How Am I Doing?

Thank you DreamDiver! I'll check it out - certainly worth trying.

And I may need to give the F20 mask a try.

wacomme wrote: ↑

Sat Apr 25, 2020 4:12 pm

Thank you DreamDiver! I'll check it out - certainly worth trying.

And I may need to give the F20 mask a try.

I wish there were more small/micro size masks for those who need them.

Consider calling the folks at CPAP.com and ask about child-sized masks. They may have more information. I think @chunkyfrog also has a tiny face. You could talk with her about solutions.

Alternatively, start a new thread strictly on advice on micro/child-sized masks, both nasal and full face!

Chris

wacomme wrote: ↑

Sat Apr 25, 2020 1:50 pm

Ok. After several night of taping my mouth for the N30i mask, the tape is starting to irritate my skin a bit (not too much, but with continued use it could be aggravating), and my wife hates the taping because I literally cannot talk.

your wife ENCOURAGES you to talk??

wacomme wrote: ↑

Sat Apr 25, 2020 1:50 pm

Thoughts? Ideas? Suggestions? What should I try next?

forum member jay aitchsee has this-

viewtopic/p1089718/viewtopic.php?f=1&t= ... s#p1086296

i've been using this for years with good result. i've modified it some from his original, but it's basically the same rig.

this plus a firm foam cervical collar has helped me the most with lowering my ahi.

maybe it could work for you.

I've slept with my minimum pressure set to 7 for the past three nights. The results looks good - see the attached nightly files for the first and third night.

The first night I slept great with the N30i mask and my chin strap - no tape over the mouth. However, I was very tired from getting little sleep the previous night.

The past two nights haven't been so good. I'm breathing out air through my mouth and it's driving my wife crazy. I ended up taping my mouth at 3 AM last night, though I put it on hastily and it leaked a bit. As a result I had minimal chipmunk cheeks.

I ended up ordering a F20 mask and it will be here by Wednesday night. While I love the N30i mask, and it leaks minimally no matter what position I'm sleeping, I can't stop breathing out a bit through my mouth. And if I tape my trap shut I get chipmunk cheeks. Hopefully the F20 mask will work out, though I'm not looking forward to having the tube in front of my face; it's great on top of my head. And yes. I considered buying the F30i mask, and will try it out if the F20 mask doesn't work out. However, my F30 mask leaks everywhere for me. I think it's the frame difference, but the nasal pillow work great for me with the N30i mask, but terrible with the F30 mask.

Data:

wacomme wrote: ↑

Tue Apr 28, 2020 6:08 pm

I ended up ordering a F20 mask and it will be here by Wednesday night. While I love the N30i mask, and it leaks minimally no matter what position I'm sleeping, I can't stop breathing out a bit through my mouth. And if I tape my trap shut I get chipmunk cheeks. Hopefully the F20 mask will work out, though I'm not looking forward to having the tube in front of my face; it's great on top of my head. And yes. I considered buying the F30i mask, and will try it out if the F20 mask doesn't work out. However, my F30 mask leaks everywhere for me. I think it's the frame difference, but the nasal pillow work great for me with the N30i mask, but terrible with the F30 mask.

Data:

screenshot-20200428-180644.png
screenshot-20200428-180655.png

Nice AHI!

I hope you find the solution that works for you for chipmunk cheeks, and although it may be a remote possibility, I hope you find contentment with the F20 mask.

Chris

Thank you. Last night wasn't quite as good - several hypopnea episodes.

And as for the F20 mask, I may like it. While the N30i is minimalist, last night I wore it with a chin strap and mouth taped - hardly a minimalist setup. And I swallowed so much air that I'm constantly burping this morning.

wacomme wrote: ↑

Wed Apr 29, 2020 6:00 am

Thank you. Last night wasn't quite as good - several hypopnea episodes.

And as for the F20 mask, I may like it. While the N30i is minimalist, last night I wore it with a chin strap and mouth taped - hardly a minimalist setup. And I swallowed so much air that I'm constantly burping this morning.

screenshot-20200429-055612.png

Couldn't get into the taping thing. Taping with a nasal mask or papcap with a full face or hybrid... The things we do to stop large leaks. Some people use stockings and scunci's but there are people better versed on that in the forum.

If you're experiencing aerophagia with these settings and with a relatively well-controlled large leak rate, it's likely the same will happen with the F20. If it's too difficult to manage the aerophagia, you may want to explore reducing your Max pressure to the point where aerophagia is resolved. Aerophagia can be just as much a wake trigger as some other events. It becomes a balance between how many apneas/etc. can we resolve vs how much aerophagia can we stand.

viewtopic.php?p=463071#p463071

Chris

I'm hoping the aerophagia is a result of taping my mouth. With a full face mask (F20) this shouldn't be an issue. Fingers crossed.

