CPAPtalk.com

SleepingUgly wrote:

ozij wrote:A third question: Do you have the same flow limitations when you're awake?

This is a good question. I am not sure the answer. I tend to read in bed with the mask before I turn out the light, so I'm recording awake time, but I just don't know if the graphs are saying that I have FLs or just showing erratic breathing that's more common when someone is awake. -SWS?

As it turns out SU tends not to present significant FL patterns during wake... at least while wearing CPAP at 4cm baseline. At least that's my take after examining several of her S9 charts...



Take a look at the very beginning of SU's sleep session above---right after SU puts on her mask. Specifically look at what SU's flow graph does in 8-hour resolution. Look at those -45 to +45 peak-to-peak flow swings while SU is awake. That's highly characteristic for SU right after putting on the mask. Her volumes are much higher then, and her breathing patterns are much more erratic then. But she doesn't really present her near-continuous flow-limited breathing patterns until after her flow volumes settle down to around -25 to +25 peak-to-peak (presumable continuous sleep). She presents a few during the early wake-associated segment, but those FL might also be during interspersed sleep---before continuous sleep gets under way. And some are FL scoring artifacts IMO given her highly erratic breathing during wake.

In summary each night, at that presumable sleep onset threshold, SU converts to presenting nearly continuous flow-limited breathing patterns for the remainder of the night at her 4cm baseline.

-SWS wrote:

SleepingUgly wrote:

ozij wrote:A third question: Do you have the same flow limitations when you're awake?

... I tend to read in bed with the mask before I turn out the light, so I'm recording awake time, but I just don't know if the graphs are saying that I have FLs or just showing erratic breathing that's more common when someone is awake.

She presents a few during the early wake-associated segment, but those FL might also be during interspersed sleep---before continuous sleep gets under way. And some are FL scoring artifacts IMO given her highly erratic breathing during wake.

The erratic breathing below just might be an example of scoring artifact during SU's initial wake segment:



The above highly-erratic breathing segment was scored as FL and it was also scored as a hypopnea by S9. If SU were awake then, PSG would have discarded those as SDB events---since sleep is prerequisite for scoring sleep disordered breathing.

If SU were asleep, the above highly-erratic flow patterns conceivably fall outside the envelope of reliable algorithmic event detection...

SleepingUgly wrote:

ozij wrote: Did you soak the mask (or at least its cushion) in warm soapy water warm for 30 to 45 minutes before using it? That was recommended by Respironics reps in talkaboutsleep years ago -- and it sure solved red mark problems for me.

Do you mean soak it for 30 to 45 minutes nightly? And then it's somewhat wet when you put it on?

I mean just once. Even if you've already washed it a few times.

SleepingUgly wrote:
I just haven't found a FFM that works with my face and since Dr. Gold's talk, I feel less motivated to try to make a FFM work if I can get a nasal one to.

SU I don't know whether you've tried the Hybrid, but... In my experience, although the Hybrid is technically a FFM, it functions as a nasal pillow mask. Because of the chin flap, my mouth always stays closed and I breathe exclusively through my nose. I wish there were a way to eliminate the mouth piece and just keep the pillows and chin flap. You can also cut the pillows apart and adjust for nostrils that aren't symetrical.

Just a comment to consider before writing off all FFMs.


r

I did try the hybrid at one time, but I will keep it in the back of my mind as an option if I can't get the Activa-LT or Swift LT to work. Thanks for the reminder.

O., I'll try soaking the mask.

KimberlyM wrote:I use the Swift LT with O-rings, as recommended by another member here. If you get sores in your nose because you feel you have to have the pillows stuffed into your nose a bit, you might try the O-rings. It makes the base of the pillow more rigid so the pillow stays put and I can pull it away from my face and put it back more lightly. They seem to stay well that way without being too far into my nose. I hope you find relief soon!

I'm not sure what the O-rings are. I saw one thread about it when I searched, but I didn't really understand it. I'll search some more.

SleepingUgly wrote:

KimberlyM wrote:I use the Swift LT with O-rings, as recommended by another member here. If you get sores in your nose because you feel you have to have the pillows stuffed into your nose a bit, you might try the O-rings. It makes the base of the pillow more rigid so the pillow stays put and I can pull it away from my face and put it back more lightly. They seem to stay well that way without being too far into my nose. I hope you find relief soon!

I'm not sure what the O-rings are. I saw one thread about it when I searched, but I didn't really understand it. I'll search some more.

I don't know which thread you already saw, SU, so it may or may not have been oldtimer's fix. If what you saw wasn't oldtimer's "O ring fix", you can find a link to it here:

Lab Rat Awards
viewtopic.php?p=127492
Scroll down to the Swift FX section -- oldtimer's O ring fix.

This was the thread that gave me the specific measurements I was able to give to one of my mechanically-minded friends so he could pick me up some O-rings for my LT at a supply place: viewtopic.php?f=1&t=45777&p=411389#p411149

This fix made all the difference for me. I've been using the same set of pillows for well over a year now. Why? Because I can.

jnk wrote:This was the thread that gave me the specific measurements I was able to give to one of my mechanically-minded friends so he could pick me up some O-rings for my LT at a supply place: viewtopic.php?f=1&t=45777&p=411389#p411149

This fix made all the difference for me. I've been using the same set of pillows for well over a year now. Why? Because I can.

