CPAP vs APAP - S9 results (your input welcomed)

[RandyJ]

Hello to all - I have been reading and posting here since March 2011 when I had my sleep study and initial diagnosis. I used cpap with a non-data capable machine from March to last week, when I got an S9 Autoset.

I have results from the S9 (finally) of my prescribed therapy (14 cmH20 cpap) and of apap range(s) I have tried: 13 to 18, and 12 to 20.

Here is the sleep study:











First, some results at 14cmH20 (AHI=2.4)




and some results at Autoset ranges stated above:

8/5/11(AHI=1.2)



and 8/7/11 (AHI=0.7)



I would appreciate any feedback at all, especially regarding whether I should stay at my prescription of 14cmH20 or with one of the ranges above, or something different.

Everyone has been helpful so far and I do appreciate it. This has been a wonderful resource of experienced, helpful people. I hope that when I have more experience I can be equally helpful.

All best,


RandyJ

[Uncle_Bob]

I'd consider opening her up all the way to 20cm and seeing what she can do when she's not stuck at 18cm

At such high pressures i would have to use EPR.

[RandyJ]

I'd consider opening her up all the way to 20cm and seeing what she can do when she's not stuck at 18cm

At such high pressures i would have to use EPR.

Thanks, Uncle Bob. Actually, in the final set of results for 8/7 the upper end of the range was 20.

[Lizistired]

I would concentrate on getting your leaks under control before I played with the pressure. The data jut isn't reliable with leaks like that. One step at a time.
Is your mask leaking or are you mouth breathing?
If you are mouth breathing, many here use Tape, chinstraps, polystrips, and I use a cervical collar to keep my chin up and my mouth shut.

[RandyJ]

I would concentrate on getting your leaks under control before I played with the pressure. The data jut isn't reliable with leaks like that. One step at a time.
Is your mask leaking or are you mouth breathing?
If you are mouth breathing, many here use Tape, chinstraps, polystrips, and I use a cervical collar to keep my chin up and my mouth shut.

I'm using a full face mask but at the higher pressures I am having some leaks.

[greg-g]

The results speak for themselves. I would certainly keep the upper pressure at 20. The lower pressure of 12 is OK if you don't mind the pressure variations, otherwise it could be increased a bit.
Have you ever used a nasal prongs mask? Leaks can be a lot easier to control.
The higher pressures will open your nasal cavities as long as you can stop mouth leaks. Some resellers have relatively cheap Swift FX masks.
I think trying to talk with a pressured nasal mask is good practice on how to seal your mouth. (The seal is actually at the back of your throat)

[Bobby269]

You need to reduce the leaks before you will see any improvements. I thought that your profile stated that you are using a full face mask. That should mean
your don't have to worry about keeping your mouth closed.
You might try this to help reduce your leaks. http://www.padacheek.com/PAC_Maskliners.html or this. http://www.cpap.co/productSearch.php?query=remzz
Once you get the leaks reduced your AHI's should go down. Then you can work on the pressure.

[RandyJ]

The results speak for themselves. I would certainly keep the upper pressure at 20. The lower pressure of 12 is OK if you don't mind the pressure variations, otherwise it could be increased a bit.
Have you ever used a nasal prongs mask? Leaks can be a lot easier to control.
The higher pressures will open your nasal cavities as long as you can stop mouth leaks. Some resellers have relatively cheap Swift FX masks.
I think trying to talk with a pressured nasal mask is good practice on how to seal your mouth. (The seal is actually at the back of your throat)

Thanks greg-g - I have never tried anything other than a full face mask, except during my sleep study. I tried a nasal mask briefly but couldn't breathe with it, my nose was a little blocked and I couldn't keep my mouth closed. Will look into getting one to try again.

[RandyJ]

You need to reduce the leaks before you will see any improvements. I thought that your profile stated that you are using a full face mask. That should mean
your don't have to worry about keeping your mouth closed.
You might try this to help reduce your leaks. http://www.padacheek.com/PAC_Maskliners.html or this. http://www.cpap.co/productSearch.php?query=remzz
Once you get the leaks reduced your AHI's should go down. Then you can work on the pressure.

Thanks Bobby269 - I just ordered a liner and leak strap, it looks like it will help. Thanks for the input.

[KeithK]

Good luck with it. I'm still in a very long learning curve.

My pressure gets up to 19.9cm (auto 14 - 20), my leaks vary daily. My EPR is currently set to 2.

I found reducing leaks help a lot. Some days I can minimise leaks by moving my head an inch, other days they drive me insane. From my experience, over-tightening a mask to reduce leaks only creates more problems. Liners didn't help me. Some days I'm lucky and I can just fit the mask in the right spot for it to rest gently without leaks.

I've tried using nasal masks and chinstraps without success. The last time I tried I taped my mouth shut which lasted an hour. I woke up in a coughing fit.

The Mirage Quattro full face is the best mask I've used to date.

Stick with it, it can only get better

[RandyJ]

Good luck with it. I'm still in a very long learning curve.

My pressure gets up to 19.9cm (auto 14 - 20), my leaks vary daily. My EPR is currently set to 2.

I found reducing leaks help a lot. Some days I can minimise leaks by moving my head an inch, other days they drive me insane. From my experience, over-tightening a mask to reduce leaks only creates more problems. Liners didn't help me. Some days I'm lucky and I can just fit the mask in the right spot for it to rest gently without leaks.

I've tried using nasal masks and chinstraps without success. The last time I tried I taped my mouth shut which lasted an hour. I woke up in a coughing fit.

The Mirage Quattro full face is the best mask I've used to date.

Stick with it, it can only get better

Thanks KeithK! I see we are using same equipment incl mask and same pressure range. I haven't tried other masks so I can't compare. Sometimes I just have a few episodes where leak exceeds the 24L mark, otherwise I seem to do ok w/mask at lower range of pressure. When pressure goes above 16 however, I tend to have more leaks. I agree that finding the "sweet spot" for the mask can be a difficult thing.

Would like to maybe try out a nasal mask; I couldn't stand it during my sleep study but might be able to get used to it at home.

Thanks again!