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Posted: Thu Mar 23, 2006 5:18 pm
by Brent Hutto
roztom wrote:GO slow with the SWift.
Try wearing it while you're watching TV or reading.
Initially feel free to wear it for a few hours only, then switch off to your other mask.
Everyone is different, if your nose feels tender during the night, change masks, don't force it.
Using the Swift is kind of like learning to ride a bike - you might fall off a few times
Tom,
I'm going to try it at bedtime tonight and just keep the Ultra Mirage handy if I need to switch out. Heck, I've been having to get up in the middle of the night to stop leaks with the mask anyway. Based on just now sticking the "Large" pillow on and breathing 10cm of pressure for a few minutes...
...man, I hope I can tolerate this thing! I didn't even snug up the straps or figure out where to put the hose and it's already working perfectly (for five minutes anyway). No fiddling, no leaks, no problems. Of course I know the gremlins will show up about the time I hit my first REM sleep of the night but hopefully I'll eventually figure out how to keep them at bay. At first try it sure seems like magic.
Very, very comfortable. Very side-sleepable. There's quite a whooshing noise every time I inhale (my Ultra Mirage II is so silent I can hear the APAP changing pitch with inhalation) but I'll tune that out after a while. At least it's rhythmic with my breathing.
BTW, once you get everything right with yours will we have to start calling you Tom Swift?
Posted: Thu Mar 23, 2006 8:01 pm
by roztom
LOL Tom Swift !!! That's Good.
Actually I haven't felt too Swift lately. I went back on my Mirage Nasal for 2 nights to give my Nares a rest from the Swift and I'm going to hit it again tonight wiht the Swift.
Swift 5 Tom 3.
I figure it's time to give the Swift another shot and see if I can make it thru the night.
When I wear the Swift I think of Lloyd Bridges and Sea Hunt..Whoosh, Whoosh.
Good luck,
Tom
Posted: Thu Mar 23, 2006 10:30 pm
by snork1
[quote="roztom"]LOL Tom Swift !!! That's Good.
Actually I haven't felt too Swift lately. I went back on my Mirage Nasal for 2 nights to give my Nares a rest from the Swift and I'm going to hit it again tonight wiht the Swift.
Swift 5 Tom 3.
I figure it's time to give the Swift another shot and see if I can make it thru the night.
When I wear the Swift I think of Lloyd Bridges and Sea Hunt..Whoosh, Whoosh.
Good luck,
Tom
Posted: Fri Mar 24, 2006 6:14 am
by Brent Hutto
Well, assuming my DME is able to fix me up with a better-fitting mask today (I'm pretty sure my "Large" Ultra Mirage II is just a tiny bit too big) I'll try to be a good boy and alternate the Swift with the mask. But it is going to be soooo tempting wear the Swift again. It will leak if I really dig my head into the pillow and wiggle around (i.e. I can twist the headgear so much that one side or the other of the pillow moves away from my nose) but if I just get in a normal position and relax it is pretty leak free.
I wore it from lights out at 9:45PM until a couple minutes before 5:00AM when I woke up and my left nostril was getting a bit irritated. I slept OK from about 10:30-11:30 and then like a log from about 11:30PM until 2:00AM (bathroom break). I also slept pretty well again from 2:30-4:45ish. That's about like the best single night's sleep out of my week with the Ultra Mirage II. I found the stiff portion of the headgear on my cheeks to be much itchier and more irritating than the nasal pillow part, at least for the fist seven hours or so.
The numbers reported by the APAP were exactly like what I get with the mask, not particularly encouraging. My 95th-percentile pressure was 10.6cm (APAP 7-12 setting), my leak rate was 0.42L/sec and my AI=2.8 and HI=11.9 for an AHI=14.7 which has been pretty consistently true for my first week.
Swift n00bies tips
Posted: Fri Mar 24, 2006 8:32 am
by yardbird
Swift pillows... which ones?
