trouble exhaling at 14cmH20

Hi all,
This is my first post.....I have been on CPAP for about 3mos... have had some good and bad nights. Most of my issues are of course mask leaks and exhaling against 14. I started with a ultra mirage ffm, since I'm a mouth breather, then a ultra mirage nasal mask with chin strap. Had good results with the nasal mask with some leaks. I have tried pillows.... the breeze was the best w/o any leaks.... but I was unable to exhale completely against the pressure,.. and the air seemed too concentrated in my nose. I'm getting ready to contact my Dr about another machine. Would I be better off with a bipap or a auto w/c-flex? Since the breeze with nasal pillows gives me the best seal, I was wondering which machine would be best. Right now I'm back to my regular cpap with soft-x for exhalation which is barely noticable, and my ultra mirage nasal w/chin strap. Basically I want the best seal and to exhale comfortably. Any advice would be greatly appreciated. I'm really glad I found this forum.

Thank, RM.

RM

If breathing out against pressure is an issue, you can deal with this using
either CFLEX (selected RemStar models) or EPR (New ResMed S8 models Vantage & Elite)

They will help.

Most people find that after a month or so, the pressure isn't a problem once they get to sleep & RAMP feature is designed to achieve that. But if you wake up in the night & find the pressure a burden then CFLEX/EPR should prove a great help.

Cheers

DSM

If breathing out against pressure is an issue, you can deal with this using
either CFLEX (selected RemStar models) or EPR (New ResMed S8 models Vantage & Elite)

These are not the only solutions! A bi-level machine would also give you exhalation relief.

While good for many, C-FLEX does not work for everyone and ResMed EPR is, as yet, essentially unproved here in North America.

If possible, get your hands on a RemStar C-FLEX machine and see if C-FLEX works for you. Try to do this BEFORE you commit to purchasing a new machine. Also, try to get ahold of a bi-level and trial it as well.

What WillSucceed and dsm told you is absolutely correct. Try out both types before purchasing. I myself could never exhale at the same pressure as inhaling no matter what the cm of H20 pressure is, so I opted for the Bi-level technology. I have a Respironics BiPAP pro 2 with Bi-Flex and I use the "flex" technology along with the different inhald and exhale pressures. I am currently at 17 IPAP and 13 EPAP.

FF

Thanks for the info. I will definately try the remstar if able. Another issue: I seem to breathe better with the nasal mask (the air is less concentrated), but it leaks....especially as my pressure increases.. the breeze w/pillows doesn't leak, but the air seems too concentrated and I really have the trouble exhaling. Even though the breeze doesn't leak and I can sleep wih it, I wake up feel lousy. I feel better using the nasal mask. My question is would a change in machines allow me to use the breeze with the same results as the nasal mask...but with the added benefit of comfort and no leaks? Maybe my pressure of 14 is just too high to be blowing up my nose through the small nasal pillows and needs to be off my nose.... I don't know. I'm just looking to be able to sleep (as I'm sure you all are) in comfort with minimal leaks and the best results. I use the Invacare polaris with soft-ex( thats barely noticeable) w/ramp and heated humidifier, ultra-mirage with chin-strap. My thoughts are that if I use the Remstar autopap with humidifier and c-flex, this would only deliver the pressure I need, back or sidelying, and provide exhalation relief. What do you think? Other thoughts: how does the ultra mirage nasal mask fare against the activa that I have been reading about on these posts?

Thanks, RM.

RM wrote: I seem to breathe better with the nasal mask (the air is less concentrated), but it leaks....especially as my pressure increases.. . My question is would a change in machines allow me to use the breeze with the same results as the nasal mask...but with the added benefit of comfort and no leaks? Maybe my pressure of 14 is just too high to be blowing up my nose through the small nasal pillows and needs to be off my nose....

_________________
I also like the nasal mask and I have my pressure at 17 all night long (although it can be a bit tough sometimes). I use the Mirage Swift. Sleepless in LI tried the AURA (as did Rested Gal) and they both like it.
I believe nasal masks and Respironics Auto with C-Flex might work for your situation. You won't know until you try it. Hopefully, your pressures on Auto will be in the lower range most of the night. My sleep doc prescribed a range of 10-20 for me if I decided to go that route. I believe my range will probably stay in the high end though. I have not tried an AUTO yet because I can't exhale at the same pressure as I inhale.

FF

Thanks for the cont info..

More thoughts... when I use the breeze nasal pillows, it does not leak, is totally comfortable, no strap marks, sore nairs etc, and I can sleep all night with it. BUT, it seems that my breaths are of short duration with it and labored, and I don't feel rested in the a.m. With the nasal mask there are leaks, stap marks, etc, but the breathing is easier... pressure at 14. I have finally found an interface (the breeze) that is comfortable with no leaks, but I have trouble with the breathing and don't feel good the next day. Also I usually have 1 nostril that is stuffy all the time. Does the swift function like the breeze? I would think it would. I don't know if a different machine would help or not. I would really like to use the breeze because it is so comfortable, but right now with a conventional cpap set at 14 that doesn't seem to be an option.
Any more thoughts???
everyone has been very helpful on this forum and seems to have been around the block a few times with these issues.
thanks, RM.

Hello again..

Just an add-on to my last post... I have heard/read that exhaling using the swift is easier than the breeze??? Is this true?

RM

Hi RM,
I've tried the Breeze and the Swift. I use the Swift. Sometimes it leaks but it is a small price to pay for comfort at such high pressures (and I am too claustrophobic to go the nose or full face mask route). I can breathe against the Swift easier than the Breeze too.

FF