AHI and masks
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AHI and masks
A really weird thing is happening. I got my auto about two months ago. I ve tinkered with the pressures as some of you know. I deciced to go back to using my old comfortfull mask (yuck). My ahi was usually in the 9-13 range. Well, since i ve been using the old mask instead of my ultra mirage my AHI is around 5, sometimes less. This is for the last 6 nites. Weird huh. My pressure is 8-19 but rarely goes over 13.
Re: AHI and masks
[quote="loonlvr"]Weird huh. quote]
Not really. I've noticed changes with different masks. Sometimes one might leak more, even if you don't feel it. Sometimes one is just more comfortable, so you sleep a little differently or more deeply. Sometimes one doesn't work right in a certain position (like on your side) so you unconsiously spend most of your sleep time in another position. And of course, there's the fact that we never quite sleep the same from night to night, so it could just have been an odd night.
But a mask can affect your AHI.
Debbie
Not really. I've noticed changes with different masks. Sometimes one might leak more, even if you don't feel it. Sometimes one is just more comfortable, so you sleep a little differently or more deeply. Sometimes one doesn't work right in a certain position (like on your side) so you unconsiously spend most of your sleep time in another position. And of course, there's the fact that we never quite sleep the same from night to night, so it could just have been an odd night.
But a mask can affect your AHI.
Debbie
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wading thru the muck!
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loonlvr,
My guess is that you were leaking treatment air through you mouth with the nasal only mask. I don't know this for a fact, but I suspect from much of the data I've seen from users having difficulty getting good treatment from an auto that a high leak level is interfering with the auto catching most of the events. I don't recall if your leak levels where high in the data derer posted for you. It may also just be that the combination of the comfortfull, your breathing patterns and the REMstar auto more accurately treats your OSA. If so, congratulations on finding the combination that works for you.
My guess is that you were leaking treatment air through you mouth with the nasal only mask. I don't know this for a fact, but I suspect from much of the data I've seen from users having difficulty getting good treatment from an auto that a high leak level is interfering with the auto catching most of the events. I don't recall if your leak levels where high in the data derer posted for you. It may also just be that the combination of the comfortfull, your breathing patterns and the REMstar auto more accurately treats your OSA. If so, congratulations on finding the combination that works for you.
Sincerely,
wading thru the muck of the sleep study/DME/Insurance money pit!
wading thru the muck of the sleep study/DME/Insurance money pit!
I've also been "tinkering". I have a 420E and have noticed that mask type makes a BIG, BIG difference.
The machine is sensitive to leaks (pressure goes up agressively), and this seems to induce flow restrictions, central apneas, and central hypopneas for me. Therefore, I've had to use an Activa mask to eliminate this as a variable.
My pressure pretty much stays at the lowest setting for most of the night, but only if the leak tracing stays "level". This results in my best AHI numbers and lowest number of "flow limitation runs", as well.
The Activa is virtually leak proof at the seal. It's not perfect, nor is it the most comfortable interface I've ever tried, but it seems to be a step in the right direction according to the software downloads I've been looking at. . .
Incidentally, even with the Activa mask, I have runaway pressures and central events with the 420E if I do not turn off "IFL1". I confirmed this last night and found that my pressures ran away due to "flow limitation runs" and got even worse at higher pressures with central apneas present (the max limit was set to 10 cmH20). I must have a strange breathing pattern, similar to "Rested Gal".
-John
The machine is sensitive to leaks (pressure goes up agressively), and this seems to induce flow restrictions, central apneas, and central hypopneas for me. Therefore, I've had to use an Activa mask to eliminate this as a variable.
My pressure pretty much stays at the lowest setting for most of the night, but only if the leak tracing stays "level". This results in my best AHI numbers and lowest number of "flow limitation runs", as well.
The Activa is virtually leak proof at the seal. It's not perfect, nor is it the most comfortable interface I've ever tried, but it seems to be a step in the right direction according to the software downloads I've been looking at. . .
Incidentally, even with the Activa mask, I have runaway pressures and central events with the 420E if I do not turn off "IFL1". I confirmed this last night and found that my pressures ran away due to "flow limitation runs" and got even worse at higher pressures with central apneas present (the max limit was set to 10 cmH20). I must have a strange breathing pattern, similar to "Rested Gal".
