High AHI with the F30 mask

mets123 · Post by **mets123** » Tue Apr 30, 2019 4:54 pm

I would like to know why when I use the F30 mask [attachment=1]screenshot-20190430-180624.png[/attachment]my AHI is much higher than when I use either the F20 or the dreamwear full face mask. I don't get any leaks with either of these masks. My AHI with the F30 is usually 4 or higher and with the other 2 masks usually 1 or less.
Any advice would be helpful as I would like to use the F30 more because of it's comfort.

Okie bipap · Post by **Okie bipap** » Tue Apr 30, 2019 7:38 pm

When I see clusters like that, the first thing that comes to mind is sleep/wake junk. Either that, or there is something screwy with your machine.

LSAT · Post by **LSAT** » Tue Apr 30, 2019 8:15 pm

Okie bipap wrote: ↑
Tue Apr 30, 2019 7:38 pm
When I see clusters like that, the first thing that comes to mind is sleep/wake junk. Either that, or there is something screwy with your machine.

The clusters are OAs not CAs...The problem is that the max pressure setting is not high enough.

mets123 · Post by **mets123** » Tue Apr 30, 2019 8:51 pm

If I raise the maximum pressure the pressure rises due to my flow limitations. This is why I leave it at that lower number.

babydinosnoreless · Post by **babydinosnoreless** » Tue Apr 30, 2019 9:29 pm

I noticed the same issue with the f30. My ahi's went up. Maybe the masks vents higher ? Also I couldn't stop the leaks. I switched to a different mask.

katestyles · Post by **katestyles** » Wed May 01, 2019 5:02 am

mets123 wrote: ↑
Tue Apr 30, 2019 8:51 pm
If I raise the maximum pressure the pressure rises due to my flow limitations. This is why I leave it at that lower number.

the machine is supposed to raise the pressure to prevent flow limitations. Do you have other issues with a higher pressure?

mets123 · Post by **mets123** » Wed May 01, 2019 5:35 am

What happens if I put my maximum pressure at a high number my flow limitations cause the pressure to run higher and then disturb my sleep. That’s why I limit the maximum pressure.

Pugsy · Post by **Pugsy** » Wed May 01, 2019 6:24 am

Do you want your sleep disturbed by the pressure or the events?

Any idea what sleeping position you end up in during those clusters? Maybe on your back more with the F30????

Clusters like that.....either on your back or related to REM stage sleep ...both of which can cause OSA to worse and/or need more pressure to hold the airway open.

I have never seen that big of a difference in results between full face masks though....which is why I wonder if REM or sleeping position is playing a part here.
I have seen that difference between nasal vs full face but not between different full face masks. I suppose wouldn't be impossible though.
Whatever....you need more pressure at those times and with the machine being limited with the max it can't give it to you.

And maybe when you thought you were being woke up with pressure increases....maybe it was what the machine was trying to prevent that caused the wake ups more than the pressure increases.

mets123 · Post by **mets123** » Wed May 01, 2019 6:33 am

Ok Pugsy makes sense. I almost always sleep on my side and not on my back.
What max pressure do you recommend?

Pugsy · Post by **Pugsy** » Wed May 01, 2019 6:36 am

Whatever max that allows the machine to do its job....
Me...I would set max IPAP at 25 and let it sort it out. It won't go higher without a good reason.

mets123 · Post by **mets123** » Wed May 01, 2019 6:38 am

Another question do you still recommend raising the maximum pressure if my ahi is usually 1 or less? Is this because it could be rem sleep that it is needed?

Pugsy · Post by **Pugsy** » Wed May 01, 2019 6:48 am

My maximum is set to 20 cm on my AutoSet. It never goes there but it could if it needed to.
Most of the time it rarely goes to maybe 15....and my AHI is usually 1.0 or less....but that is because I don't tie the machine's hands...I give it room to do whatever it thinks it needs to do.

Now if giving it room caused problems...aerophagia or something...then I might limit the max but otherwise I let the machine sort it all out.

My best guess is that probably when those clusters happened you were on your back and in REM...double whammy for pressure needs.
We can't control REM at all and we need REM to complete the sleep cycles. We can't always control sleeping position either....so that's why I say just let the machine sort it out.

The timing of the clusters....makes me suspect it was REM related. Google "sleep stages" and look at the various normal hypnograms when REM normally happens.
The fact that you don't have those clusters in the wee hours of the morning when we normally have a lot more REM makes me then think sleeping position related because if it was just REM related then should have more clusters in the 2 to 3 hours before you get up.

So probably a combination of factors that come together and end up with you just need more maximum pressure to hold the airway open and better prevent the airway from collapsing.
Maybe a little related to the mask...maybe a little related to REM....maybe a little related to sleeping position
and the sum total adds up pointing to needing more maximum pressure so the machine can better do its job.
We really can't know for sure what all those maybes might be and since we can't know and couldn't really do much about them anyway....just let the machine sort it out.

tyrone747 · Post by **tyrone747** » Wed May 01, 2019 7:33 am

What's the reason for letting the pressure drop then? If you can tolerate 15 with no aerophagia Pugsy why not just set CPAP 15? Is there a reason to want less pressure at times? Does it hurt sleep quality having pressure above the amount required at a certain sleep stage?

mets123 · Post by **mets123** » Wed May 01, 2019 7:38 am

Thanks Pugsy for your feedback. Besides flow limitations which tend to make my pressure rise I have suffered from aerophagia and that’s another reason for limiting the maximum pressure. I guess I can go up slowly and see what happens.
Makes sense?

Pugsy · Post by **Pugsy** » Wed May 01, 2019 7:43 am

tyrone747 wrote: ↑
Wed May 01, 2019 7:33 am
What's the reason for letting the pressure drop then? If you can tolerate 15 with no aerophagia Pugsy why not just set CPAP 15? Is there a reason to want less pressure at times? Does it hurt sleep quality having pressure above the amount required at a certain sleep stage?

Because 15 all night long isn't much fun in terms of comfort.
Greatly increases the chances for aerophagia with the constant higher pressure against the LES....put enough pressure on anything and eventually it blows.

I have done a fixed pressure experiment....my sleep quality went in the toilet simply from a comfort aspect.
My AHI was pretty much non existent at 11 EPAP and 15 IPAP fixed....but my sleep quality wasn't so great. Lots of arousals from just a comfort aspect. Numbers don't mean much if you wake up a gazillion times getting those low numbers.

My primary goal....because my sleep is so fragile from outside factors....decent sleep quality.
I don't want to use 15 all night just to deal with the 20% of the night I might be in REM and need 15. It's simply not comfortable.
Most people don't find that comfortable. Some people do but most won't.

High AHI with the F30 mask

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