Two questions: one mask/one machine

Third night with CPAP and I have a couple of questions:
1. I use a Respironics Comfort Classic Nasal mask, my first mask. It seems to be fine except for the fact that my upper lip is very tender and sore. I have a very short mustache and beard. It doesn't necessarily bother me at night, but in the morning it is a bit painful. I have attempted adjustments with the straps and if I loosen the strap too much, I get leaks. Any suggestions on making strap adjustments or should I call DME and try a new mask?
2. I have a PR Remstar Pro C-flex plus machine. When a check the AHI on the LED screen, it is showing 9.8 after three nights and a few naps. It was 10.3 after the first night. I know AHI is suppose to be under 5, but I'm not sure how accurate the AHI showing on the LED screen is after only three nights. I had 22 AHI at sleep study.
Thanks in advance for any replies. Wonderful folks at this site.

goirish, You might try the current mask a bit longer before giving up on the nasal mask. You might find the pillow type to be more comfortable. You could go ahead and talk to the DME if you are that uncomfortable. Some lanisoh cream (found in the baby section- it's a cream for breast feeding mothers) may help with the soreness.
I would wait a month before being concerned with the AHI. If after a month it is still high you may need a pressure adjustment. Are you do for a check up after a certain amount of time? A lot depends on how you feel, too. There is debate on how important AHI is in determining efficacy of treatment.
Hang in there,sounds like you use the mask all night, every night, and naps, and keep us posted. Good Luck.

If you can't get the mask to work for you, then go ahead and try a different mask. The DME gets a free replacement from the manufacturer if you return it within 30 days to try another one. With a mustache, you might find that a nasal pillows mask is easier to seal.

The PR machines do a bad job of displaying data on the machine itself. The AHI you are seeing on the machine is either a 7 or 30 day average. So it's good that it's dropping. But you can get so much more information from your machine. One option is to buy the EncoreViewer software for about $100. There are also 2 free options available that have been developed by people here. Search the forum for Onkor or SleepyHead and you should find them. These programs will both give you very detailed information about each night, including your AHI broken down by event type, leak data, etc.

One thing to remember is that, until you have eliminated (or at least cut down on) leaks, your AHI is meaningless. A really high leak can confuse the machine with its event reporting, plus if you have a leak then you aren't getting the full effect of your treatment. So looking at your leak using the software is the very first step before you worry about your AHI.

Also, anytime you make a change (mask, pressure, etc.) you should always wait a week or two before making another change. Same goes for starting therapy. Don't worry about your AHI for the first 3 nights, because you are still getting used to everything. If the mask doesn't work, go ahead and change it, but give yourself at least a few weeks on the CPAP before worrying about your AHI. My doctor refused to make any changes to my pressure setting sooner than 1 month.

Your leaks may not be a problem. Depends on how high the leaks are. Do you have a number?

Please take the time to register here at the forum and add your equipment to your Profile.
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Also if you register members can send you private emails with ideas on how to get your reports so you can see full details each night and not just the on screen average.
Here are examples of your software options.
viewtopic.php?f=1&t=64906&st=0&sk=t&sd= ... re+options

LSAT asks about leak numbers but don't bother with the leak number on your machine screen. Again it is only the 7 and 30 day average so virtually useless EXCEPT that if the number is anything more tha zero you have BIG leak problems. To get reliable leak data you must use software--check the online options for Onkor or Sleepyhead.

goirish wrote:and a few naps.

I don't know if this happened to you, but when I take a short nap (less than an hour) while using CPAP, the AHI for that short period of time will often come out wayyyy higher than it does when I've had a 4 hour or longer sleep session. That can make the "weekly" average AHI be higher (I think of it as "artificially higher) than it would probably have been if the naps had lasted at least at least a couple of hours at a time.

That said, it's certainly advisable to use your CPAP even for short catnaps -- and not worry about it possibly inflating the "weekly" AHI. Just makes it more difficult to really get a handle on what your treated AHI really is. The software is a better way to look at the overall picture.

Not being able to see "daily" data in the little window on the machine is one of the reasons I'm not as fond of Respironics (Philips Respironics) machines as I am of ResMed machines which do provide daily data in the window, as well as the weekly/monthly results.

Janknitz wrote:LSAT asks about leak numbers but don't bother with the leak number on your machine screen. Again it is only the 7 and 30 day average so virtually useless EXCEPT that if the number is anything more tha zero you have BIG leak problems. To get reliable leak data you must use software--check the online options for Onkor or Sleepyhead.

First of all, thanks for all the responses. On my machine, it has a category that says "LARGE LEAK" in the info section. It states that the seven and thirty day average is 1%. I thought that meant I wasn't experience much leakage, but after reading your post, it sounds like it should be a concern. Am I correct? Thanks

goirish wrote: It states that the seven and thirty day average is 1%. I thought that meant I wasn't experience much leakage, but after reading your post, it sounds like it should be a concern. Am I correct? Thanks

1 % of the time spent using the machine you have had a Large Leak. It takes a HUGE leak to be flagged as large. Way beyond what I would find acceptable in the neighborhood of 90 L/min (Respironics has never give us an exact number).
Best thing to do is look at the software reports to see exactly how much leak is going on. You can have a 75 L/min leak and it won't ever trigger the Large Leak notice and depending on mask and pressure...that is way more than I would be happy with.