Too much for one post?

[Bentley'sDad]

I looked up the references, and might agree except that the software is actually counting these "double breaths" as full breaths at double the number per unit time.
This was taken from last night and looks like this may be "normal" for me in a high breath rate that does not hyperventilate? I guess this seems innocuous enough?
Meanwhile I am still concerned with my leaks. It seems that my leaks and incidents are co-incidental and one may relate to the other. Last night I had to take off my mask near 4-5AM. Slept till 830 after that.

[Pugsy]

You aren't hyperventilating. If you actually manually count each full respiration the number isn't anywhere near what the graph is reporting. This is something you shrug your shoulders and move on and don't give it another thought because it means nothing and you can't do anything about it anyway.

[Bentley'sDad]

I have been looking at the stats and find no direct correlation between AHI, Flow limit, Leak rate, large leak and total time in apnea, except when all are above average they sometimes correlate loosely. Sometimes total time in apnea and AHI have no relationship to the others at all. Interesting in itself as I would have thought they would correlate more directly.
I did find that many of the OA are probably due to repositioning and or adjusting mask, not breathing after resettling or sighs etc. So unless I am wrong that is a good thing overall and I should somewhat discount these incidents?
I am back to dealing with mask issues. I put the mask on and adjust it using the leak check function nightly. I have noticed that I have to tighten it a little (as if the headgear is stretching with use).
My large leaks are getting worse on average and the total time with large leaks is getting worse. That said, the overall efficacy (AHI and total time in AHI is getting better on a week to week basis.
I have had 2 nights at or under .25 AHI with 6 plus hours sleep each night over last 14 days. Those nights left me refreshed.
Last night my AHI was only 2.5 (peak 8,6,4), but my leak rate was 46.4% Large leak using dreamwear FF (med wide). Apparently the fit changes nightly with this beast. I love how it feels and it seems to allow lower pressure therapy but I woke today tired.
I am now able to sleep through leaks, when I first started that was impossible (have been able to block pain and noise all my life).
Aug 1-3 I used the F20 and was able to almost eliminate leaks (tightened using test and made sure face was relaxed before starting). But it actually left marks in my skin and my lips were swollen and red from blood flow issues when wearing it. Slept good and felt good except for my face and lips and the tightness of the mask to stop leaks.

Screen Shot 2021-08-07 at 11.12.55 AM.png (206.58 KiB) Viewed 2479 times

I forgot to mention that I am playing Didgeridoo about 10 mins a day avg for the last week.

Remember, I never felt poorly until after this damn machine, now I am tired and have lousy sleep a lot. Any suggestions for the next mask/type to try? obviously these two are not working for me. I am a mouth breather so opted FF but willing to do anything to sleep well and feel refreshed.

[Pugsy]

Your leaks are SO bad that it is entirely possible that a truckload of apnea events are happening during those times but the machine has no idea they are happening.
So the nice low AHI might not be so low if the large leaks weren't happening.
We don't know if the AHI is low because not much happened event wise or the machine simply was so deep in large leak territory it couldn't sense what was happening.

Sorry, I don't use, nor never have used, any full face mask beyond a brief trial for a couple of nights so I can't help with suggestions about fit or mask.

[ChicagoGranny]

Aug 1-3 I used the F20 and was able to almost eliminate leaks (tightened using test and made sure face was relaxed before starting). But it actually left marks in my skin and my lips were swollen and red from blood flow issues when wearing it.

There is definitely something wrong in the adjusting and maybe the sizing. That mask is designed to inflate and "float" on the face. Have you looked at some youtube videos on fitting and adjusting the F20?

Remember, I never felt poorly until after this damn machine, now I am tired and have lousy sleep a lot. Any suggestions for the next mask/type to try?

Maybe you need to take a break from CPAP for a week. Just make sure you come back.

There are some other things I can recommend, but I think you should take a break and then try again with the masks in your possession.

If you do take a break, try to avoid back-sleeping. OSA is often worse while sleeping on the back. Gravity is pulling the tongue and soft palate directly into the airway. During side or stomach sleeping, the effect of gravity is somewhat lessened.

Oh, I see in your signature that Bentley is your dog.

[GrumpyHere]

Any suggestions for the next mask/type to try? obviously these two are not working for me. I am a mouth breather so opted FF but willing to do anything to sleep well and feel refreshed.

You said you love the DreamWear frame.
But the FFM cushion is not working out for you.

Well, you can get either the nasal cushions or the pillow cushions that fit the frame. Philips pushes that versatility as a major selling point for the DreamWear system.

