P10 Mask - Which pillow size?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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palerider
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Re: Flow Limitations - Min Pressure Too Low?

Post by palerider » Mon Jan 17, 2022 12:39 pm

MMcG wrote:
Mon Jan 17, 2022 5:50 am
I like the idea of the Bleep, except that I expect the prongs would irritate my nostrils (very sensitive).
What "prongs"? there aren't any 'prongs' on the bleep..

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palerider
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Re: Flow Limitations - Min Pressure Too Low?

Post by palerider » Mon Jan 17, 2022 12:43 pm

MMcG wrote:
Mon Jan 17, 2022 10:52 am
I think what happens is that the tubing (the mask frame) compresses under the weight of my head on one side, thus diverting nearly all the air to the other side. Then the machine responds immediately by nearly doubling the fan speed (to maintain the delivered pressure). That's what it sounds like anyway.
No, the machine doesn't do that. the airflow out of the vents doesn't change just because one of the two hoses gets pinched off. either hose allows enough airflow by itself.

It may sound like it, but something else is happening.

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Re: Flow Limitations - Min Pressure Too Low?

Post by MMcG » Mon Jan 17, 2022 12:48 pm

palerider wrote:
Mon Jan 17, 2022 12:43 pm
MMcG wrote:
Mon Jan 17, 2022 10:52 am
I think what happens is that the tubing (the mask frame) compresses under the weight of my head on one side, thus diverting nearly all the air to the other side. Then the machine responds immediately by nearly doubling the fan speed (to maintain the delivered pressure). That's what it sounds like anyway.
No, the machine doesn't do that. the airflow out of the vents doesn't change just because one of the two hoses gets pinched off. either hose allows enough airflow by itself.

It may sound like it, but something else is happening.
Well I guess then it is just the air that would have gone down the left side all goes down the right side when the left tube gets compressed. But the effect is an apparent doubling of the noise. After reading Pugsy's review of the N30, I think I'm going to try it. Should stop the noise problem anyway.

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palerider
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Re: Flow Limitations - Min Pressure Too Low?

Post by palerider » Mon Jan 17, 2022 12:51 pm

MMcG wrote:
Mon Jan 17, 2022 12:48 pm
palerider wrote:
Mon Jan 17, 2022 12:43 pm
MMcG wrote:
Mon Jan 17, 2022 10:52 am
I think what happens is that the tubing (the mask frame) compresses under the weight of my head on one side, thus diverting nearly all the air to the other side. Then the machine responds immediately by nearly doubling the fan speed (to maintain the delivered pressure). That's what it sounds like anyway.
No, the machine doesn't do that. the airflow out of the vents doesn't change just because one of the two hoses gets pinched off. either hose allows enough airflow by itself.

It may sound like it, but something else is happening.
Well I guess then it is just the air that would have gone down the left side all goes down the right side when the left tube gets compressed. But the effect is an apparent doubling of the noise. After reading Pugsy's review of the N30, I think I'm going to try it. Should stop the noise problem anyway.
It'll be different sounds, and yes, I've heard a lot of people complaining about the noise of that mask.

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Re: Flow Limitations - Min Pressure Too Low?

Post by MMcG » Wed Jan 19, 2022 11:22 am

I just stumbled upon something which may be fairly central to my machine problems. I discovered that the Devilbiss machine's default settings for defining hypopneas and apneas can be adjusted upwards or downwards in terms of duration and % airflow restriction. The default settings are 90% and 50% for apneas and hypopneas respectively, but for some unknown reason, the hypopneas on ny machine are set at 40%, i.e. too sensitive. This has more consequences than over-reporting of hypopneas (making the AHI reading larger) because the machine actually responds aggressively to them. Going to see what happens tonight with it reset to 50%. I increased the max setting last night to 12 (from 9) and the machine got right up there for about ten minutes, waking me, after responding aggressively to two very dubious/marginal hypopneas.

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Last edited by MMcG on Wed Jan 19, 2022 12:07 pm, edited 1 time in total.

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palerider
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Re: Flow Limitations - Min Pressure Too Low?

Post by palerider » Wed Jan 19, 2022 11:49 am

MMcG wrote:
Wed Jan 19, 2022 11:22 am
got right up there for about ten minutes, waking me, after responding aggressively
So you're discounting the *fact* that breathing issues during your sleep disturb your sleep and wake you up.

Have you actually zoomed in and looked at how long it takes for that pressure to increase?

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Re: Flow Limitations - Min Pressure Too Low?

