I thought I was sleeping okay

https://www.cpap.com/cpap-machine/respi ... -flex.html
https://www.cpap.com/cpap-machine/respi ... -plus.html

Try to exchange for the auto which can be used in a range of pressures or single pressure and is data-capable. They both have the same insurance code(E0601?) but the DME will make less profit by providing the upgraded one. If you really get hassled at least insist on the Pro which is not an auto but is data-capable. Many DMEs don't know the difference between compliance data and detailed data(AHI, Leaks, Snores,etc). I just heard it repeated again recently that we have to become medical consumers and not patients. I'm really sorry for the confusion. Keep us posted.

DoriC wrote:https://www.cpap.com/cpap-machine/respi ... -flex.html
https://www.cpap.com/cpap-machine/respi ... -plus.html

Try to exchange for the auto which can be used in a range of pressures or single pressure and is data-capable. They both have the same insurance code(E0601?) but the DME will make less profit by providing the upgraded one. If you really get hassled at least insist on the Pro which is not an auto but is data-capable. Many DMEs don't know the difference between compliance data and detailed data(AHI, Leaks, Snores,etc). I just heard it repeated again recently that we have to become medical consumers and not patients. I'm really sorry for the confusion. Keep us posted.

I will contact my DME tomorrow regarding a swap; I'm afraid it will be past 30 days before I can return it to them, I don't know if that will be a problem or not.

Also, if I can swap I assume I should keep the Encoreviewer 2.0 software?

You know, I was a little miffed because I had done some research on here before I went to my DME for my cpap and when I went there, they had already set one up for me. I guess I was too much of a newbie to question what was given me. So, I hope this might serve as a lesson for other newbies: Read, learn, be proactive in your care and don't always assume you're being taken care of in the best way possible for you. Not just with cpap, but with all areas of your health!

According to the description the machine is data capable.

I travel with my job as well. I have noticed that when not at home I have more leaks. I agree it has to do with the pillows and bed.

IMHO, there is a method to getting all of this gear to work right. I will put on my flame suit now and say, for the record, that pillows do nothing for me... I have tried 20 different pillows and while mask performance varies between them due to the 'squish' factor... once you have found the right MASKS (plural) it should be irrelevant what pillow you are sleeping on. I can sleep on feathers or a rock. Makes no difference to my leak rate now. The first thing you need to do in getting your XPAP system working for you is to get the right mask(s) for you and that will include no less than two different masks, one being a nasal pillow/nasal mask and the other being a full face mask (FFM). Why the two? Simple. The first for 'regular' nights when your nose is nice and clear and the full face mask when there is any tendancy towards mouth breathing due to nasal congestion (all the taping in the world will not correct for a plugged nose) which can be caused by allergies or a variety of minor ailments. You have got to play around with different masks and different sizes until you find the nose mask and the FFM that work for YOU. It is a chore to be sure. I have settled on the Mirage Activa LT nose mask and on the Mirage Quattro in sizes that work FOR ME. I have a friend who has tried the same masks and hates them. That's just the way it is. The next thing you need to know is that there is an ART or SCIENCE to using a mask. First and foremost your face needs to be clean. I use a Strydex pad (astringent) after washing before going to bed. THAT's clean. I then put on the mask and adjust the straps and forehead brace for (a) maximum comfort and (b) best possible fit THUS FAR. Then I lay down and go through the process all over again making minor adjustments to the straps the get sufficient tension to make a good seal without pinching the bridge of my nose and without making dents in my face. With the Mirage masks that have a dual 'film' seal setup; there is one last trick that you really need to do during the masking-up process and that is to grab the mask squarely and pull it about 3/4 inch away from your face and allow it to plonk back onto your face. This permits the two 'film lips' to settle squarely on your face and will eliminate pretty much all leaks. You may need to do this a second time if you don't feel that you have achieved a solid seal. All of this is done WITH THE AIR RUNNING as the mask is designed to be put on that way. If you don't do this with the air running you are probably wasting your time as the minute you turn the air flow on the seating of the mask is going to change. Make sure you make the final adjustments while laying down as well, as previously mentioned. My reultant performance? The Mirage Activa LT nasal mask - solid seal until I 'squish' up against my pillow as a side sleeper... then all bets are off. Chances are that the seal will remain good but perhaps not perfect during the night as I move around and in any event, the seal is more than satisfactory. The Mirage Quattro is put on in a very similar manner and most importantly, have the air running and 'pluck' the mask away from your clean face to permit the two layers of silicone rubber to sqaure up, flatten out and so on and then return the mask to your face squarely... presto, a solid as a rock seal. Adjust your head brace in both cases to ensure your nose is not pinched or you will undoubtedly mess with the mask(s) while half asleep and never recall a bit of it... due to the discomfort. My data results indicate that these two masks cover my needs 100% and give me almost perfect seals... the FFM being the better of the two.

Now, having said all of this, I have to say that I love my nasal pillow mask. Problem is that they don't work worth a poop and when squished against a pillow, hard or soft, the ends become constricted and they turn into little pressure washers and drill holes through my sinus' into my eyeballs. I have not given up quite yet and have spent the last few months collecting several nasal pillows in various sizes and will make a valiant effort to add them to my list of masks that work for ME shortly. In the meantime, it is the Mirage Activa and the Mirage Quattro that work for me.... if and only if I put them on right and take the time to do so. If I just slap them on I am guaranteed a lousy fit and a lousy night.

