not, I was titrated at 9!!) With proper adjustment, am I going to be able to get this mask to work even at highter pressures. Opinions?

[DreamStalker]

Where are you getting the leaks ... nasal pillows or around the mouth piece?

If that is a representative picture of you, your face does not have the typical round shape that other successful users have ... not that you still cannot make it work ... you may have to try a little harder though.

- roberto

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CPAPopedia Keywords Contained In This Post (Click For Definition): Nasal Pillows

[Sleepless in St. Louis]

I'm not sure where the leaks were happening. I was too sleepy. I only know that I could hear them and were annoyed by them. Instead of playing too much with the mask to try to get it readjusted, I just swapped it out for my trusty swift. I'd be more willing to play around with the adjustments on a weekend when I don't have to be "on".

That's pretty much what I look like. My face is a little long, not round at all. I'm not ready to give up yet even though I've also read that this mask has had the best success with rounder shaped faces. Hope springs eternal for me, especially when it comes to getting a decent night's sleep.

Tim

[wolftracker]

make sure to feel around the edges of the mask ...
it has a very high vent volume and it appears
to leak, when it blows on your face inside the mask
but is not leaking outside the mask.

that was causing me problems until I figured out that was
what it was suppose to do.

now my snore rate has gone up a bunch and i am not
sure why that is.

my .02
wolf

[sidesleeper]

The leak rate reading is high on the Hybrid because the Co2 flush is high. You can get leak warnings without a real leak. Try different pillows and cushions if your really leaking.

[DreamStalker]

Things I might try assuming leaks are not from pillows is to:

1) looking in the mirror make a closed-lip smile and determine which is the smallest mouth piece (of the three S, M, L) that will cover your mouth from corner to corner.

2) also check to see if the chin flap is causing the open area of your mouth piece to shift down allowing corners of your mouth not to be covered. Some have had to cut their chin flaps in order to make them work but I only would do this as a last resort when everything else has been tried.

3) tighten up the straps ... ouch that hurts! ... then loosen back as needed while maintaining seal ... aughhhhh that feels better

If leaks are from pillows ... you will just have to try all 3 sizes and adjusting the vertical height till you get them to inflate and seal properly.

This mask has many possible adjustments ... try'em all ...

- roberto

[sidesleeper]

If I could give someone advice to save them time on the Hybrid fittings and misfittings it could be summed up in a few words.

Watch the video first !

You'll be surprised how much watching the video helps you get the right fit.

[roster]

Watch the video twice.
Use the smallest mask cushion that will cover your mouth.
Adjust the mask in front of a mirror with the apap connected and running.
The two top straps should be adjusted evenly and the two bottom straps should be adjusted evenly while the mask is centered on your face.
The head strap should be adjusted to achieve optimum snugness of the nose pillows.

I use large pillows with Swift but medium pillows work better for me with Hybrid. I had problems with leaks from mask cushion until I removed the chin flap and downsized to medium mask cushion.

It is a great mask for me. I hope it works out for you.

[tooly125]

Sleepless,

I use cpap my pressure is 19 and the hybrid handles it nicely.
I have had three other FF masks and the hybrid is the first one that I can wear without having to over tighten.

There are a lot of options to choose from while adjusting your hybrid. Not only do you have a lot of pillow and seal choices but also you have five straps
To play with. An adjustment on the top or bottom straps could change the angle of the pillows and make all the difference. Also don't forget the strap that goes over your head!

I am wondering if your headgear is the new improved version that
Snoozie_suzy was sent viewtopic.php?t=12392

Anyway be patient it might take a lot of playing around to get it to work but once you get it working you wont be sorry.
Good luck

[Sleepless in St. Louis]

Thanks to everyone who took the time to type out their tips. It seems to me that it's just going to be a process of trial and error. Having only used the swift in my cpap life, it was really an unpleasant feeling at first to have something covering my mouth. I don't know how you full face mask guys do it. HOT and HUMID is the best way to describe the feeling to me as contrasted to the swift. We'll see if I can get used to this thing. I know there will be some advantages for me.

