Hybrid Mask - Snore Index

[communilink]

Let me start this with a note that I have not read every single message about the hybrid mask, but I have read 90% at least.

I got my mask last night and spent time getting it fit like I thought it should. Slept with it last night for 7.5 hours, and woke up with a sore upper lip and I would say that was the worst issue with the mask fitment. Good leak index even with a full mustache and beard.

what buged me and what I don't remember being discussed is that my Snore Index when through the roof. My wife even commented that she could hear me snore during the night.

I am at 14cm not 16, as I lowered it from the sleep study, and had my AHI below .5 for about 10 days now, until last night when my Snore Index went up massive.

My OA and HA is stll very low.

Anyone else experience this or have any suggestions??


On a side note, my wife had a sleep study after seeing me sleep so good with the machine, was perscribed a machine set a 7, and the DME the doctor sent her to told her she would have to get the machine they carry not the machine perscribed unless we paid the difference in cost as required by our insurance. (which is bull), when we told them we have 100% DME coverage regardless of product, per our insurance and provided them a contact, they said they could no longer do business with us because we did not follow their policies regarding communication with the insurance company.

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CPAPopedia Keywords Contained In This Post (Click For Definition): DME, AHI

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CPAPopedia Keywords Contained In This Post (Click For Definition): DME, AHI

[maskjkie]

Let me start this with a note that I have not read every single message about the hybrid mask, but I have read 90% at least.

I got my mask last night and spent time getting it fit like I thought it should. Slept with it last night for 7.5 hours, and woke up with a sore upper lip and I would say that was the worst issue with the mask fitment. Good leak index even with a full mustache and beard.

what buged me and what I don't remember being discussed is that my Snore Index when through the roof. My wife even commented that she could hear me snore during the night.

I am at 14cm not 16, as I lowered it from the sleep study, and had my AHI below .5 for about 10 days now, until last night when my Snore Index went up massive.

Based on the fact that you are reporting a sore upper lip, the oral cushion is not sitting above the upper lip. I suggest you re-position it or try a larger oral cushion. Once you do that, you may also have to switch the nasal pillows to the short setting but that may not be necessary.

I suspect that you are getting a leak right at or slightly above the upper lip and thats why your wife could hear you snore. The leak rate displayed is not a 100% good indicator because it depends on mask setting used on the machine.

[Snoredog]

Snores don't usually result in a drop to your SAO2 levels like the other more severe events. However, a snore usually precedes an apnea event which is why most autopaps try and eliminate them. But not always.

Ignoring the noise from snoring for the time being, your lower AHI score and how you feel the next day is what you want to go by. If that means a little snoring is heard, so be it, as long as the noise doesn't bother your partner. Once she goes on the hose, it won't matter anyway.

The problem encountered sometimes in totally eliminating snores by increased pressure is it can trigger central hypopnea or even apnea due to the higher pressure. You have to be aware of that, if you had a lab titration they should have noted these on the reports as OA or MA's.

In a lab titration they will also try and eliminate those snores, but if in doing so they SEE it triggering those central events they stop and/or back off pressure, then that becomes your titration pressure.

Now if you go home and start using an autopap and set the high pressure limit above that lab found pressure, it is very likely that the machine will pick up on the snores with increased pressure going over where the lab tech found centrals, so the machine's probing alone can be the cause of these and higher seen HI scores. To an autopap these centrals can look the same as obstructive events. Then if you switch and use a interface like pillows or a swift mask you can hinder the autopap machines ability to detect if those events are central vs. obstructive.

So if you want to prevent that from happening, then lower the high pressure limit down to your 95% pressure. Only give it room or increase that limit should you suspect your pressure is not high enough. Again, you are looking for lowest AI & HI's with the most refreshed sleep.

[Snoozin' Bluezzz]

In a lab titration they will also try and eliminate those snores, but if in doing so they SEE it triggering those central events they stop and/or back off pressure, then that becomes your titration pressure.

Now if you go home and start using an autopap and set the high pressure limit above that lab found pressure, it is very likely that the machine will pick up on the snores with increased pressure going over where the lab tech found centrals, so the machine's probing alone can be the cause of these and higher seen HI scores. To an autopap these centrals can look the same as obstructive events. Then if you switch and use a interface like pillows or a swift mask you can hinder the autopap machines ability to detect if those events are central vs. obstructive.

So if you want to prevent that from happening, then lower the high pressure limit down to your 95% pressure. Only give it room or increase that limit should you suspect your pressure is not high enough. Again, you are looking for lowest AI & HI's with the most refreshed sleep.

That describes perfectly the finding on my sleep study and has since been confirmed by my own APAP data review. My pressure has gone up 1cm H2O since my study so my sweet spot is 9 and not 8 but looking at data over time my AI and HI goes up as the Remstar Auto seeks to clear snores. It is a very distinct inverted bell curve with a clear bottom at 9cm H2O. This has had me run straight CFLE with pretty good success.

I have not run on Auto with the Hybrid to see if that interface moves the sweet spot because I am battling a cold but I will do it sometime over the next few weeks.

Thanks for sharing.

David

[communilink]

What I think I may do is up the pressure 1 or 2cm's in small increments to see if it helps. I can feel the back of my throat close now that I am on my back with the new Hybrid, where I did not feel it with the nasal mask.

We will see what happens over the next couple of nights

Don

[Goofproof]

[quote]
I suspect that you are getting a leak right at or slightly above the upper lip and thats why your wife could hear you snore. The leak rate displayed is not a 100% good indicator because it depends on mask setting used on the machine.

[OwlCreekObserver]

What I think I may do is up the pressure 1 or 2cm's in small increments to see if it helps. I can feel the back of my throat close now that I am on my back with the new Hybrid, where I did not feel it with the nasal mask.

We will see what happens over the next couple of nights

Don

I know that my apnea events are higher on my ComfortFull (full-face) than on my ComfortCurve 2 (nasal) -- even when I have the leaks under control.

One thing that is keeping me from investing in the hybrid is the fear that I'll get the same numbers that I'm getting with my ComfortFull. If so, then I'd rather put up with the mouth taping and get the better results.