If you're average size, start with medium pillows. If you find you're getting a sore nose INSIDE your nares, you PROBABLY need to use the next size up. (See next section as you may also simply be wearing it too tight)
Adjusting Strap Tension
DO NOT keep tightening the straps to get a seal. Put the Swift on, loosen the straps until it leaks, then tighten the top and back in VERY small amounts just until you get it to stop leaking. REMEMBER you can rotate the "barrel" part with the pillows on it to get the best angle against your nares. This may not be your "final" adjustment, but you'll be really close. You may need to tighten just a little but you probably won't need to loosen it.
The pillows should be resting AGAINST your nares, not being pulled up tight inside them.
From personal experience and observation...
This pillow interface seems to get noisey if you regularly use a pressure over approximately 11cm. My normal pressure range runs between 6 and 10 and I have never found it to be noisey.
At my pressure range, while quiet, I can MAKE it louder by having anything come in close proximity to the exhaust ports which shoot out in front of you. A blanket, pillow, my arm, whatever... if something comes within a few inches of the exhaust ports you'll probably hear the air hitting it.
Some folks have suggested putting plastic mesh inside the barrel to baffle the air. I haven't found this necessary. Again... my pressure runs between 6 and 10. Higher pressures might make the mesh useful, but I've simply not found it necessary.
The PadaCheek buckle covers for the Swift are a wonderful addition. I never really had any issues with feeling the buckles, but the covers DID alleviate the visits from the night time hair knot tying elves.
I live in the northeast (near Niagara Falls). Humid summer nights, very dry winter nights. My humidifier is on the middle setting. I get absolutely no rainout at all. My hose does NOT run UP to a hook or fastening on my headboard and then DOWN to me. It runs along the head of my mattress and basically comes UP to me. My machine sits on a shelf on a nightstand about 3 inches off the floor.
Hope this helps someone when trying the Swift.
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Posted: Fri Mar 24, 2006 8:48 am
by JohnnySouth
Thanks, Yardbird!
VERY helpful - I am on day 11 with the Swift (and with Cpap in general) so I am still adjusting - your post adressed several questions I had - and has given me some tools/tweaks to try tonight and subsequent nights.
Posted: Fri Mar 24, 2006 9:53 am
by ozij
Brent,
You might try raising the lower pressure slightly, to get rid of those hypopneas. They were only about half of your events in the sleep study, but they're a major part now.
Also, take into account that for some cases of hypopneas, cpap is better than APAP (derek is a case in point). This has to do with the way the hypopneas appear, and the machines' algorithms.
O.
Posted: Fri Mar 24, 2006 11:13 am
by Brent Hutto
I'm gathering 30 days of data at 7-12cm for the sleep doctor. My suspicion is that many (most?) of those "hypopneas" are actually reductions or hesitations of breathing subsequent to arousals. In my sleep studies, I had a total rate of over 80 arousals+microarousals per hour both in the diagnostic night and, unfortunately, during my titration night. He picked 7cm because in my titration study I did as well during my brief interval at 7cm as I did at the ending point of 9cm.
I know my normal breathing pattern is to slow down or skip breaths at random times anyway. I have a feeling that the APAP may be pretty close to doing what it can as far as keeping my airway patent and that I'm going to have a long drawn-out process of elimination to figure out why my sleep is so fragmented.
But regarding your suggestion, I'd bet a nickel that when the 30 days are up the sleep doc is going to either bump me up to 9-10cm on the APAP low end or even try CPAP at something over 10cm. Won't that be nice...
Posted: Sat Mar 25, 2006 6:51 am
by Brent Hutto
Bella wrote:Brent: My first mask was a ComfortFull ff. It leaked like heck, so I switched to the Swift. Now I happen to be a back sleeper, so there is that difference, but I adjusted to it with no problem. I don't use any gel. Plus I don't find it noisy now. I think it may depend on your machine too. I had a Harmony S/T with pressures 14/4. The Swift was noisy with it. When I switched to the Synchrony S/T, the Swift became a lot quieter. Perhaps the newer technology.
