CPAP Therapy ?'s

Hi Everyone... looking for some expert opinions here... I've been using my CPAP since December 2012. I sleep fine with my masks on. I have both a nasal pillow Swift FX and a Mirage Quattro. I was noticing many leaks with the Quattro, just couldn't get a tight/comfortable fit. The FX i have been able to crank down, but the past few days I have those nasal pillows jammed in so tight, that my nostrils are starting to hurt. I have had a horrible time with congestion so I have been testing the humidity levels, using a sinus rinse and all the other stuff required with my allergies... Fun times.

My average nightly AHI is .55. Seems pretty good to me, but i don't know. I have noticed no more morning headaches. Yay... And I am sure it is helping me in other ways. But, I am still extremly fatigued. I'm sleeping well as before.
My husband even noticed saying, you seem more tired than before you started on the cpap. I know it takes time.

Is an AHI of .55 good enough? Any suggestions on how to improve this? I am wondering if a increase in pressure (currently at 11) would help lower the AHI and help me feel better?? Also, another thing I noticed is when wearing the FFM i sometimes feel like I am not getting enough air flow through the mask and I wake up gasping. Mostly I use the pillows.

I am meeting with my ENT next week to see what he says. Would like to be able to have a good discussion with him.

SnuzzieV wrote:Hi Everyone... looking for some expert opinions here... I've been using my CPAP since December 2012. I sleep fine with my masks on. I have both a nasal pillow Swift FX and a Mirage Quattro. I was noticing many leaks with the Quattro, just couldn't get a tight/comfortable fit. The FX i have been able to crank down, but the past few days I have those nasal pillows jammed in so tight, that my nostrils are starting to hurt. I have had a horrible time with congestion so I have been testing the humidity levels, using a sinus rinse and all the other stuff required with my allergies... Fun times.

My average nightly AHI is .55. Seems pretty good to me, but i don't know. I have noticed no more morning headaches. Yay... And I am sure it is helping me in other ways. But, I am still extremly fatigued. I'm sleeping well as before.
My husband even noticed saying, you seem more tired than before you started on the cpap. I know it takes time.

Is an AHI of .55 good enough? Any suggestions on how to improve this? I am wondering if a increase in pressure (currently at 11) would help lower the AHI and help me feel better?? Also, another thing I noticed is when wearing the FFM i sometimes feel like I am not getting enough air flow through the mask and I wake up gasping. Mostly I use the pillows.

I am meeting with my ENT next week to see what he says. Would like to be able to have a good discussion with him.

How do you know what your AHI is? Your profile shows a non-data-capable machine (aka "brick" ).

Machine: S9 Escape™ CPAP Machine with EPR™
Mask: Mirage Quattro™ Full Face CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control

Den

.

In terms of numbers, an AHI of .55 is great ... many people would be THRILLED to get close to that.

There's something wrong though ... you shouldn't have to "crank down" your mask like that. This is a common mistake for new CPAP users. Regardless of the kind of mask (the FFM or the nasal pillows) the trick is to use the least possible pressure and let the silicone "blow up like a balloon" to create the seal.

This is way easier said than done, I know. The natural instinct when a leak has awakened you is to tighten the mask. That often makes the leak stop, and you fall asleep. Well done, right? But in fact this will become a vicious loop and before long you'll have that sucker tightened up so much you'll create a bruise!

Usually when I have a leak I REMOVE the mask, let the seals restore their normal shape (two seconds ... sometimes I block the pillow holes to puff them up) and then put it back on. That's often all that's needed.

You should also look in to Lansinoh ... it is a highly refined lanolin ointment. To use it take a very small amount (VERY) and apply to the pillows. It's a little tacky and helps create a seal. You can fine Lansinoh online and in many larger drugs stores. It's typically near the infant bottle feeding area, because it's primary purpose is to soothe sore nipples from breastfeeding. Note, however, that it's location is NEAR that area. In the Walgreens I found it at, it was actually in the same aisle but on the opposite side, on the very bottom.

