HELP New P-10 Use=Blow Fish Cheeks

The chipmunk cheeks are a by product of the mouth/lips staying closed when the air enters the mouth.
If they didn't puff out with the other masks either the mouth opened so the air went out and the cheeks didn't inflate or the air didn't enter the mouth in the first place. That's pretty much it for reasons..either air entered the mouth and exited before the cheeks inflated or it never entered the mouth. I am betting it exited the mouth before it ever puffed up the cheeks enough to wake you up.

What other masks have you tried besides the Amara View which I remember you mentioned?

If you had graphs after the SD card got washed but just not from last night then probably the SD card just didn't get seated correctly in the machine for some reason or other. I have had it happen..I insert the SD card and for some reason it doesn't stick totally and if that happens the SD card initially appears to be inserted but it isn't connected completely and then we don't get the detailed files which make up the graphs.

When you insert the card...just make sure you watch the machine so you see it recognize the card like it is supposed to.

When you put your tongue in the roof of your mouth,
use the rest of your inside mouth to cuddle around your tongue.
Like, bring your cheeks in around the back of your tongue and alongside your teeth.
Notice that if you allow the middle of your tongue to fall, air goes right THERE.
Feel the bubble. Now push it back where it belongs. Now keep it there.
It gets easier with practice.

Here's a visual of the airflow during mouth leaks (bottom).
While exhaling through your mouth, start to make a "K" sound to experience and feel how the velopharyngeal muscles and tongue work to stop the airflow.
viewtopic.php?f=1&t=112758&p=1085906#p1085906

Hi Pugsy..I sent you my compressed SD card as you suggested...thank you so much.
The latest is that I used a Large pillow that I requested from my supplier last night..very comfortable..with taped mouth & used a chin holder too. Did feel a slight bit of chipmunk cheeks, but not enough to be distressed during sleeping. There was a bit of leaking. Hope you can advise further. Feel much more rested today with a AHI of .7..Lil

Oh crap...my internet connection is telling me an hour for the download of your SD card. I am being punished with dial up internet speed because I have exceeded my monthly allowance. I do have plan B available but don't have time to implement it.
And I have to go get my hair done shortly.
I will have to do the review later after I get back from getting my hair done.

I will get back with you later today.
Just wanted to let you know so you wouldn't think I was ignoring you.

Glad last night seemed to work a little better.

Okay...I got the data and I have SleepyHead reports in front of me.
Last night...you taped and used a chin strap...question for you...did the tape ever come off or loose? I am trying to decide if the leaks shown from last night was from mask movement or if the tape came off and these might be mouth leaks.

Also I need a bit of history...did you have an in lab sleep study without cpap for diagnostic purposes? If so, what was the AHI results of that sleep study?
Then did you have an in lab sleep study where they tried to determine your optimal pressure?
You may have mentioned this elsewhere but I don't remember it if you did and don't have time to go back through all your posts.

Did you keep a log as to which mask you used each night? You have some nights where the leak was minimal and some nights where it was pretty ugly. I don't know which night was what mask.

Which mask do you prefer to be your primary mask? Just from comfort aspect and your own personal preference???

Your AHI is low...and even in the face of some of the large leaks I don't think the machine is missing a huge number of events. It looks like flow limitations are your main problem and I don't know how critical they might be in the grand scheme of things...meaning you might be able to get by with less pressure if we want to accept ugly flow limitation graphs. At least maybe for now until you get mask issues sorted out and all that.

Hi Pugsy..Thanks so much for looking everything over & your response.
I had a home study which showed 8 AHI. Then I had a sleep study at a center which showed "0" the tech told me..I had a full face mask on & it was awfully tight. My
RX is for the ffm is 7-12. My sleep dr. just recently last week's visit, said I could go lower when I get my new nose pillows. I have been using both the P-10 & Amara View each night, but last night I spent the whole time with the P-10 on 6-10 pressure...(the chipmonk cheeks weren't annoying enough to wake me). The tape could have come loose some & I know the large nose pillows (used all the sizes supplied me) did move as I had loud noises & my husband woke me up to fix it. I feel rested today though I now have a-fib bothering me at this time. I do want to stay with the pillows..just don't have the pressure # down pat yet, have to get rid of the chipmonk cheeks & know that my AHI events are low & might help with my A-Fib. I do sleep on my side & barely move around during sleep. Thank you so much for any advice you might have...Lil

REDHEADED LIL wrote:I had a home study which showed 8 AHI. Then I had a sleep study at a center which showed "0" the tech told me..I had a full face mask on & it was awfully tight.

Okay...just so it is clear...the in lab sleep study that showed 0 AHI was the titration sleep study where you used a really tight full face mask and they came up with the pressure RX???
The 0 AHI was with cpap therapy...correct?