Thanks for that link to gl's post, Jeff! I've now added that link under oldtimer's award in the Swift LT category on the Lab Rat Awards page.
Why? Because I can.

I have found 2 things that has helped me with my swift LT nasal pillows. The first thing I do is to place a small rubber band ( the type that is used with hair braids) around both of the pillows . This allows the pillows to be angled at the right position to mimiumise leaks. I also before placing the pillows on my nares I start my cpap to allow them inflate which allows the placement on the nares & not inside. Hope this helps.

SleepingUgly wrote:

KimberlyM wrote:I use the Swift LT with O-rings, as recommended by another member here. If you get sores in your nose because you feel you have to have the pillows stuffed into your nose a bit, you might try the O-rings. It makes the base of the pillow more rigid so the pillow stays put and I can pull it away from my face and put it back more lightly. They seem to stay well that way without being too far into my nose. I hope you find relief soon!

I'm not sure what the O-rings are. I saw one thread about it when I searched, but I didn't really understand it. I'll search some more.

I'm sorry, fortunately it appears others have put the link up to the O-ring fix. I bought mine at Ace Hardware. They are the #93 O-rings for size medium nasal pillows. They fit around the base of each pillow and hold it up a bit so the pillows don't collapse so easily. I use them even on my new pillows because I like the way they hold the pillow up.

Well, I managed almost 7 hours of (interrupted) mask sleep time last night with the Swift LT for Her! I was pleasantly surprised that I could keep it on so long.

For some reason I feel I can't breathe with nasal pillows at low pressures, so I had to put it up to 6cm instead of 5cm. The straps on the side of my face were a little uncomfortable when I laid on them, but I put lansinoh in my nostrils and they didn't really hurt. Toward the end of the mask time I was opening my mouth, though. I wonder if it's due to REM, where nearly all my hypopneas occur. Perhaps my mouth opening is either due to increased atonia, or perhaps increased need for pressure during REM? These are just guesses.

My AHI was 1.5, and my 95% leak was 3.6. Some of my AHI was attributable to centrals that I think registered after I woke up, got up, and wasn't yet asleep. I can't tell if my FLs are any better than they were at 4 or 5cm using the Activa-LT...perhaps slightly. I need to remember how to post a graph, as it's been so long since I've done it.

The "arms" of the Swift LT for Her that touch my face have those covers on them, but is there a way to make them more comfortable to lie on? Can anyone speak to whether Padacheek's covers for these help with the discomfort? Here is a link to them:

http://www.padacheek.com/PAC_SwiftLT.html

If I hadn't made this "public commitment" and gotten this support, I wouldn't have worn the mask last night, as I had to be up early, and fear of trashing my sleep further would have made me skip a night. So thanks again!!

SleepingUgly wrote:Perhaps my mouth opening is either due to increased atonia, or perhaps increased need for pressure during REM? These are just guesses.

As long as we're just guessing , could it be a a sign of deeper sleep?

Drowsy Dancer

SU, I hope you have a great day after a better night's sleep!

SleepingUgly wrote:Well, I managed almost 7 hours of (interrupted) mask sleep time last night with the Swift LT for Her! I was pleasantly surprised that I could keep it on so long.

For some reason I feel I can't breathe with nasal pillows at low pressures, so I had to put it up to 6cm instead of 5cm. The straps on the side of my face were a little uncomfortable when I laid on them, but I put lansinoh in my nostrils and they didn't really hurt. Toward the end of the mask time I was opening my mouth, though. I wonder if it's due to REM, where nearly all my hypopneas occur. Perhaps my mouth opening is either due to increased atonia, or perhaps increased need for pressure during REM? These are just guesses.

My AHI was 1.5, and my 95% leak was 3.6. Some of my AHI was attributable to centrals that I think registered after I woke up, got up, and wasn't yet asleep. I can't tell if my FLs are any better than they were at 4 or 5cm using the Activa-LT...perhaps slightly. I need to remember how to post a graph, as it's been so long since I've done it.

The "arms" of the Swift LT for Her that touch my face have those covers on them, but is there a way to make them more comfortable to lie on? Can anyone speak to whether Padacheek's covers for these help with the discomfort? Here is a link to them:

http://www.padacheek.com/PAC_SwiftLT.html

If I hadn't made this "public commitment" and gotten this support, I wouldn't have worn the mask last night, as I had to be up early, and fear of trashing my sleep further would have made me skip a night. So thanks again!!

Good for you!!! You asked about Padacheek's covers. I made some out of fairly thick polar fleece and it is much more comfortable than it was, so I assume Padacheek's covers would do the same thing, if they have any padding to them. The arms on the Swift LT are pretty stiff, so your bed pillow is a factor too. You want a pillow that is supportive but not too hard or soft.

Your mouth opening could be a number of things. Did you wake up with a stuffy nose? If my nose is stuffy, my mouth opens. Also, if you were completely relaxed and in deep sleep, it could be that your jaw relaxed and your mouth opened. That also has happened to me. Congrats on keeping the mask on!

Just a comment on the Lansinoh. I know many people have success with it on here so I bought some when I got my mask. It actually caused my seal to break repeatedly. Another member recommended going without it. Now I just go to bed with a clean, oil free nose and clean nasal pillow and the seal is excellent. If you have trouble with leaking as you go along, you may consider going without the Lansinoh.