Giving the Fit Life a Try

GaryG wrote:What I find interesting is that my AI is way down, and there really is no pressure change in my CPAP machine when I experience HI's. Does this mean that I'm at my optimum pressure?

Auto machines don't automatically increase pressure for "every" hypopnea if the machine doesn't sense the things it requires as indicators of an apnea event. Discussed in great detail in other threads. So if your machine doesn't think those hyponpnea events, it has flagged, merit an increase in pressure, it won't go there.

All in all if you are feeling good, I think your data looks exceptionally good and I would think you should be very pleased.

Pugsy, its weird but I think I actually felt better on the Liberty when leaking and when my AI's and HI's were off the charts. Maybe I just hit a plateau and will take some more time to get more benefit. Only been two nights (one which was a short night with rainout).

I actually lowered my humidity setting down to 1, and I wasn't dry at all.... thinking of shutting off the humidity tonight.

Pugsy wrote:Auto machines don't automatically increase pressure for "every" hypopnea if the machine doesn't sense the things it requires as indicators of an apnea event. Discussed in great detail in other threads. So if your machine doesn't think those hyponpnea events, it has flagged, merit an increase in pressure, it won't go there.

All in all if you are feeling good, I think your data looks exceptionally good and I would think you should be very pleased.

Ok, I follow that auto machine will only adjust pressure for events it senses. But then if the machine doesn't sense the events then how to reduce the HI? You mentioned discussion in other threads. OK. I can look. but what do I search for?

GaryG wrote:Pugsy, its weird but I think I actually felt better on the Liberty when leaking and when my AI's and HI's were off the charts. Maybe I just hit a plateau and will take some more time to get more benefit.

You know a couple of months ago I had a night where I had AHI of 10 something. I always have more apneas and minimal hypopneas. I use auto machine also. I felt awesome that day. I was so surprised at how good I felt especially when I saw the numbers. It was a fluke though, only happened once. If I could reproduce it, I would be satisfied with therapy and that number. It was like I was on the best drugs available and I wasn't taking a darn thing. I can't reproduce it with an AHI of 3.0 now... bummer

I don't go into super panic when I have some leaks. The machine will help me out to some extent. I don't expect flat line leak rates. While they are nice, it just isn't something I strive for. While good numbers are great if you feel good along with them, they don't mean so much if you don't. You might just need some more time with the new mask so of course give it a good trial. You can always go back to the Liberty later and see if you still notice a big change in the way you feel despite the leaks.

I see you wonder about the other threads discussing auto machines not chasing after each and every hypopnea. Let me try to find a couple of them.
Auto machines have an algorithm that they follow. Each brand is different but the premise is the same. ResMed autos won't increase pressure above 10 cm for events that it doesn't also sense certain indicators for. These indicators could be snores, flow limitations or whatever it has in its little brain to point to OSA event.
Example, if you turn over in your sleep you will often stop breathing momentarily. This is common. The machine will flag this as a hypopnea most likely because it fits part of the definition. BUT it won't be preceded by any of the other normally seen OSA event indicators (snores, flow limitations), so the machine just says "you had a hyponpnea for some reason but it didn't look like anything related to OSA so I did nothing to chase after it".... Does this sort of make sense? It tends to confuse some people.
ResMed will most assuredly increase the pressure above 10 cm for events that meet the algorithm's requirements for events related to OSA.

GaryG wrote:But then if the machine doesn't sense the events then how to reduce the HI? You mentioned discussion in other threads. OK. I can look. but what do I search for?

We cannot expect to totally eliminate the Hypopneas. Especially those associated with ResMed machine users and especially those patients that have more hypopneas than apneas.

Hypopneas are important. Have enough of them back to back and you can get significant desats and damage. So we don't want to discount them entirely. I think we just need to learn to accept and trust the machines.
If your auto machine sees or flags a hypopnea but doesn't respond with an increase in pressure then it probably doesn't meet the requirements of an osa related hypopnea. HI numbers in the 2-5 range I would think, would be cause for a party. Between 5-10 I might wonder about if they also had some AI numbers to go along with them.
Above 10 HI numbers and I would probably want to investigate as much as possible. Might be centrals? Might just need pressure adjustment? And with all the above I would factor in how I felt. Best numbers in the world don't mean squat if you feel like crap.

For your reading enjoyment poke around in the threads below which also have threads inside them. Lots of discussion about ResMed and hypopneas and auto machines and pressure increases and no pressure increases.

viewtopic.php?f=1&t=45011&st=0&sk=t&sd= ... +hypopneas

viewtopic.php?f=1&t=43948&p=390817&hili ... as#p390817

viewtopic.php?f=1&t=43362&p=384262&hili ... as#p384262

As far as side sleeping goes, I don't have a problem doing it. No leaks at all.