Couple more questions to help me get an idea about your history.

Do you ever have much nasal congestion? Did you experience any nasal congestion last night?

What symptoms caused the at home sleep study in the first place? What has been going on with you to make them think sleep apnea?

Do you wish me to post related images of your SleepyHead reports for others to see so they can offer their input?
I don't mind doing it (assuming imgur quits acting up) but just wanted your okay first.

Since you wish to use the nasal pillows as your primary mask then let's proceed with trying to make them work for you.
Last night 25% of the night was spent in large leak but only once was it very prolonged and the bulk was below 35 L/min when it was in large leak territory.
So let's keep trying to use the nasal pillows with your current set up at these lower pressures. You are maxing out the max pressure of 9 but when you were using 12 it was also maxed out. Your Flow Limitation graphs are UGLY and I am reasonably certain that it is the flow limitations driving the pressures up and in this situation I am not so sure that the flow limitations are something we just have to reduce and make less ugly right now.

Let's concentrate on getting you to be able to use the nasal pillows and actually sleep the bulk of the night with them and then worry about the Flow limitations.
Your low AHI is probably accurate and the time in large leak probably isn't missing much in terms of events that would be reflected in the AHI.

When you tape...make a mental note if the tape comes loose so we will have a better idea if we are looking at leaks from mask movement or mouth opening.

Hi Pugsy..My permission is given for you to post my graphs...I have A-Fib, which a lot of the time came during the night & my mind was foggy till mid morning.
Yes, I was on c-pap with the "0" at the sleep center. RX was 4-11 with ramp & I changed it to finally be 6-11 with Amera View. Using the P-10 since Mon., but only for part of the evening (due to chipmunk cheeks)..but last night I used it only. I have no nose conjestion. I do think both my tape & pillows moved last night...thank you for all your help..much appreciated..Lil

Ahhh..A Fib..now I remember.
Are you on any meds now?
On the home study did they mention much of an oxygen level drop?

I will post last night's report a little later. I don't see much sense in reporting the old ones...the AHI is always low and leaks were always bad and the Flow Limitations were all ugly. Let's work with the present and see what we can get accomplished.

Let's tape and use the chin strap for now in an effort to keep the chipmunk cheeks from being a problem and maybe later you can do without them.
Primary goal right now..just get you where you sleep half way decently through the night with the mask and keep wake ups to a minimum.

I will explain more on the ugly flow limitations later...was kinda hoping we could blame them on nasal congestion but since we can't we go with what they likely are.

Hi Pugsy..I started c-pap on 6/7/16...I had originally a Resmed AirFit 10 (frame was too big (med))..maybe one more other before that..then Amera View with taped mouth..Mon. of this week I went to the P-10..1/2 the time on each except for last night I used it only..taped mouth & chinstrap. Yes, I am on meds for heart, b/p, & cholestrol. In my home study it said minimal oxygen desaturation....the average desaturation across all sleep disordred breathing events is 2.3%. The orig. sleep dr. mentioned a mandibular advancement will likely provide treatment benefit independent of OSA severty. I have a different sleep dr. now.
Last night wasn't too bad for me eventhough I awoke with rapid heartbeat of 109..I will tighten everything up & notice if there is any movement with the P-10 or tape....thank you for your encouragment & help..Lil

Here's last night's report. I sacrificed the pressure graph (it's maxed out at 9 most of the time anyway) so that I could get the flow limitations graph in the image.
Imgur.com has some sort of bug and if I choose the usual Large thumbnail it kicks me over to the wrong image so I had to use huge thumbnail.

Pugsy wrote:Imgur.com has some sort of bug and if I choose the usual Large thumbnail it kicks me over to the wrong image so I had to use huge thumbnail.

you can always fix it by just changing the last character before the last period (.jpg, .png, etc) from "h" to "l" (l for large)

palerider wrote:you can always fix it by just changing the last character before the last period (.jpg, .png, etc) from "h" to "l" (l for large)

Wanna bet that I totally forget that I can do that? Probably by tomorrow morning.
For some reason doing that sort of stuff goes flying right over my head...sort of like how my eyes glass over when we start talking battery stuff. I am good at remembering (and understanding) some stuff and totally suck at remembering/understanding other stuff no matter how much I might try.

I do hope they (imgur) get that little bug fixed soon. Having to think more goes against my lazy mindset.

Pugsy wrote:

palerider wrote:you can always fix it by just changing the last character before the last period (.jpg, .png, etc) from "h" to "l" (l for large)

Wanna bet that I totally forget that I can do that? Probably by tomorrow morning.

no bet I just offer options, if your brain doesn't wanna remember 'em, that's between you and it