Post by MMcG » Wed Jan 19, 2022 12:16 pm

palerider wrote:
Wed Jan 19, 2022 11:49 am
MMcG wrote:
Wed Jan 19, 2022 11:22 am
got right up there for about ten minutes, waking me, after responding aggressively
So you're discounting the *fact* that breathing issues during your sleep disturb your sleep and wake you up.

Have you actually zoomed in and looked at how long it takes for that pressure to increase?
No and yes respectively. The machine increased the pressure very quickly to the new max of 12. I scanned both the flagged events and my breathing pattern and what triggered it was two marginal hypopneas, one probably between 40% and 50% for just over ten seconds and then another about a minute later which looked like a genuine hypopnea but just about ten seconds long at a stretch. When it got to 12 it stayed there and I had two further flagged hypopnea events in close succession a few minutes later. But they were fairly clearly arousal events based on the prior disrupted breathing pattern. So, on this occasion, I'm fairly sure that it was the machine that woke me.

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Re: Flow Limitations - Min Pressure Too Low?

Post by palerider » Wed Jan 19, 2022 1:59 pm

MMcG wrote:
Wed Jan 19, 2022 12:16 pm
palerider wrote:
Wed Jan 19, 2022 11:49 am
MMcG wrote:
Wed Jan 19, 2022 11:22 am
got right up there for about ten minutes, waking me, after responding aggressively
So you're discounting the *fact* that breathing issues during your sleep disturb your sleep and wake you up.

Have you actually zoomed in and looked at how long it takes for that pressure to increase?
No and yes respectively. The machine increased the pressure very quickly to the new max of 12.
What does 'very quickly' mean? within a few seconds? a couple of breaths?
MMcG wrote:
Wed Jan 19, 2022 12:16 pm
. So, on this occasion, I'm fairly sure that it was the machine that woke me.
And not the fact that you were having problems breathing?

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Re: Flow Limitations - Min Pressure Too Low?

Post by MMcG » Thu Jan 20, 2022 1:23 am

palerider wrote:
Wed Jan 19, 2022 1:59 pm
MMcG wrote:
Wed Jan 19, 2022 12:16 pm
palerider wrote:
Wed Jan 19, 2022 11:49 am
MMcG wrote:
Wed Jan 19, 2022 11:22 am
got right up there for about ten minutes, waking me, after responding aggressively
So you're discounting the *fact* that breathing issues during your sleep disturb your sleep and wake you up.

Have you actually zoomed in and looked at how long it takes for that pressure to increase?
No and yes respectively. The machine increased the pressure very quickly to the new max of 12.
What does 'very quickly' mean? within a few seconds? a couple of breaths?
MMcG wrote:
Wed Jan 19, 2022 12:16 pm
. So, on this occasion, I'm fairly sure that it was the machine that woke me.
And not the fact that you were having problems breathing?
Thanks for the feedback, but it does really look like the default settings on the machine were the problem. Settings back to min 6 and max 9 last night with hypopnea algorithm reset correctly to 50%. Slept much better (woke less frequently) and the 95 percentile pressure was only 7.7 and never got any higher than 8.2, i.e. the machine stopped responding to false hypopnea flags. My Ahi was 1.8 but really more like 0.5 due to some false-flagging of arousals. So, looks like the wrong algorithm setting on the machine was the problem. Going to see my sleep consultant later today and also going to change to either a P10 or N30 mask in a few days time. Hopefully, all will be resolved then.

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Re: Flow Limitations - Min Pressure Too Low?

Post by BuckarooBanzai » Sun Jan 23, 2022 12:27 pm

You mentioned that you don't really 'trust' your machine, and so you are just riding out the 12 month contract before getting another one. Let's not minimize this issue. Trust is important. If you cannot trust your machine to work correctly - to keep you 'safe' - how will you ever manage to rest?

Can you afford to rent or buy the proper machine now, and just bite the bullet knowing you've also got to pay on this machine for a few more months? I'm not into burning money, but we're talking about your health, your very life, here.

Also, I use the ResMed AirFit P10 pillows. As Pugsy said, they do not enter your nostrils. If they do, that means you're using the wrong size and must size up. They are very gentle; once I settle in for the night, I forget I am wearing them. P10 is a good choice if you're going for minimalist gear.

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Re: Flow Limitations - Min Pressure Too Low?

Post by MMcG » Mon Jan 24, 2022 12:09 pm

BuckarooBanzai wrote:
Sun Jan 23, 2022 12:27 pm
You mentioned that you don't really 'trust' your machine, and so you are just riding out the 12 month contract before getting another one. Let's not minimize this issue. Trust is important. If you cannot trust your machine to work correctly - to keep you 'safe' - how will you ever manage to rest?

