Re: CAs with P10 Pillows/Taping but not with DreamWear FF

Pugsy,

I understand heebie-jeebies and will scratch the idea.

All said, it seems you've hit on a probable explanation for what I'm experiencing and for that I'm so thankful.
I'll try another mask solution and report back.

Thanks!
Paul

Pugsy wrote: ↑

Sun Nov 18, 2018 1:38 pm

I get a bad case of the heebie jeebies even thinking about blocking vent holes.
Especially on a mask with such tiny holes as the P10 with a CAI of around 3 to 4 which isn't all that horrible.
Now if someone was using the gel pillow DreamWear version that has the 2 vent holes...maybe it wouldn't be quite so scary for me and the heebie jeebies wouldn't be so big.

Yeah, me too, There was a lot of hesitation, and 'full disclosure' when I started approaching the guy with the idea of blocking up one of the vents.. part of my feeling that it wouldn't be actually dangerous was the fact that philips put two vents on the mask, if THEY weren't satisfied that it wasn't actually harmful to have the bottom vent blocked, why would they have a second one at the top? Otherwise they'd have done something to prevent the bottom one from getting blocked,

So, he tried it, and ... huge improvement.

Blocking the vents on the P10, euh... I'd insist on a lot of trials while awake before sleeping with that. maybe a little bit of tape over part of one side, then wear it for a while and see if there's any feelings of getting 'out of breath', or noticing that the respiration rate was increasing...

Thank you Palerider,

I was at my wits end for an explanation of what might be causing this. When I saw radical improvement with the CAs using h the Dreamweaver FF I was relieved but still baffled. If you don't mind me asking, was the patient you helped with a similar issue using the Dreamweaver FF or the Dreamweaver Nasal mask?

I'd like to stick with pillows so may try the Brevida that Pugsy mentioned.

Thanks again,
Paul

partialpaul wrote: ↑

Sun Nov 18, 2018 2:15 pm

Thank you Palerider,

I was at my wits end for an explanation of what might be causing this. When I saw radical improvement with the CAs using h the Dreamweaver FF I was relieved but still baffled. If you don't mind me asking, was the patient you helped with a similar issue using the Dreamweaver FF or the Dreamweaver Nasal mask?

I'd like to stick with pillows so may try the Brevida that Pugsy mentioned.

Thanks again,
Paul

Dreamwear nasal. He had a variety of masks, but that one was the easiest to increase the 'dead space' with.

If you still have the DreamWear full face mask you can use that frame and just add a different headgear and the gel nasal pillow.
I have the headgear I could loan you but I don't know if I have a gel pillow....I will go look and see.

Pugsy,

It was so nice of you to offer to loan me something to try.
Unfortunately, I no longer have any of the Dreamwear gear but can order it.

Since I'm accustomed to the P10 pillows, the gel pillow version of the Dreamwear line sounds good to me.
I assume the Dreamwear frame acts as the needed "dead space" that could keep my Co2 from washing out.

Oh, and I've been typing Dreamweaver instead of Dreamwear...sorry.
Wish I could correct that in my original post.

Thank you,
Paul

partialpaul wrote: ↑

Sun Nov 18, 2018 5:14 pm

Oh, and I've been typing Dreamweaver instead of Dreamwear...sorry.
Wish I could correct that in my original post.

You should have the ability to edit your own posts...see the little pencil icon upper right??? If you click on it you can edit your posts as well as the topic itself.
If you can't find it...let me know and I can fix the error for you.

Pugsy,

Thanks, I edited my posts to correctly spell DreamWear.

Thank you,
Paul

I would take Pugsy's advice and try the Brevida as well. It has some 'holding space' in the pillow, as well as a filtered/diffused vent cover that cuts down on the exhaust air a little. You may not wash out as much CO2 because of those two things.

It's worth a try,...... plus it's a VERY comfortable mask.

Thank you Mark, I really appreciate it.

Paul

After trying multiple types of masks to help with what seemed to be an uncontrollable and continued rise in CA's over the past few months (up to 72 CA's during one particular night) combined with >5 AHI and feeling crappy most of that time, I learned a very valuable lesson in my journey with CPAP therapy and the thing I had come to take for granted...a good night's rest.

