newbie,17 pressure, ffm leaks unless on v tightly

[pupsmom]

Hi,
I've been using a Remstar Auto A-flex for three weeks now. I was using a small ffmask. It sealed pretty well but head straps seemed awfully big.

Had my check back w/pulmonologist a week ago and he said the machine hadn't really eliminated (I think that's what he conveyed) respiratory events until it got to a pressure of almost 17. So that's what he prescribed. The machine had been set on like 6 to 20 adjustable pressure.

Abyhow, I mentioned the size thing to my DME and she tried on the extra-small mask and it right away seemed like a better fit to me. But that was w/o any air pressure. Now that I've been using this smaller one for a week, my nose is sore, bridge feels bruised. I've been adjusting straps very tightly to get rid of leaks, especially around my eyes. I know the info says looser is better w/the Mirage Quattro mask and I experienced the looser fit working w/the small mask. However the pressures were not consistently almost 17 like they are now. (She did set it to ramp up.)

I shldn't have made the two changes at the same time, I see now.
Pupsmom

[PetrusKy]

Have you tried nasal and/or pillow mask? Perhaps with a chin strap?

[pupsmom]

No, haven't tried a nasal mask. wanted full face because I'm a mouth breather. I don't know if I cld stand to put a chin strap on. I don't mind the mask or being connected but one more piece of equipment is just too much. Besides, I reminds me of Marley in Scrooge.

[geoffc]

I was having the same trouble with my mirage quatro. I called my DME and she switched me to a mirage micro and I haven't looked back.....

Good Luck,

Geoff

[glcksc]

Hi, Just wanted to add my 2 cents. I started with the FF Quattro and had AHI's ranging from 17 to 40. My mask would leak very easily which contributed to my Aeneas. I switched to the Resperonics GEL Nasal and my AHI's dropped to 1.8. I originally thought I would need the FF because I had dry mouth most nights. When I switched to the GEL Nasal I wanted to try without the chin strap and have not needed it so far.

[LaCansada]

I have a pressure of 12 and I had to take my Quattro FFM back. Way too many problems. But, like you, I am a mouth breather and I also had to tighten the living dickens out of those FFM's despite this is NOT what the instructions say to do. But if it was on loosely, it just totally blew off of my face. I reluctantly tried the nasal pillows (Swift LT for her) with that ruby red chin strap they sell and I really have no problems with it. My AHI is down from 10 to an average of 2.2. I cannot use any kind of nasal mask alone w/o a chinstrap or I just lose all of my air. I finally settled on this after buying about 5 masks and spending a lot of money. So that's my story for what it's worth.

[sleepmba]

Pupsmom,
Have a look at my blog about mouth breathing: http://www.sleepandcpap.blogspot.com
It may shed some light on what you are experiencing. Have a look in the May part of the blog for that topic.

Good Luck!

[DoriC]

Are you adjusting your mask for leaks at full pressure and not with ramp setting?

[pupsmom]

bummer, I just wrote a long reply and had forgot to log in, so the message didn't get posted. Is there any way to get it back or find it? I don't have time to rewrite it right now, got to check out of our hotel soon.
pupsmom

[jweeks]

Had my check back w/pulmonologist a week ago and he said the machine hadn't really eliminated (I think that's what he conveyed) respiratory events until it got to a pressure of almost 17. So that's what he prescribed. The machine had been set on like 6 to 20 adjustable pressure.

Hi,

This screams red flag to me. Did they readjust your machine? If you get little treatment until you get to 17, your machine is going to take so long to ramp up that it is going to miss events. This isn't going to help you much. The range on your machine should be something like 15 to 22. In fact, at that level of pressure, you should probably be using a BiPAP or above rather than a CPAP or APAP machine. Did you get a titration study done in a hospital or sleep center? If not, they are doing little more than guessing. At that pressure level, if they don't watch you for centrals, they could make your sleep problem even worse. I suspect that you need to find a different doctor or a 2nd opinion. From what you write, this sounds really goofy to me.

-john-

[pupsmom]

I've tried three times to tell you abt last night and I keep losing the drafts. I used a t-shaped gel pad on my nose last night, loosened top head strap a little and also started with the nose piece fully open to 24. Then I closed it one click at a time to get rid of leaks. Adjusted top straps in teeny amts and ended up w/a good night's sleep and woke up w/my nose feeling better.

The machine is set to ramp up from pressure 6 or 8 to 17 in about 15 minutes. I end up having to adjust the mask parts as the pressure increases because it starts leaking as pressure goes up.

I don't understand, John, what you are telling me about the settings or why I need a bipap. I don't know what the exhale is set at. So far the setting and changing and adjusting are mysteries to me. All I know is that at 16.7 or so, the respiratory events stopped when I had my sleep study. They put a cpap on me at abt 4 a.m. that morning but I don't think it was long enough to tritrate it.

When I went back in two or three weeks, they read data from the memory card in the cpap and that's when the pressure was increased to 17. The dr. may have said the I had 15 stops of breathing and 10 central apneas. or maybe 15 apneas, 10 shallow breathing and then some central apneas during my sleep test? I was a bit befuddled and not keeping up w/evrything he was saying. The resp. therapist said she observed 40 breathing incidents during the sleep test. Some of not breathing and some of shallow breathing.

I wish I had the printed results of the first two or three weeks w/me but they're in the car. We're in a different motel and it's 12:03 a.m. and I'm not going to get them tonight. More info tomorrow, or shld I say, later this a.m.?

Thanks for your attention. Keep the info coming.

Pupsmom