Please read what I suggested earlier on how to deal with mouth breathing and see the pictures of the cushions.

https://www.cpaptalk.com/viewtopic/t182 ... l#p1390508

The gel pillow for example is about $13 on Amazon

Large
https://www.amazon.com/Replacement-Pill ... B071HPZRZW

Medium
https://www.amazon.com/Respironics-Drea ... B07G7J73DJ

Other cushions are about $9 - $30
https://www.amazon.com/s?k=dreamwear+cushion


Another thought, AirTouch F20 cushion is compatible with the AirFit frame and headgear. The AirTouch cushion uses memory foam for contact surface. It might be more forgiving of face shape changes.

Medium $19
https://www.amazon.com/ResMed-AirTouchT ... B075MRSXLN

[GrumpyHere]

It's a bit outside of the box ...
but have you considered the Falcon position?

Your face is against the mattress in this position so your face has less freedom of movement. Thus less likely to change shape.

http://www.uarsrelief.com/sleeppositions.html

[ChicagoGranny]

Well, you can get either the nasal cushions or the pillow cushions that fit the frame.

If you are switching him to a nasal interface from an FFM, you need to tell him how to keep his mouth shut.

[GrumpyHere]

Earlier in the thread...

And you can deal with mouth breathing by:

• taping

• pushing your tongue up against the roof of your mouth

• Scuncis

• firm foam cervical collar

[Bentley'sDad]

Ok, I took the week off. Had really bad sleep a couple nights. Felt tired all day a couple days. Had to take 3 naps Sunday after sleeping a full night even though I didn't feel awful I was tired.
SO...now that I have opened Pandora's box I have to move forward I guess.
Monday, Called DME, needed new scrip as the Physician had stated FF mask. Called Dr. and ordered new scrip.Tuesday, Doctor's office called me, told me new scrip was delivered. Friday called DME, no scrip. Called Dr. and started over. Friday 8pm DME called. I am only telling you all this so you know how much I "love" HMO plans.

Was just delivered my new elephant trunk. Very weird not being able to talk and wear it and the first time I opened my mouth all kinds of stuff sprayed forth (good think DME guy was wearing mask). ROFL.

Tonight will be first night with the Wisp. I noticed right away that:
1. It seems unlikely that one would sleep mouth open because of the movement of the Uvulva and how uncomfortable the kind of airflow is
2. Talking will be impossible or very funny.
3. it seems hard to balance ear pressure if you can't open your mouth to do so.

Its all going to be fun I think. will update later.

[Bentley'sDad]

Second night on WISP. I taped my mouth for most of the night. Notice the leaks? I had a better nights sleep but woke up a lot from the new mask and tape. Feel better overall but a little tired because of waking.
Notice that with the Wisp the pressure seems to be effective at a 2cm lower than with a FF.
I know that I was awake around 230. I think I took the mouth tape off and then put it back on sometime after that. I am using the medium Wisp and will change to large tonight. Any other ideas to reduce the leaks?

[ChicagoGranny]

Notice that with the Wisp the pressure seems to be effective at a 2cm lower than with a FF.

It's not the mask type. It's the tape.

When a person's mouth opens, the lower jaw moves slightly backward. This adds more restriction to the airway. Keep the mouth shut, less restriction/lower pressure requirements.

[Bentley'sDad]

Ok, I have stopped using the tape and have been adjusting the mask. Started rather loose then began tightening 1/8 inch a night. I move a lot in my sleep and this mask seems to leak every time I move. I also noticed that the material stretches somewhat, this means that at a certain point the material stretches overnight and the mask is as loos as it was the night before (as an example).
Large Leak Rate is about38-48%. Not good and the leaks wake me. I hate the tape but may have to go back to it. At least twice last night I had mild parchment mouth which means that I am opening my mouth causing the leak at least some of the time.

Good news is the nasal mask seems to use lower pressure than a FF for what seems better efficacy. AHI is under 2 consistently now.

Any ideas beyond what I am trying?

[Miss Emerita]

For mouth leaking, it sounds as though you find that tape helps, so is that workable for you? For mask leaks, might you want to consider the Bleep Dreamport mask? It has no headgear; the interface just sticks onto your nose with adhesive. It's a little fiddly to use, but with practice it goes pretty smoothly.

If you're interested in giving the Bleep a try, let us know. Lots of tips we could share.

[Bentley'sDad]

This is getting interesting at least. Even though I have HUGE leaks this mask seems like it it making me feel better, the sound of the leak doesn't wake me up as much. One can easily see that I have leaks about 50%of the night. If the machine is reading my AHI correctly then the efficacy is there. Generally I feel better in the mornings than with the full mask, but a little tired still.
You can easily see when I adjust the mask as well. Which means that either I am doing it while asleep or incidentally when turning/rolling over.
At least now I do not feel as if my mind is not sharp.Just a little tired.
I have been inconsistent with tape as I am not used to it and feel a little claustrophobic.