Michael

First night with the F20 mask. So far I'm not that impressed. Leaks and aerophagia. One night is not a deal killer, but today I'm not as hopeful it'll work out as I was yesterday.

So far the N30i mask is the best, followed by the P30i, followed by the F20, and then the F30. In ResMed's arsenal, I think I have one more mask to try - the F30i. My hope for finding mask nirvana is diminishing.
Michael

wacomme wrote: ↑

Thu Apr 30, 2020 7:04 am

First night with the F20 mask. So far I'm not that impressed. Leaks and aerophagia. One night is not a deal killer, but today I'm not as hopeful it'll work out as I was yesterday.

So far the N30i mask is the best, followed by the P30i, followed by the F20, and then the F30. In ResMed's arsenal, I think I have one more mask to try - the F30i. My hope for finding mask nirvana is diminishing.

screenshot-20200430-065944.png

Michael

Hi Michael,

While you say there were leaks, extended large leaks aren't really showing up in this graph. Those spikes at 23:10, 12:45, 1:30, 4:00 and twice around 5:30 look like you get a noticeable leak, maybe like the famous "mask fart" that wakes you, and you're rearranging your mask to resolve it. Is this the case? This kind of leak is frustrating because it's a wake trigger too. But it's not a large leak, so the graphs we're seeing here may have more verity than if there were lots of extended large leak.

I was concerned about aerophagia from your previous post. Aerophagia is not mask dependent. When you're not large-leaking, for some of us, when the pressure goes to a certain level (different for everyone) aerophagia happens regardless of mask. Then it becomes a balance between lowering your Max pressure to combat aerophagia and setting the Min level as needed to reduce events. Some people never get aerophagia. For those of us who do, there's a sweet spot for your min pressure and a limit on your max.

You've currently got your Max set to 20. It may be time to reduce your Max to a more comfortable pressure. The "pressure" graph is a better indicator of what's happening to your pressures than the "mask pressure" graph. I wonder if you could swap out "mask pressure" for "pressure" in your graph setup, leaving all the other graphs that you have showing as they are. Then you can take a closer look at where the aerophagia is happening.

You could try the F30i, but like all masks -- if you're not getting large leaks and you're prone to aerophagia and mouth leaking, it may not make a significant difference from the F20 or F30.

Chris

Just want to second the point that finding the sweet spot is important. With inhalation pressure of 9.8, I find aerophagia tolerable. Every time I try to go up to 10, it is rough. I'll keep trying, maybe every few months, but I may have to settle in where I am for the long run. (What I'm working on is flow limitations. The better that's treated, the better I sleep.)

Thanks for you feedback. Below is the data with pressure, not mask pressure.

What you suggest trying for max pressure? I set the minimum to 7 and that seems to have helped my episodes. I had the max set at 15 until I realize how to set it my self. Would 12 be reasonable for starters?
Michael

And good to know about the leaks, or lack thereof. Being a new mask, I fiddled with it most of the night.

wacomme wrote: ↑

Thu Apr 30, 2020 11:17 am

Thanks for you feedback. Below is the data with pressure, not mask pressure.

What you suggest trying for max pressure? I set the minimum to 7 and that seems to have helped my episodes. I had the max set at 15 until I realize how to set it my self. Would 12 be reasonable for starters?

screenshot-20200430-111510.png

Michael

With this latest screen capture, it looks like you had Max at 20.
It looks like your worst time was right about 5:20. I'm guessing that's when your aerophagia was really noticeable.

There are a few considerations here:

1. You could reduce your Max to see if that reduces your aerophagia. Setting it to 12 is a long way from 15. Usually we reduce in small steps. You could be right, though. If you didn't have any aerophagia when you had it set at 15, you could try starting there again.

OR

2. It's possible raising your minimum could flatten out your pressure curves so that you never reach aerophagia-inducing pressures even if your Max setting is 20.

OR

3. Also, since a lot of what we're seeing is Hypops, it might be appropriate to simply consider lowering your EPR setting, maybe from 3 to 2.

These are all different approaches to changing your therapy that may or may not end up being beneficial. I'm not sure which would be the best approach. Someone else will come along with the appropriate suggestion soon.

Chris

Thanks for this feedback.

Regarding EPR - I think I only have it set for ramp. So, how does lowering it from three to 2 help my hypops? And why would lowering EPR help hypops anyway? That seems counter-intuitive.

And how can raising the minimum pressure help with aerophagia? That also sounds counter-intuitive. Granted, the aerophagia tends to come during the last half of my sleep; I don't know why I don't have the problem, as well as chipmunk cheeks, earlier during my sleep. Most of my issues are after 4 hours of sleep.

For starters, I'll lower the max pressure to 15; this is what it was set at by the CPAP tech.

Michael