Lowering your AHI isn't going to help ... that's not the problem now. The problem now is that your sleep is disrupted from getting used to therapy, and probably from leaking, etc.

SnuzzieV wrote:Hi Everyone... looking for some expert opinions here... I've been using my CPAP since December 2012. I sleep fine with my masks on. I have both a nasal pillow Swift FX and a Mirage Quattro. I was noticing many leaks with the Quattro, just couldn't get a tight/comfortable fit. The FX i have been able to crank down, but the past few days I have those nasal pillows jammed in so tight, that my nostrils are starting to hurt. I have had a horrible time with congestion so I have been testing the humidity levels, using a sinus rinse and all the other stuff required with my allergies... Fun times.

My average nightly AHI is .55. Seems pretty good to me, but i don't know. I have noticed no more morning headaches. Yay... And I am sure it is helping me in other ways. But, I am still extremly fatigued. I'm sleeping well as before.
My husband even noticed saying, you seem more tired than before you started on the cpap. I know it takes time.

Is an AHI of .55 good enough? Any suggestions on how to improve this? I am wondering if a increase in pressure (currently at 11) would help lower the AHI and help me feel better?? Also, another thing I noticed is when wearing the FFM i sometimes feel like I am not getting enough air flow through the mask and I wake up gasping. Mostly I use the pillows.

I am meeting with my ENT next week to see what he says. Would like to be able to have a good discussion with him.

I don't use nasal pillows...but...I know they are not supposed to be in the nostrils. The should float on the outside of the nose. Could that be part of the problem?

Sorry... updated my profile... i traded it in for an S9 Elite.

SnuzzieV

I agree with Khauser, your AHI of .55 is enviable - most of us would love to achieve that! Now as for the pillows, I am using the Swift LT, very similar to your Swift FX & the when you have a leak, removing the pillow for a few seconds works for me, allows the pillow to physically 'reset'. If you are having trouble keeping a seal without stuffing the pillow up your nose (and its not supposed to be stuffed up the nose), then you may have the wrong size or perhaps even the wrong mask. The pillow should 'ride' at the outside edge of your nostril, not in the nare.

Another trick I learned from a forum member is to stabilize the pillow with an O ring. Now I was told this to lengthen the life of the pillow (which it does quite well), but I found out it eliminated my leaks. For a size small, a 9 is good, for a medium a 10 is recommended, but I had already bought them, so I'm using a 9 with a medium pillow. I got the O rings at Home Depot in the plumbing supply area. Now I know this sounds a little crazy, but it works. I'm having no pesky leaks & I'm using the same used up pillow I started my "trial' of the O ring with.

The Swift FX didn't fit me as well as the Swift LT for some reason, so you might fall into that category of user. There are a lot of forum folks that use the Swift FX so I think its a very viable mask for most. I can use it, just found out (by accident) that the Swift LT works better for me. Remember we all have different size heads, faces & nostrils, so what works for me may not work for you. I have found the O ring trick to be wonderful. its also very cheap to try, I got a small box of around 20 O rings for about $3. Cheap trick & I was lucky, it helped entend the life of my pillows (my intended outcome) and also has helped me with stability which ended all my small leaks (unintended outcome!).

If you have stopped using CPAP & are re-entering usage, you might have sleep debt, but If I understand correctly, you just switched from CPAP to APAP, so I don't think sleep debt factors into your problem.

Good luck & hang in there, you will find the problem and the fix, just keep at it.

Jen

Elite is straight pressure; Autoset and Escape Auto (yuck) adjust pressure as needed.

Oops - I didn't realize the Elite was straight CPAP. Just leave out all of what I said about the APAP vs CPAP. Thanks frog for letting me know of my oops.

Jen

Thank you for all the suggestions. I feel like a boob, it must be the lack of sleep, but I was actually using the Mirage Swift 2.

Snuzzie, if you check on the Mirage Swift 2 page on the host website (cpap dot com), you can watch some of the fitting videos they have for your mask. They show you where the nasal pillows should sit and how loose the headgear should be so that you will have a comfortable fit.

Good luck!

–M