Bella,
I brought home a Mirage Ultra FF yesterday because it seemed to fit better than any size of the Ultra Mirage II (my original mask from the DME) or Activa. I used it for the first two hours last night but then took it off for a moment around midnight to put on my glasses and tell my APAP machine that I had changed masks. Then I couldn't get it resealed on my face to save my life, maybe I was just sleepy or maybe I got too p-o'd to be patient with it.
So anyway, I switched back to the Swift. After the first night my nose was a little stretched-out feeling later in the day but not sore. I figured I'd be taking a chance using it a second night in a row but I wore it for over 5 hours and no problems. I seem to be one of the lucky ones like you, the Swift just fits well and works well right off the bat.
It is definitely louder than the Ultra Mirage nasal or full-face masks but for normal breathing at pressure up to 11cm it isn't that bad. When I first tried it out I was taking some really deep breaths and it can get noisy on inhale for for real-world nighttime breathing it's less of an issue. The only real noise problem is if the exhaust comes too close to the bed covers, that'll wake me up because it sounds like a leak.
It works great on my back or on the side that leaves the hose on the top of my head. Not so well with the hose-side down of course. And I do have to be a little careful not to dig my head down into the pillow (but not as careful a with a nasal or FF mask).
Posted: Sat Mar 25, 2006 11:52 am
by Linda3032
I switched back to the Swift. After the first night my nose was a little stretched-out feeling later in the day but not sore.
Brent, why would your nose have a stretched-out feeling? You are not putting the pillows up inside your nares are you?
Or maybe I did it wrong when I tried the Swift. I just put the pillows to my nares, and the pressure inflated them a little to form a seal. After the Aura, I just hated everything about the Swift.
Posted: Sat Mar 25, 2006 1:50 pm
by Brent Hutto
Linda3032 wrote:I switched back to the Swift. After the first night my nose was a little stretched-out feeling later in the day but not sore.
Brent, why would your nose have a stretched-out feeling? You are not putting the pillows up inside your nares are you?
Or maybe I did it wrong when I tried the Swift. I just put the pillows to my nares, and the pressure inflated them a little to form a seal. After the Aura, I just hated everything about the Swift.
Well, the smaller part of the two nozzles does go up in my nose a ways (maybe 1/4" or so) but that's not where it feels stretched out. It's like my whole nose has been opened up to twice its usual diameter. That's a good thing, I normally have congestion and nose whistles when I breathe. But the lining of my nose feels kind of pulled taut like a balloon that's stretched to the breaking point.
When the machine is running I can put my finger on the outside of my nose and feel it bulging out a bit. I think that's what irritates the lining. I used the Swift again for part of last night and had no irritation at all today so it was probably just a first-night thing.
Posted: Sat Mar 25, 2006 2:04 pm
by Linda3032
I only used mine for an hour - so I'm definitely not a Swift expert , but when I tried to get rid of leaks, I had to tighten the straps. Then I got Pig Nose - yes, my nostrils were definitely flared out. .....
I guess you could say "I'm not too Swift".
Hardy Har.
Posted: Sat Mar 25, 2006 8:02 pm
by roztom
I'm not TOm Swift, not yet.
I'm STILL struggling with it.
Swift 6 TOm 3.
I seems one of my Nares gets an abrasion on it. My Nares are large and slotted so I think I'm using the right size - large. I keeps it as loose as it will go just before I leak.
I'm still not sure if I'll get it right. I'm beginning to question IF I can wear a nasal pillow mask.
I've done everything.... GRRR.
Tom
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Posted: Sat Mar 25, 2006 8:14 pm
by TerryB
Hi Tom,
I'm just going into night number three with the Swfit and I have nice round nares. I'm very happy with the Swift so far.
Have you rolled the barrel forward and back to change the angle of the pillows? It seems like just about every direction and angle can be tweaked and I suppose nare shape would be one of those inponderables that could screw you up. I remember one on line mask fitting questionaire which nare shape. I'll see if I can find the link.
TerryB
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Posted: Sat Mar 25, 2006 8:17 pm
by roztom
Terry I think I might be a Nare freak
I might just not be qualified.
tom