Night #3: Woke up at 6 and noticed that my hose was disconnected from my mask. What a bummer. Also observed that the mask fit at the bottom (over my chin, actually seems to prevent my mouth from opening, so I'm wondering if this mask could be used to teach me to get away from mouth breathing.

Anyway, my results from last night demonstrate why using the LCD numbers off of the screen may not always be the true story. LCD showed 0.8 L/Sec (48 L/Min) which is too high.

However, when I downloaded the detail, I see I had a good night as the disconnection of the hose happened after most of my events. So another reason to have the software for anyone questioning the value.

Another observation from Night #3: I turned down my humidifier to the OFF position, and did not experience any dryness. With the Fit Life, I don't need the humidifier. Tonight I'll simply remove it and put it away.

I am assuming that you mean you have your humidifier set to "off" but with water in the chamber last night. If that's the case, you are getting "passover" humidity, not "no" humidity.

I use passover humidity almost all year round but I seem to need at least passover humidity. You may find the same thing works better for you than heated or no humidity.

Hawthorne, thanks for the info. But I've got to tell you, the water level looks like it never moved, so I assumed it was off. Will actually remove tonight and see if I notice a difference. But if I do, this will have been the reason.

My water level goes down just a little (maybe less that 1/4 inch a night) when I use passover mode. I don't notice much difference in water level for a couple of nights in passover mode.

You will know, if you take the humdifier off, though, whether or not you might be better with passover mode at least.

Give it a try! It may take a few nights to see if you need at least passover mode.

I am fairly new to this and have been using the Fit Life (my first mask) for about a month. Before starting but after reading many of the threads here I was concerned about finding a mask that didn't torment me. As it turns out the Fit Life has worked very well for me, and I use it both sleeping on my side and on my stomach (using the Falcon position which I must say I used to use for sleeping before I ever heard of Falcon).

Using the Resmed software 3.7, I find the leak rate is usually zero except when my face itches and I reach under the mask to scratch (anyone have a good solution for face itching, which I guess I am prone to). However, on those rare occasions when my pressure goes up to around 12--it usually adjusts to around 11--I sometimes do get some leaking. For me an adjustment that helps diminish leaks is to take the strap that is on top of my head and move it back a bit.

There are a couple of questions maybe someone can help me out with. My AHI numbers are not so great, usually in the 5 to 10 range. BUT, when I look at the data minute by minute I find most of my supposed apnea events occur either while I am still awake, trying to get to sleep, or after I break the seal on the mask to itch my face (meaning after a large leak is recorded and obviously after I have woken up for a moment).

As to the former, is it unusual to have apneas recorded while awake, and if it is does this indicate any sort of breathing problem separate and apart from sleep apnea? As to the second issue (the recorded apneas that occur during or immediately after periods of leaks induced by my breaking the seal to scratch my face) does anyone know how Resmed is scoring this and what triggers it? (I haven't yet read the threads on how Resmed decides there is an event, so if this is all explained there, just let me know that it is and I'll hopefully find what I am looking for in those threads).

Second, I recently got a bad cold, and still had major congestion and sneezing after using antihistamines. Accordingly, I stopped using my APAP machine for a few days. The result this morning was a rather bad headache. Is there any viable way to use APAP while badly congested and also sneezing? Or do we just go back to the olden days of no therapy for a few days while we recover from the cold?

Parenthetically, after using the Fit Life for awhile, I also tried the Full Life (partly because I would like to monitor my sleep using Zeo with its forehead strap, which I doubt is possible with the Fit Life on). I couldn't get the Full Life to stop leaking, but will probably try again in the future. Any suggestions or advice about the Full Life that isn't evident from the instructions provided with it?

Hawthorne, just took a nap without humidifier hooked up and seemed ok. Will see what a whole night shows.

Jay, I'm still a newbie, and unfortunately I don't know enough to comment. You might want to create your own post, and post your detail results, and I'm sure someone can help you. It will be helpful to view if the pressure responded to the apneas or not, as well, even though you're awake when you experience them. Also, a breakdown of AI vs HI might help as well.

Night #4: 2nd night in a row with non-mask issues. Hi leakage but noticed I was sleeping on my hose and also the connection from the hose to my machine was loose. Median leak was 0.0 but my average leak as shown on display was 0.94 L/S. Data showed zero leakage for most of night, then a period of 2 hours with big leakage. Will try and insure all connections are good tonight. I think the mask is fitting properly, and this will be my mask, let's see what happens tonight.

Night #5: Checked all connections thoroughly. All seemed fine. Again awoke with high leakage # overnight. Now I'm thinking of adding back the humidifier on a low setting tonight. Possibly I need a little humdity to seal the mask. I don't know if this makes sense, but worth a shot as my non leakage nights were with the humidifier (even if I didn't feel dry).