FF mask trouble

[Buckeroo54]

I am currently using a dreamstation with a wisp cushion and chin strap. This set up gets me 2-3.5 AHI’s if my wisp is fresh. As I seem to be a mouth breather (dry mouth, throat without chin strap) I have tried to change to a prescribed resmed airtouch FF and have had no success getting under 5 AHI’s. I have had no resolution from my sleep pros (MD’s and Techs) with getting the airtouch working.
Pressures as set by my clinic are :
Min- 12
Max- 20
90%- 12.8
It seems that during my session, with either the wisp, and especially with the airtouch FF the pressure runs up until I start getting leaks which eventually wakes me. I’ve tried light strap, tight strap adjustments.
My wife has a resmed airsense 10 with a airtouch mask and gets - 0.5 AHU’s average per session and has since receiving it 3 years ago.
Yes I’m pretty frustrated.

[DreamDiver]

I am currently using a dreamstation with a wisp cushion and chin strap. This set up gets me 2-3.5 AHI’s if my wisp is fresh. As I seem to be a mouth breather (dry mouth, throat without chin strap) I have tried to change to a prescribed resmed airtouch FF and have had no success getting under 5 AHI’s. I have had no resolution from my sleep pros (MD’s and Techs) with getting the airtouch working.
Pressures as set by my clinic are :
Min- 12
Max- 20
90%- 12.8
It seems that during my session, with either the wisp, and especially with the airtouch FF the pressure runs up until I start getting leaks which eventually wakes me. I’ve tried light strap, tight strap adjustments.
My wife has a resmed airsense 10 with a airtouch mask and gets - 0.5 AHU’s average per session and has since receiving it 3 years ago.
Yes I’m pretty frustrated.

Welcome!
I wonder what your original psg prescription was for your machine. Have you made any pressure settings changes?
If your 90% is 12.8cm, I wonder if it's necessary to keep the max pressure at 20cm.
Also, any chance you could post a few nights from your data using OSCAR software?
https://www.sleepfiles.com/OSCAR/

We could help you review your settings, your large leaks, flow limitations, etc., and help you determine how you want to proceed for next steps.

Looking forward to learning more!

Chris

[Buckeroo54]

I am currently using a dreamstation with a wisp cushion and chin strap. This set up gets me 2-3.5 AHI’s if my wisp is fresh. As I seem to be a mouth breather (dry mouth, throat without chin strap) I have tried to change to a prescribed resmed airtouch FF and have had no success getting under 5 AHI’s. I have had no resolution from my sleep pros (MD’s and Techs) with getting the airtouch working.
Pressures as set by my clinic are :
Min- 12
Max- 20
90%- 12.8
It seems that during my session, with either the wisp, and especially with the airtouch FF the pressure runs up until I start getting leaks which eventually wakes me. I’ve tried light strap, tight strap adjustments.
My wife has a resmed airsense 10 with a airtouch mask and gets - 0.5 AHU’s average per session and has since receiving it 3 years ago.
Yes I’m pretty frustrated.

Welcome!
I wonder what your original psg prescription was for your machine. Have you made any pressure settings changes?
If your 90% is 12.8cm, I wonder if it's necessary to keep the max pressure at 20cm.
Also, any chance you could post a few nights from your data using OSCAR software?
https://www.sleepfiles.com/OSCAR/

We could help you review your settings, your large leaks, flow limitations, etc., and help you determine how you want to proceed for next steps.

Looking forward to learning more!

Chris

Sorry about delay, I appreciate your response. I’m having to set up photo sharing app (flickr) to share charts. I will get back with them ASAP. I have charts for both full face and wisp (what I’m using currently). Thanks!

[zonker]

Sorry about delay, I appreciate your response. I’m having to set up photo sharing app (flickr) to share charts. I will get back with them ASAP. I have charts for both full face and wisp (what I’m using currently). Thanks!

you can post images directly to the site using the "attachment" tab that you see when you are posting.

good luck!