-John
420E & IFL1
Hi Jomo,
I also have a PB420E. I use the NasalAire II interface. I had a very hard time with pressure runs at first, when the machine was set "wide open" (pressure 4-20). I have been narrowing my pressure range, and after a conversation with Titrator (thanks Ted!) turned off the IFL1. My titrated pressure was 14, and I am running the auto at 10-17. It will spike up to 17 a few times a night, in response to events, but doesn't stay there long. At 16-16.5 it would top out for longer periods, and my AHI would increase. I am generally under 3 AHI, sometimes a little higher. My average pressure is generally 10-12, which is much more comfortable than a straight 14! I have never used another mask, although I am considering trying the Aura -- it has gotten such great reviews!
I agree with your statement about the agressive response to leaks, but on my charts, there is usually an event that occurs first. I suspect that the event arouses me enough to move (triggering a leak?), or change breathing pattern, which the machine senses and reponds to. Have you looked at the larger view -- it is easier to line things up on the time line (not as compressed!). On my detailed record, there is a firm correlation between the leak line and the pressure line, with the pressure being a more dramatic up & down response.
Interesting stuff -- huh?
Sleep well,
Jane
I also have a PB420E. I use the NasalAire II interface. I had a very hard time with pressure runs at first, when the machine was set "wide open" (pressure 4-20). I have been narrowing my pressure range, and after a conversation with Titrator (thanks Ted!) turned off the IFL1. My titrated pressure was 14, and I am running the auto at 10-17. It will spike up to 17 a few times a night, in response to events, but doesn't stay there long. At 16-16.5 it would top out for longer periods, and my AHI would increase. I am generally under 3 AHI, sometimes a little higher. My average pressure is generally 10-12, which is much more comfortable than a straight 14! I have never used another mask, although I am considering trying the Aura -- it has gotten such great reviews!
I agree with your statement about the agressive response to leaks, but on my charts, there is usually an event that occurs first. I suspect that the event arouses me enough to move (triggering a leak?), or change breathing pattern, which the machine senses and reponds to. Have you looked at the larger view -- it is easier to line things up on the time line (not as compressed!). On my detailed record, there is a firm correlation between the leak line and the pressure line, with the pressure being a more dramatic up & down response.
Interesting stuff -- huh?
Sleep well,
Jane
Hi GlassGal,
In my case, using a ResMed Vista mask (very leaky for me--and most people), with IFL1 turned off, usually, the machine triggers on snore (acoustical vibration) by raising the pressure by 1 cmH20. The leakage then increases excessively due to a combination of higher pressure and a marginally stable seal. It seems that the higher pressure creates a "super leak", so at the face-mask interface there may be a local pressure drop which triggers more snoring and another subsequent pressure command from the 420 until I get the leak "under control" either by waking up and adjusting, or by a positional move. At these higher pressures accompanied by massive leaks, I have many more CA's and Hypopneas, as well.
With the Activa (not prone to seal leaks), if the pressure increases, the leakage increases due to a higher exhaust rate, but the tracing more or less follows the "max leak" line almost exactly in both direction and magnitude.
Since I do not seem to snore very much with the Activa, in comparison to the Vista, there are not very many pressure increases. The main trigger seems to be flow limitation runs accompanied by a decrease in amplitude (remember, I have IFL1 turned off). In this case, my AHI is very low (generally <1.2 vs. >2.5 with the Vista) for the night and there is a relatively low snoring index, as well. Also, the %"normal cycles" is >90% vs. about 80% with the Vista.
I wish the Vista sealed better, because I find it very comfortable. Unfortunately, even at my relatively low pressures (6 to 10 cmH20) it leaks like a spaghetti strainer. If ResMed could combine the best features of the Vista with the best features of the Activa, they'd have a winner, in my book! Meanwhile, I'm stuck with the Activa.
One day, I may get my old Breeze out of the closet and give it another try--after all, I'm sure PB designed the 420E and 418P/A around their interfaces, at least to some extent.
Just goes to show how critical the mask can be for both compliance and efficacy. Also, that Silverlining 3 software is tops. . .
