New mask, new results?

Last night I switched masks, and there seems to be a marked difference in therapy results. Or is this just a coincidence?

From 1030 pm to 145am, I was using my usual mask, Comfortlite 2 pillows. Leaks were 0 to 2.4 L/M. Red line wavers between 9.2 and 9.4 and keeps air flow open, with 1 apnea and a handful of hypopneas.

I woke up, nares were a little sore, so I switched to my new Mirage Comfortgel, a nasal mask. The mask is very comfortable, and I slept soundly with it on. I changed the Mask Setting to Activa, which is what Resmed recommends. Red line is steady at 9.4, and apneas are popping up all over.




Analysis please??? Even though there are no leaks, is therapy less effective with the Comfortgel? I noticed that I hardly felt the air pressure with the Comfortgel--is the air pressure diffused, and thus less effective?

For comparison, here is a detailed graph of the night before, wearing Comfortlite 2 pillows all night. Pressure settings were the same.

Katie I asume you have never worn the new mask before. You will need to learn the ins and outs of this mask and how to adjust it just like you did your old interface.
Gerry

Thank you Gerry, but if the leaks are O, and it feels comfortable, isn't the mask adjusted properly? What else should I be doing?

You should be letting yourself get used to the mask before you decide if it's working or not. You might have (for example) been more tense because you weren't used to the feel of the new mask, which could have made you have more apneas. Always try any change for at least a week before you decide if it is for the better or worse.

Ha! good replies so far. You really need to look at things for about a week before deciding whether there is a real change. That said, I found my nasal pillow (swift LT) mask gave me consistently better results than a full nasal (Comfortgel) over an extended period.

Qualitatively, how do you feel? Numbers are only half the picture.

Katie, just curious but why did you change masks? I can't remember if you had any previous complaints about the one you were using.

I agree that the numbers look better with the nasal pillow, "but one night does not a trend make," to quote the old adage. I think any new mask requires a few nights to get used to it, and its eccentricities. I am surprised you'd go to a nasal mask as opposed to a nasal pillow, as pillows are generally more comfortable for most folks if they can successfully use them. Give it some time.

DoriC wrote:Katie, just curious but why did you change masks? I can't remember if you had any previous complaints about the one you were using.

Dori, I do like the Comfort Lite 2 nasal pillows, and they are my 1st choice. I also have the Headrest pillows, and like them also. But after a few days, my nares need a rest, or during the night I wake up and find they have shifted to the wrong angle, and are causing discomfort/pain.

So I have been alternating between the pillows and the CL 2 Simple Cushion which covers the whole nose, but is not as big or as stable as a regular nasal cushion. But even with modifications, it tended to leak more than I liked. So I chose the Mirage Comfortgel as my "back up".

I appreciate everyone's advice of giving it more time, and I certainly will do that. I bought the mask at cpap.com, and got the 30 return insurance.

Well, maybe it was just a bad night? Just it for several more night and see what happens.

Yep, yep. I have CONSISTENTLY noticed a "first night effect" when switching masks. I've always had a fully data capable Resmed (except for the first two nights they tried to pawn off a pre-M Series Plus on me - and then it was ONLY for two night BECAUSE they delivered it late on a Friday afternoon) and I am addicted to checking my data each day.

I've been thru 13 masks during that time, hating some, liking some more than others, and REALLY liking two and the difference w/the two is DRASTIC.

I REALLY like and use the Simplicity simple nasal cushion (thanks to the CL2 for leading me in THAT direction) w/a chin strap AND I find I REALLY like the ProBasics Zzz-Mask full face. Both required some "fixing" of their headgear to fit as I do NOT have the head of a giant.

Slinky wrote:I REALLY like and use the Simplicity simple nasal cushion....

Thanks for mentioning the Simplicity mask, as I hadn't considered that one. I'm going to try that on when my insurance will pay for a new mask (in January). My DME only carries Respironics, ResMed and Fisher-Paykel, so unless I want to pay full cost out-of-pocket I need to concentrate on those manufacturers. Since the Simplicity is made by Respironics, it's going on my list!

~ DreamOn

KatieW wrote:I noticed that I hardly felt the air pressure with the Comfortgel--is the air pressure diffused, and thus less effective?

I have noticed a big difference in the feeling of air pressure between the nasal mask (Mirage ActivaLT) and pillows (AEIOMed Headrest) too. In fact, I've been wondering the same thing. It seems like when the air is blowing directly into your nostrils with the pillows that you'd be getting more concentrated pressure into your throat, but maybe not. It sure does feel like it, though. Sometimes I can't even tell there's any air blowing with the nasal mask. I'm still testing to see if therapy results are different with each mask.

~ DreamOn

Also, keep in mind that masks fit us all differently, and I even find that on certain nights a mask will fit better than other nights (or at least it seems that way). Almost impossible to get a pure comparison even from day to day as there are too many variables, such as our mood, when we last ate before going to sleep, what we ate last, do we also have GERD or other factors....

Yeah, that's rather perplexing, isn't it? All you do when removing the mask is unclip one clip. It fit great and relatively leak free all night. You put it on the next night, all you have to do is clip the clip, no other adjustments. And the fit "ain't so hot". Go figger.

We also find that even when we get the same replacement mask there's a sort of break-in period for a few nights. Slinky, we've never been able to just "unclip and reclip" as do many people. We usually have to readjust the straps and I always tell Mike his head must be crooked!