[Buckeroo54]

Ok, thanks for the heads upon attachments!
The 1.55 is a good night with my Wisp, the other is a bad night using a resmed air touch full face. I'm a mouth breather and want to go to a FF. I recently changed my pressures from 12/20 to 11.5/15. My good 90% is 12.0ish and I have a guess that my low of 12 was not giving the machine and chance to settle. I was having nights of hi pressures <17.
Thanks for your attention!

[DreamDiver]

Ok, thanks for the heads upon attachments!
The 1.55 is a good night with my Wisp, the other is a bad night using a resmed air touch full face. I'm a mouth breather and want to go to a FF. I recently changed my pressures from 12/20 to 11.5/15. My good 90% is 12.0ish and I have a guess that my low of 12 was not giving the machine and chance to settle. I was having nights of hi pressures <17.
Thanks for your attention!

Perhaps I'm reading it wrong... I can't tell because I'm not seeing large leak indicators in the event flags or flow rate graphs... It looks like you had some large leak during the wisp night, but almost all the way through the airtouch night regarding AHI. But it could also be due to the pressure regime change...

I wonder if you've got the airtouch properly seated on your face if there is such a drastic difference between the wisp and the airtouch. You may have already done this, but if not, it might be worth playing with the mask fit option on the Dreamstation Auto while you're prone, maybe in several usual sleeping positions. If it's hard to see the mask fit icon in regular sleeping positions, you could ask your significant other to watch the icon for you.

Have you tried the recent pressure change with your airtouch ff yet?

Chris

[Buckeroo54]

I’ve discovered that my “mask fit” option was never turned on by my dme. I tested for mask fit and found no problem for either the wisp or full face. I tried my sleep positions, on back and left side, I even simulated a mouth leak, no test fails. I notice the leak charts showing big leak all session with FF and a couple of leaks for the wisp. I can’t understand whats going on, is there some other setting at play? Puzzled

[DreamDiver]

I’ve discovered that my “mask fit” option was never turned on by my dme. I tested for mask fit and found no problem for either the wisp or full face. I tried my sleep positions, on back and left side, I even simulated a mouth leak, no test fails. I notice the leak charts showing big leak all session with FF and a couple of leaks for the wisp. I can’t understand whats going on, is there some other setting at play? Puzzled

DME's... My experience with them has been that they tend to intentionally throw more obstacles between me and solutions than is acceptable.

My face may have a resting position when I'm unconscious that isn't identical to my face's resting position when I'm awake. It makes it more difficult to determine whether the mask fit option is working properly with regards to large leaks. #restingbitchface

It's possible this is the same for you. See if you can consciously relax all the muscles in your face while you're awake. It can be really difficult to achieve, but perhaps, you must need practice mastering your own awake #restingbitchface, especially in supine and prone positions. Try laughing genuinely and then relaxing your face during mask fit.

I hope adding some levity to the situation isn't offputting. Sometimes, just a little laughter can make a difference.

[Janknitz]

Here's the thing about air cushion masks--the more you tighten them, the more they leak. That's because the air cushion is supposed to mold lightly to your face, but it cannot do that if it's strapped down tightly.

Your machine has a setting called (I think) "mask fit". That sets the pressure to it's highest set level for 40 seconds so you can fit the mask at your highest pressure--that way it won't blow off your face when the pressure increases in the middle of the night. See https://www.youtube.com/watch?v=jU0-vRZXPh0

Here are my tips for fitting the mask using the mask fit feature:
1. Loosen all the straps on your mask.
2. Lay down in your bed with the mask on and turn on your CPAP.
3. LIGHTLY hold the mask in place with one hand while you adjust the straps with other, just enough to stop the leaking.
4. Now move into your usual sleeping position and readjust the straps as needed, but again using just enough pressure to stop the leaking, no more.

FF masks are frustrating because there's a lot of surface area and your face moves a lot during the night.

[Buckeroo54]

thanks for the info!