Tim

[snoozie_suzy]

You know what is so strange Tim? When I first got the Hybrid, the first 10 days or so, my chin and face seemed to almost perspire, it felt so hot. I have A/C in my bedroom so it shouldn't have been a problem, but that chin cup is rubber/silicone material so I'm thinking because it has skin to skin contact vs. other full face masks that come "near' your face, but not literally touch.

All I know is now, I don't sweat anymore. I'm wondering by your picture though if you won't end up being a person who fares better from cutting off the chin flap (although definatley give it at least over the weekend so you have much more time to tweak things a bit in front of a mirror and try the different sizes etc. )

Under the 'search" function look up some of Mike Moran's and Oldgearhead's fixes to the mask. They seemed to encounter some leak issues and incase you do end up wanting to perform "surgery" they both posted in great detail what they did to remedy.

If all else fails try calling the company, I love the new headgear they sent me. I am going to post about this in a new thread. Because it is much much sturdier and more 'foamlike" the straps dont' have to be tightened quite so much and I didn't encounter ANY leaks last night at all, plus hardly any marks on my face. I had ordered the PADacheeks a month ago but have not been able to use them as of yet, because i had to keep readjusting the straps of the crummy old headgear, it was akward to do with the padacheeks in place.

Good Luck Tim, keep us posted. Don't give up. Its wonderful when you get just the right combination of everything, the big exhaust and CO2 exchange makes a difference.

Suzy

[snoozie_suzy]

OOops, I noticed after writing the above post, I didn't even answer the original question you were asking about, "What is our setting".

I use my Auto as mostly CPAP these days, purely because I noticed from my data over the past 9 months that I have a very narrow window of effective treatment, which is roughly 9-10cm. Any lower big increase in AHIs and any higher big increase, almost makes a "U" shape on the My Encore graph. .Because I use it in straight cpap vs. auto, I wouldn't know if there is a change by using Hybrid. Sorry, wish I had some input.

Keep fiddling with the mask, perhaps over the weekend, although you had mentioned recently an impending business trip, so maybe as soon as you get more "free" time. Good Luck

Suzy

[Sleepless in St. Louis]

Thanks for all the good tips. I think I'm going to call the hybrid folks and see if they'll send me the new headgear anyway. From the way you described it (suzy) it sounds like a better set up to begin with. With what that mask costs, I suppose they can spring for the upgraded headgear. I thougth about fiddling with the hybrid while I'm up east, but I'm already tired enough from fighting the leaks last night. It would be embarrassing for me to fall asleep in front of my coworkers tomorrow a.m.

Night to all.

Tim

[Snoredog]

my opinion is you need to go back and see your sleep doc and talk about your last PSG because if you were titrated at 9cm and now need 18cm there may have been a valid reason you were to use 9cm.

Normally your pressure findings won't be off by that much going from a PSG found pressure to what an autopap finds.

[Snoredog]

snoozy_suzy wrote:

I use my Auto as mostly CPAP these days, purely because I noticed from my data over the past 9 months that I have a very narrow window of effective treatment, which is roughly 9-10cm. Any lower big increase in AHIs and any higher big increase, almost makes a "U" shape on the My Encore graph.

That inverted bell curve shown by myEncore is your "sweet spot" and you did exactly the right thing by limiting your machine to that found pressure.

some SDB artifacts can cause the machine to trigger and increase pressure where it doesn't necessarily lower your AHI any.

Your example shows what many fail to see when they get an autopap, they miss their sweet spot and allow the machine to continue on sometimes doubling their required pressure. Then they wonder why they are still tired.

Many times it is okay to let a few events go untreated if treating those remaining events would require a much higher pressure.

I'm seeing these pillow style interfaces like the Swift, Breeze etc. are resulting in much higher AHI scores than conventional masks.