My time (for xPAP) has come! (Slinky, Rested Gal? Help!)

Thanks to everyone who helped and guided me through my trials and tribulations with UCLA's sleep center.

I eventually decided to get a referral from my endocrinologist, a doctor who I trust. Sadly, his referral turned out to be a pretty sleazy guy... turns out this doctor was his own DME and patients must sign a form required by the state of California which informs patients that the doctor has a "major financial stake" in this business. I was initially looking for the PB GoodKnight 420E, but he said he didn't carry them. I asked him why, and he said "They're too bulky". Bulky? Ridiculous! They're the smallest units out there! So I called him on it, and he did some serious body language backpedaling... rubbing his hand over his mouth awkwardly and such.

Anyway, I now have my Resmed S8 Elite II and am CPAPing without the guidance of a physician, with mixed results.

A week ago, the respiratory therapist came over and hooked me up. As I am a stomach sleeper, I asked for an over-the-head model like the breeze or the aeiomed headset. She told me she would bring some, but showed up with only the Swift and the Optilife (she let me keep both).

My results?

Mixed.

During my CPAP titration study, my AHI was 0.4 (in my prior study which was fully non-titrated, my AHI was 5 with RDI of 10). On the Resmed, my AHI was as 11.8, and as low as 4... a far cry from the 0.4 of my titrated study. The only improvement I have managed to tweak for myself is that I have managed to get my leak rate down from 4.0 to 1.4. Also, the bulk of the AHI comes from the HI events, not the AI.

For example, last night's breakdown was 9 HI and 2.8 AI (11.8 AHI). Last night was unique in that I decided to tape my mouth (worked great in terms of eliminating dry mouth, but my HI skyrocketed somehow). Leak was 1.4. I used the Optilife and programmed the CPAP for "Mirage" as the manual indicates. I do suffer from stuffy sinuses (dust and cat allergies), and used a neti pot saline/baking soda warm water solution to flush my sunuses before putting on the mask.

Despite the comparatively high AHI, I awoke somewhat clearer than in previous nights. I fight less with the tubing on Optilife than with the Swift so I have chosen to stick with Optilife for now... until I give it a fair shot (the huge lip bar on the Swift is terribly uncomfortable to me, and the cylinder pushes against the pillow and jams it up into my cheek).

Because of the chronic sinus issues, I wonder if the hybrid mask is actually a better idea for me? Will breathing through my mouth help to eliminate the high HI readings? What other masks would you recommend for this situation?

Thanks again for everyone's kind help and collective wisdom.

Adam

Bump....

Any advice? You guys were really helpful before....

Thanks,

Adam

I'm not ignoring you, Adam. I just don't have an answer for you. I would return the Swift since it isn't the new Swift that you asked for. But that's not a lot of help until the Swift you asked for comes in.

Hey Adam,
Masks are so individual that it's something you have to decide yourself. What works for me may not work for you -- I use a Headrest, which is similar to the breeze you requested. I'm not a tummy sleeper so I can't give you any input on that.

I agree with Slinky though, return the Swift since it obviously isn't going to work for you, but make sure you have something. If the DME says they don't have a specific mask, ask them to order it. Be firm and let them know if they won't order one, you'll find a DME that will.
I really don't care for the situation you're in where the Doc has a financial interest in the "other service provider" -- smells like a conflict of interest, but......In my case it was the x-ray lab....

Masks are the "Holy Grail" of xPAP, so you're on the trail....Keep at it -- for sure you'll find one that works.
(I use 3-4 different masks depending on the situation. The headrest is my main mask, but if my nares get sore I'll use the ComfortGel for a couple nights. If I get realllllly congested I'll try the HC431 even though it doesn't seal all that well. I also have a NAII that I use once in a while -- so as you can see, there isn't really one answer for me -- it may be the same for you.....)

Don't give up!!!
Take Care!!!
cheers
goose