Mask change central coming back!

Question: I have changed masks last night from f&p H431ffm to a Resmed quattro FX ffm (which I like!), however my AHI has increased with central up by nearly 50%, leaks are lower with quattro FX. My question is, with the smaller size and volume with quattro fx do I infact need less pressure?. Has any one noticed an AHI difference when changing between Full face masks?.(I know that there are posts with regards to changing from nasal to ffm and vice versa).

A bit of background, I thought I was making progress over the last 4 weeks, I have been averaging 3.7 AHI with my full face mask, min pressure 9.6 max 11.4. However I noted that I had a sore on the bridge of my nose, itchy face (I use a cloth mask liner and moles skin) and the mask just felt more uncomfortable as time as gone on. So I decide to try a nasal pillows and cushion mask as also I wanted to try get my AHI consistently down from the average of 3.7 that I was getting with the F&P H431 ffm. It did not work for me as I was mouth breathing (I had posted about this a few weeks back), any way to cut a long story short I went back to the H431, and initially got a AHI 2.6, 2.7, 3.5, 3.6, 1.7, 4.8, 3.9, 5.5 but started to increasingly feel uncomfortable with the mask to the pont that I am waking up wanting to take the mask off and a couple of days of no therapy. I restrated therapy again, slight increasing the min to 9.8 and got 4.14, 5.75 and finally last night changed to quattro fx, very comfortable, low leaks (mean 6, 95% 13), but AHI 7.9!!, CENTRAL = 5.4, Hyps =2.37, Obstuctives = 0.1) and all from one of 2 big clusters.

I note that when I first stared in December last year with the S9 and the H431 mask the my centrals were high, I hope that I do not have to go thru several months with the new mask before the centrals start to come down

Thanks for your help, feel bad today!!

Hi Summer,
I'm sorry I can't really help, but I can definitely relate.
I have personally found that different masks require changes in pressure. I have also experienced these clusters of CSA's.
I'm suspecting that I do better with centrals when my AutoSet is used as APAP. Don't know that for sure, but will test it tonight and share any data.

My initial thoughts are... when changing masks, did you change the mask settings on your S9? If not, it will affect how your S9 performs and possible leak rates.

Sheriff

by Sheriff Buford on Thu Feb 16, 2012 1:48 pm

My initial thoughts are... when changing masks, did you change the mask settings on your S9? If not, it will affect how your S9 performs and possible leak rates.

Sheriff

Sheriff, the mask type is currently set to Full face for the past few weeks, it could have been left on the pillows setting that I has a few weeks ago! so thank you for asking!!

Whenever I see clusters (large number) of "centrals" I immediately suspect sleep transition or semi awake events. Random here and there...yeah maybe real but when nothing much going on except for a truckload of stuff within a small time frame...I think awake or semi awake fiddling with stuff and false positives on the report.
This happens to me fairly often during the last hour or so that I might be sort of waking up but don't get up right away. It also happens when I wake up fiddling with my mask during the night.

This may or may not be what is going on with your "clusters" of centrals. Before I would really worry about them I would make sure no chance of them being "false positives" caused by fiddling with the mask.

by Pugsy on Thu Feb 16, 2012 2:53 pm

Whenever I see clusters (large number) of "centrals" I immediately suspect sleep transition or semi awake events. Random here and there...yeah maybe real but when nothing much going on except for a truckload of stuff within a small time frame...I think awake or semi awake fiddling with stuff and false positives on the report.
This happens to me fairly often during the last hour or so that I might be sort of waking up but don't get up right away. It also happens when I wake up fiddling with my mask during the night.

This may or may not be what is going on with your "clusters" of centrals. Before I would really worry about them I would make sure no chance of them being "false positives" caused by fiddling with the mask.

1
Hi Pugsy, I hope your are well!, I just feel awful today!, so I am trying to review the last 10 days stats, and its seems to have started when I increased the min pressure by 0.2 from 9.6 to 9.8 on 10th feb. Although leading up to this date I was having mask problems, just not comfortable any more with H431. Anyway after this date and prior to using the quattro last night I seem to get one big cluster at about 3.00am with mostly Centrals, and the average over 3 nights the centrals are higher than before the 10th. I have a web cam now, and I seem to be semi awake during this time and I felt that it was a mask comfort issue, together with variable leaks that I decided move to the quattro FX ffm.

I awoke last night at 3.10am lying on my side, not sure why I woke(could be dry mouth) but looking a time fram of 40 mins I looked more static than the night before, there were periods were I was pretty motionless , I stopped machine checked AHI it was 3.4 after 4.2 hours sleep. Mask felt good, very quiet and light. I resealed the mask and put machine back on (ramp) 20 mins, next I woke at 5.55am. I later checked sleepyhead and all 90% of the central + hypopneas (40+ events ) happened between 3.30 and 6.00 am. I think the central were they real deal, and I seem prone to them if I make any changes to the settings etc, but I have had some good results over the past weeks. Last night I not sure whether an arousal cause the central or the central causes the arousal!

But I like the new quattro FX FFM, so TONIGHT I'm thinking of lowering the max pressure to 10.8 leave min at 9.8, or may be I should just reduce min back to were it was to 9.6. It just seems that I may need less pressure with quattro, and that's why centrals have gone up more.
Any suggestions would be welcome, please!!

Interesting. I posting something similar this morning (Why Would Apnea increase with a different mask). I switched from Phillips fit life full face mask to Quattro FX and experienced the same thing. With 5400 hours of use on resmed Auto 25 I had average of 0.4 over a year and AHI around 9. With this I have been feeling very good. Due to some allergic reaction I bought the other mask thinking the mask had something to do with the reaction. Next morning AI was an order of magnitude higher at 4.0 and AHI was 19. I haven't seen those number for a long time. After a couple of days I found out the mask was not causing the allergic reaction (skin redding) so I switched back to the Fit life and the numbers are back down. Today I took the Quattro back for another Fit LIfe.

Too bad as I really liked the Quattro. The comfort and fit were good. Seemed like there was a lot more air being expelled than the fit life. The settings were per manufacturers instructions. Everything identical except the mask. Very curious. I'll be interested to see if anyone has an answer, perhaps the manufacturer would know.

My 95% pressure is in the 11-12 range with the Swift FX, but any of my full face masks gives me 13-14 cm.
The mask setting on the machine has been set for the correct mask.
Maybe it's related to the volume of air allowed through the ventilation ports.
Of course, the vents are designed to flush co2 out of the greater volume inside the mask.