-John
In my case, using a ResMed Vista mask (very leaky for me--and most people), with IFL1 turned off, usually, the machine triggers on snore (acoustical vibration) by raising the pressure by 1 cmH20. The leakage then increases excessively due to a combination of higher pressure and a marginally stable seal. It seems that the higher pressure creates a "super leak", so at the face-mask interface there may be a local pressure drop which triggers more snoring and another subsequent pressure command from the 420 until I get the leak "under control" either by waking up and adjusting, or by a positional move. At these higher pressures accompanied by massive leaks, I have many more CA's and Hypopneas, as well.
With the Activa (not prone to seal leaks), if the pressure increases, the leakage increases due to a higher exhaust rate, but the tracing more or less follows the "max leak" line almost exactly in both direction and magnitude.
Since I do not seem to snore very much with the Activa, in comparison to the Vista, there are not very many pressure increases. The main trigger seems to be flow limitation runs accompanied by a decrease in amplitude (remember, I have IFL1 turned off). In this case, my AHI is very low (generally <1.2 vs. >2.5 with the Vista) for the night and there is a relatively low snoring index, as well. Also, the %"normal cycles" is >90% vs. about 80% with the Vista.
I wish the Vista sealed better, because I find it very comfortable. Unfortunately, even at my relatively low pressures (6 to 10 cmH20) it leaks like a spaghetti strainer. If ResMed could combine the best features of the Vista with the best features of the Activa, they'd have a winner, in my book! Meanwhile, I'm stuck with the Activa.
One day, I may get my old Breeze out of the closet and give it another try--after all, I'm sure PB designed the 420E and 418P/A around their interfaces, at least to some extent.
Just goes to show how critical the mask can be for both compliance and efficacy. Also, that Silverlining 3 software is tops. . .
-John
Re: 420E & IFL1
I too have the 420E. I am set at auto from 5-14. It is a rare night that I hit 11. I seem fine at the lower end. My pops and aps's are less than 10 per night. I'd like even less. I'm using a swift, (not worse/net greatest--am used to it-2 mos now). I ordered the Aura. I hope I am not disappointed.
The breeze was too stiff and hard coming down the front of my face, and felt it was too intrusive.
I would gladly sell the breeze, never worn, nasal pillows never touched tried on the head pc wore it a few times to see if I could "cope" and said I DON"T THINK SO. Do not like anything on my face. Bad enuf to have the NIke logo on my cheeks ea. morning from the swift.
And worse is the lousy chin straps, which by morning have wormed their way up my face, covering my mouth (good thing I guess) and suffocating me all together.
Oh what we go thru! Keep at it tho'----have too!
The breeze was too stiff and hard coming down the front of my face, and felt it was too intrusive.
I would gladly sell the breeze, never worn, nasal pillows never touched tried on the head pc wore it a few times to see if I could "cope" and said I DON"T THINK SO. Do not like anything on my face. Bad enuf to have the NIke logo on my cheeks ea. morning from the swift.
And worse is the lousy chin straps, which by morning have wormed their way up my face, covering my mouth (good thing I guess) and suffocating me all together.
Oh what we go thru! Keep at it tho'----have too!
glassgal wrote:Hi Jomo,
I also have a PB420E. I use the NasalAire II interface. I had a very hard time with pressure runs at first, when the machine was set "wide open" (pressure 4-20). I have been narrowing my pressure range, and after a conversation with Titrator (thanks Ted!) turned off the IFL1. My titrated pressure was 14, and I am running the auto at 10-17. It will spike up to 17 a few times a night, in response to events, but doesn't stay there long. At 16-16.5 it would top out for longer periods, and my AHI would increase. I am generally under 3 AHI, sometimes a little higher. My average pressure is generally 10-12, which is much more comfortable than a straight 14! I have never used another mask, although I am considering trying the Aura -- it has gotten such great reviews!
I agree with your statement about the agressive response to leaks, but on my charts, there is usually an event that occurs first. I suspect that the event arouses me enough to move (triggering a leak?), or change breathing pattern, which the machine senses and reponds to. Have you looked at the larger view -- it is easier to line things up on the time line (not as compressed!). On my detailed record, there is a firm correlation between the leak line and the pressure line, with the pressure being a more dramatic up & down response.
Interesting stuff -- huh?
Sleep well,
Jane
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