Prior to 3 months ago, for several years I've enjoyed an average AHI of about 2.0, so good that I would rarely pay much attention to my numbers. Then my CA's started spiking and I began feeling rough like I used to prior to CPAP. I was so sure my new problem was mask related that I ended up trying 3 types of FF masks and 2 types of nasal pillows but none of those actually fixed the problem...a couple even seemed to make things worse.

The cause for the majority of my CA's turned out to be a bad mattress and the resulting back pain that can go along with that. I simply didn't realize I was tossing and turning all night until the back pain became so severe that I couldn't sleep at all. For some reason, it took me a couple of months to connect the back pain with the poor quality of sleep I was experiencing. All that tossing and turning was effecting my sleep in a bad way and Sleepyhead was indicating CA's were happening all night long, like every 10 minutes.

Having ditched the bad mattress, I feel 10x times better now and my CPAP compliance numbers support that.
All said, the best mask in the world won't fix a bad mattress.

I hope this helps some of you!

They weren't real CAs/centrals. They were false positive flags brought on by the pauses in your own breathing irregularities while awake/semi awake tossing and turning from the discomfort.

I wish you had mentioned the back pain issues earlier. I would have then pointed you to this
http://freecpapadvice.com/sleepyhead-free-software
and told you to watch the videos so you could learn how to distinguish a real flagged event from an arousal or awake breathing flagged event that doesn't count.

I have back issues also...toss and turn and wake up a lot from the pain. Not long ago I had a night where the AHI was 3 something which was unusually high for me. I had a nice mixture of centrals, OAs and hyponeas. I took the time to look at each one to figure out if it was real or not.
Not a single flagged event was real...they were all related to an arousal or awake breathing.

I know it sounds crazy Pugsy but I wasn’t really that aware of the back pain as it was mainly occuring during the night and wasn’t waking me up completely. When it finally also started hurting during the day it got so that I just couldn’t sleep much at all, even with Ambien.

I had visited that link before so I was fairly confident they weren’t real CA’s but just didn’t know what was causing the disruptions and the rough feeling in the mornings. I felt pretty silly when I figured it out.

Thank you.

Pugsy wrote: ↑

Sun Nov 18, 2018 12:12 pm

Using EPR tends to "wash out" the carbon dioxide somewhat. That's why we sometimes suggest turning EPR off to see if it helps.

Hi Pugsy,
I'm new here, and have largely fixed my mild/moderate OSA with an S10 AutoSet. I'm using EPR of 3, and pressure from 5.4 - 10. I still have a few CAs (CAI of 0.7) so I read this thread.

My question really is curiosity more than anything: Why would EPR cause more "wash out" than steady pressure? Seems like the steady pressure would force even more air out the mask vents than a reduced EPR pressure.

milehigh wrote: ↑

Thu Dec 06, 2018 5:16 pm

Pugsy wrote: ↑

Sun Nov 18, 2018 12:12 pm

Using EPR tends to "wash out" the carbon dioxide somewhat. That's why we sometimes suggest turning EPR off to see if it helps.

Hi Pugsy,
I'm new here, and have largely fixed my mild/moderate OSA with an S10 AutoSet. I'm using EPR of 3, and pressure from 5.4 - 10. I still have a few CAs (CAI of 0.7) so I read this thread.

My question really is curiosity more than anything: Why would EPR cause more "wash out" than steady pressure? Seems like the steady pressure would force even more air out the mask vents than a reduced EPR pressure.

It has to do more with how a person breathes than it does with the pressure.
How the body does the exchange of gases.
It can also happen when a person is on a pressure without any exhale relief. Some people (very small minority) just breathe differently and the imbalance occurs. We don't really know why or at least I have never seen a real technical explanation.
Same thing happens when people who don't have any central apneas to speak of (we all have an occasional one and it's normal and no big deal) but they have obstructive apnea and they get put on cpap and the end up with cpap emergent central apnea.

I use EPR...no problems with centrals. Someone else might not use any EPR and get a truck load of centrals after starting cpap.

I don't know if this will explain it well enough for you
https://www.youtube.com/watch?v=CU-XTcf ... e=youtu.be

But it's not limited to EPR...and the people who only get it when using EPR are just a very small number of the other very small number you get cpap triggered central apnea or complex sleep apnea.

EPR triggering it....not very common at all and if it were then EPR wouldn't be considered a comfort feature for people to adjust at will.