Nasal pillows and higher AHI

I've been trying to use an OptiLife (tried both pillows and cushion) for awhile now (I've got a Swift FX on the way), but my AHI is up around 6 while it's usually around 1 using an Activa LT nasal mask. The average leak is a bit higher with the pillows, but it looks like the main issue is with increased hypopneas and RERAs with the pillows. I'm using straight CPAP with a pressure of 9cm. Anyone else have a similar experience or any thoughts on why this is occurring?

I routinely switch between a Quatro FX, Activa LT and a Nasal-Aire prong mask (short version of long story -- I can tolerate a mask only for a couple of nights in a row before it becomes too irritable to sleep with -- may be some allergy issues at play).

I've noticed higher AHI's using the prong mask than I do on the other two. LT and FX are usually well below 1 and the prong is usually between about 1.7 and 2.9 -- leaks are not an issue with any of them.
HOWEVER, I'm fairly certain it is a direct result of sleep position -- with the prong mask, because of how it fits, I usually sleep more on my back. With the other masks I'm more of a side sleeper.

Are you sleeping differently for the different masks?

Tip10 wrote:I routinely switch between a Quatro FX, Activa LT and a Nasal-Aire prong mask (short version of long story -- I can tolerate a mask only for a couple of nights in a row before it becomes too irritable to sleep with -- may be some allergy issues at play).

I've noticed higher AHI's using the prong mask than I do on the other two. LT and FX are usually well below 1 and the prong is usually between about 1.7 and 2.9 -- leaks are not an issue with any of them.
HOWEVER, I'm fairly certain it is a direct result of sleep position -- with the prong mask, because of how it fits, I usually sleep more on my back. With the other masks I'm more of a side sleeper.

Are you sleeping differently for the different masks?

I tend to move around abit - start on my back and usually roll to one side or the other, but I do that regardless of which mask I'm wearing. Interesting thought though. I did notice early on that my AHI tended to be higher when sleeping on my back (propped myself up so I wouldn't roll to my side) vs. my side. So, I suppose it's possible that I'm sleeping more on my back with the pillows for some reason. Of course, since I'm asleep, I have no way of knowing (short of setting up a video camera) if my sleep position is different during the night when using the pillows. I may try propping myself up to sleep solely on my side with the OptiLife to see if that helps. I'm curious to see if my results with the Swift FX will be any different than the OptiLife.

Have you checked your data on the software (not the screen)? It might give you a better idea of what's going on.

I'm a big fan of the Swift FX, but I could NOT get the Optilife to seal to save my life. So I'm wondering if leaks are an issue, but you can't tell without the software.

The Swift is a great mask, but if you move around a lot be forewarned that you will have to take steps to stabilize the mask so you don't spring leaks from your active sleeping style. It's such a soft and lightweight mask that it's hard to stabilize. There are some suggestions on my blog (see signature below) that will help.

Janknitz wrote:Have you checked your data on the software (not the screen)? It might give you a better idea of what's going on.

I'm a big fan of the Swift FX, but I could NOT get the Optilife to seal to save my life. So I'm wondering if leaks are an issue, but you can't tell without the software.

The Swift is a great mask, but if you move around a lot be forewarned that you will have to take steps to stabilize the mask so you don't spring leaks from your active sleeping style. It's such a soft and lightweight mask that it's hard to stabilize. There are some suggestions on my blog (see signature below) that will help.

Yes, I check my data with the software. That's how I know the main issues are with hypopneas and RERAs. The average leak is higher with the OptiLife than the Activa LT, so that is likely part of the equation. Also, the medium pillows are a tad too big and the small pillows are a tad too small, but that's generally the problem I have with all the Respironics masks I've tried (OptiLife, Comfortgel Blue and Comfortgel Full). Resmed's masks tend to fit me better, so I'm hopeful that I'll have better results with the Swift FX.

I have read through your blog about the Swift FX - good stuff, and your info contributed to my decision to buy one. So, I will wrestle with the FX and hope I can make it work for me. However, if not, the Activa LT works well and I've also ordered a Mirage Quattro to play with. Thanks for the input.