Can you afford to rent or buy the proper machine now, and just bite the bullet knowing you've also got to pay on this machine for a few more months? I'm not into burning money, but we're talking about your health, your very life, here.

Also, I use the ResMed AirFit P10 pillows. As Pugsy said, they do not enter your nostrils. If they do, that means you're using the wrong size and must size up. They are very gentle; once I settle in for the night, I forget I am wearing them. P10 is a good choice if you're going for minimalist gear.
Yep, I've thought seriously about biting the bullet in that way. But alternative machines, especially Resmed's are hard to get right now and probably will be for some months yet, from what I've read - mostly down to the recall of some Phillips machines. But, I've been re-assured that the Devilbiss machine is OK and that the remaining issue (noise) is mask related. I expect to get a new mask this week - probably will take a few days to get used to it though.

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Re: Flow Limitations - Min Pressure Too Low?

Post by BuckarooBanzai » Mon Jan 24, 2022 12:18 pm

It's true the Resmed machines are hard to get right now, but there are ways to find them. I got my Resmed AirSense 11 Autoset just last month. Kaiser Permanente ordered it for me.

Best wishes to you.

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Re: False Flags and Mini-Leaks Question

Post by MMcG » Tue Jan 25, 2022 2:34 am

OK, a new question, and as required here, I've changed the title of the post and kept to the same thread. I've experimented a bit over the last week with pressure settings (while waiting for a new mask) and it has made little difference. For example, last night, I raised my minimum pressure to 7 for about three hours. I had no trouble falling asleep initially, but struggled to get back to sleep so reset it back to 6 then. My AHI score for the first three hours was similar to previous nights for the same period (about 2.5) - a couple of centrals but mostly hypopneas. I noticed that they nearly all coincided with small spike leaks. So then I looked back over my history and I noticed the same pattern. Looks like about 75% or more of my flagged events either coincide with or are preceded (within seconds) by a mini-leak. The breathing pattern before and after most of these events tends to confirm false flags too, from what I've learnt here and from linked videos.

So, my question is, whether the coincidence of small spike leaks with flagged events is a strong signal that they may be false? I suspect that my apnea is nearly fully controlled and that I may be trying to solve a problem that no longer exists, just because my machine is flagging false events. BTW, my visit to my sleep consultant wasn't very helpful. Some fifteen minutes later and with a much lighter wallet, all I had learnt was that she didn't need to see me again because my AHI score was less than 5! The only reason that I'm still pursuing this is that, while I'm definitely sleeping better than before treatment, I still feel tired more often than not most mornings, i.e. not refreshed.

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Re: False Flags and Mini-Leaks Question

Post by Pugsy » Tue Jan 25, 2022 9:56 am

Mini leaks could be causing arousals. Just because a leak isn't massive doesn't mean it isn't affecting overall sleep quality.
Once a person has an arousal or awakening then that increases the chance of a false positive flag.
Also increases the chance of a transitional or sleep onset apnea getting flagged when one does go back to sleep.

Now figuring out and fixing the cause of the arousal in the first place...not always so easy.
It might be the mini leak or the mini leak could also be from the arousal and/or tossing and turning. Which came first thing..the chicken or the egg?????

Sleep apnea events isn't the lone culprit on the "causes for crappy sleep" list. That list is miles long.
Feeling less than well rested....the list of culprits is also miles long.

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Re: False Flags and Mini-Leaks Question

Post by MMcG » Tue Jan 25, 2022 11:33 am

Pugsy wrote:
Tue Jan 25, 2022 9:56 am
Mini leaks could be causing arousals. Just because a leak isn't massive doesn't mean it isn't affecting overall sleep quality.
Once a person has an arousal or awakening then that increases the chance of a false positive flag.
Also increases the chance of a transitional or sleep onset apnea getting flagged when one does go back to sleep.

Now figuring out and fixing the cause of the arousal in the first place...not always so easy.
It might be the mini leak or the mini leak could also be from the arousal and/or tossing and turning. Which came first thing..the chicken or the egg?????

Sleep apnea events isn't the lone culprit on the "causes for crappy sleep" list. That list is miles long.
Feeling less than well rested....the list of culprits is also miles long.
I'm guessing that, with my mask (Respironics Dreamwear Nasal Cushion), it doesn't take much movement of the head to move the nasal cushion slightly, resulting in a brief "spike leak". My read of it is that when I see such a leak coincide with disturbed breathing (deep, irregular breaths), and then followed by a flagged hypopnea or apnea, the event is more than likely a false flag, especially if the event isn't followed by a few deep breaths.

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