Once you have addressed the mask issue successfully you need to address the pressure issue - and in my honest and outspoken opinion, regardless of what any MD tells you or prescribes for you, you need to do two things: firstly, you need a data recording machine like the ResMed S8 or S9 Auto and you need to take that data and interpret it in order to maximize the effectiveness of your treatment, which includes my second (third?) point and that is simply that you need to reach a level of comfort in interpreting the data and adjusting your pressures accordingly. It is also a very good idea to get a recording oximeter that will measure your blood oxygen saturation during the night as this is essential clinical information that you should be taking with you to your sleep doc appointments. And if your sleep doc, pulmonologist, respirologist, whatever, wants no part of your efforts YOU MUST FIND A NEW MD!!!

You will begin to approach a 'magic bullet' where everything begins to come together through your hard work and efforts with your MD's. Unfortunately, it is only the sleep study with the use of an EEG that will ultimately tell you what kind of a night of sleep you had, but when you do that sleep study (and ASK FOR A COPY!) your MD's will have a history of blood oxygen saturations, apnea/hypopnea events, pressures, etc., to work with.... and they will be able to expend further effort on ensuring that you are getting the best night of sleep possible and evaluate things like blood oxygen saturation/desaturations creating awakenings and so on.

To illustrate; I now have two masks that fit almost perfectly. I have a pressure range that seems to work almost perfectly (zero apnea and zero hypopnea events) but I am still getting lousy nights of sleep.... we will now (this month) concentrate on supplemental oxygen infusion based on my daily (nightly) recordings of SaO2 data and S9 Auto outputs and hopefully will then take the opportunity to do a sleep study with 'the magic bullet'.... and see what we have with EEG information added in.

So, you see, it is not a simple matter at all and you are on the right track. It is essential that the very first step in getting on the path towards your 'magic bullet' be getting your mask to work well for you, WHATEVER IT TAKES. Without a well fitting mask you will keep skidding off the path and getting skewed data. Be tenacious as a pit bull in getting this done and do not be disheartened for it is a point that we all have had to go through on the road to the perfect sleep. Keep at it. And give yourself a pat on the back for being willing and taking the time to get educated on the matter... more than 75% of CPAP/XPAP patients never reach their magic bullet or drop the therapy completely.

DO whatever it takes. It is not just about a good night of sleep but rather is about LIFE itself. And you will begin to feel so much better when awake when your liver is functioning at its nominal capacity and processing all those bodily juices, chemicals, hormones and enzymes. The downside to poor CPAP therapy is "he/she died peacefully in his/her sleep"... you will be sleeping with low SaO2 and high blood pressure. It kills. And incredibly, it begins with getting a mask or masks that will fit well for you. Having found mine, I have purchased a five year supply of each that can likely be stretched to ten years if necessary. It is THAT important. You are on the path. Good luck to you.

One other thing and that is simply this. The simplest methods in the world of getting an otherwise desireable mask to fit well usually work well. I laughed at the underwear elastic and pantyhose suggestions at first when I was new to this battle. I now embrace them solidly... consider that pantyhose trick the same as simply taking a finger and pressing down on the front of the mask while in use. It seals instantly and solidly.... I am now a secret user of panty hose when necessary to keep my mask sitting tightly enough (but not TOO tightly) for a solid seal. WHATEVER IT TAKES! Let that be your motto from this moment forward. Your quality of life and indeed your life itself depends on it.

skylark40 wrote:I've been using the Swift LT for Her for a mere two weeks now and thought I was sleeping well. I'm currently away from home, staying in a hotel, and find I'm having tons of leaks, mouth breathing, etc. I went so far as to tape my mouth shut last night (along with my chin strap) but found I was having leaks around the nasal pillows which I seldom had at home. What's the deal? My daughter is with me and she says I sound like a leaky air mattress

Now I'm thinking I need a hybrid mask but hate to think about it. Any suggestions?

Since you have only been using the mask for two weeks...I doubt the nasal pillows are worn out...BUT....they usually only last about a month....so be on the look out for that!

I securely taped my mouth shut last night, increased the humidity to the max and seemed to sleep better. The only problem was my throat was extremely dry and my humidifier tank still had 3/4ths of a tank in it. I am wondering if the humidifier is working correctly.

Anyway, in regards to the posts from yesterday, I contacted my DME about swapping my cpap for a Pro version which - I hope - gives me more than simple compliance data on the SD card. It will cost me $300 out of pocket though, because my insurance (Anthem BC/BS) won't cover anything other than a straight cpap. Even the C-Flex part isn't covered.

I have also asked about trying a hybrid mask and she said they carry the Liberty. I haven't researched it, yet - does anyone have any comments about it?

Thanks fellow hosers.

The Pro is a straight cpap. The difference between the Plus and the Pro is that the Plus only gives compliance data. The Pro gives detailed data. With software and the Pro you can see you events, leak etc.

The next up would the the Auto which can be used in cpap and auto mode.

Hawthorne wrote:The Pro is a straight cpap. The difference between the Plus and the Pro is that the Plus only gives compliance data. The Pro gives detailed data. With software and the Pro you can see you events, leak etc.

The next up would the the Auto which can be used in cpap and auto mode.

I'd have to pay for that upgrade out of my pocket, too. At least with the Pro I'll be able to see what's happenin'.

skylark40 wrote:...I have also asked about trying a hybrid mask and she said they carry the Liberty. I haven't researched it, yet - does anyone have any comments about it?...

Most of who wear hybrids wear the Hybrid not the ResMed Liberty. Hybrid is $119 from Johnny (https://www.cpap.com); it comes with 3 sizes of oral cushion and 3 sizes of pillows that can be set to 2 heights making it easier to get a good fit than with the Liberty. I have both and can't get the Liberty to seal, i.e., not leak.