CPAPtalk.com

This is looking so much better! Now you have your AHI at a good level and you can begin to really adjust to cpap.

I think the tired feeling will improve as you adapt to this pressure.

Have you contacted Karen at "Pad-a-Cheek"? She may be able to ship something to you in the way of a mask liner at a reasonable rate. She has helped so many people here with mask issues. You should email her and see what she can do for you.

Try staying at this pressure and let things stabilize, as 49er has suggested. You may want to try putting Smartflex to 1 after a couple of days ( don't do it right away) and see if that makes a difference now.

Keep at it! You will feel better soon!

26October2013
95th Percentile Pressure 12.0
90th Percentile Pressure 12.0
AHI 6.0
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 0.25
EPI 12
Lower: 9.0
Upper: 15.0
Smartflex: off
Delay: 0
Delay Pressure: 8.0
Mask: Full Face Mask

-Still feeling very tired this morning.
-Face mask did not leak as much, but still enough to wake me up a couple of times last night.
-Exhale puffs increased.

I think you should put the Smartflex back on - maybe at 2. You may be tired from breathing out against the new, higher pressure. You need the higher pressure but you may be having difficulty breathing out against the full pressure now.

I would try it with SMartflex at 2. Smartflex is a comfort feature to make it easier to breath out against the pressure. As you know it lowers the pressure for exhalation and, with your pressure now higher, you may need that relief. My pressure is set at 11 cm to 13 cm and my 90/95% is 12. I need the exhalation relief, I have found.

Agree with suggestion by Hawthorne. Also continue to search for mask liners as perhaps cutting down the leaks will provide improved sleep.

Did you get a response by Karen, with padacheck about possibly shipping to South Africa?

49er

Forgive me if I am wrong here as I know nothing about full face masks but would a high EPI with a full face mask really be indicating leaks? I assumed if the mask was not leaking at all, the Devilbiss should give an EPI of zero regardless of how much you breathe out of your mouth.

My understanding was that the Devilbiss only flagged quite major leaks so you could have minor leaks all night and still end up with a zero leak reading. Perhaps these minor leaks are causing regular minor awakenings that are contributing to the tiredness but not impacting the AHI number.

Madbear wrote:Forgive me if I am wrong here as I know nothing about full face masks but would a high EPI with a full face mask really be indicating leaks? I assumed if the mask was not leaking at all, the Devilbiss should give an EPI of zero regardless of how much you breathe out of your mouth.

My understanding was that the Devilbiss only flagged quite major leaks so you could have minor leaks all night and still end up with a zero leak reading. Perhaps these minor leaks are causing regular minor awakenings that are contributing to the tiredness but not impacting the AHI number.

Hi Madbear,

I think we are in agreement that Alexchetty could still be having minor leaks which are causing awakenings even though a major leak is not being flagged. I don't think a 12 EPI is significant from what I remember. Tried downloading a PDF file that didn't open but I will keep looking to make sure my memory is correct.

Let me know if I am missing something from your post.

49er

madbear - you could well be correct. I use nasal pillows and have never used a full face mask. My leak rate is always low unless the nasal pillows are old and ready for replacement.

About full face masks and the leaks that might or might not affect things, I know nothing!

Hi 49er - yes I wasn't sure if I had that right regarding the relationship between EPI and leaks with a full face mask. Do you think a raised EPI with a full face mask could indicate a minor leak on exhale only? Perhaps turning the Smartflex back on might ease the pressure inside the mask on the exhale or perhaps with the Smartflex off the mask needs to be a little tighter? Or perhaps it was just one of those nights where the mask leaks no matter whay you do

Regarding mask liners, I thought I read a post once where someone was cutting their own liners from some sort of clean dish cloth (or perhaps it was unscented, alcohol free baby wipes) but I cant find it now. Might be worth experimenting with if postage to South Africa is slow or expensive. Good luck Alex - looks like you are making steady progress.

27October2013
95th Percentile Pressure 13.5
90th Percentile Pressure 13.5
AHI 4.5
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 0.25
EPI 4
Lower: 9.0
Upper: 15.0
Smartflex: off
Delay: 0
Delay Pressure: 8.0
Mask: Full Face Mask

-I'm not feeling as tired this morning as I did yesterday.
-Face mask did not leak as much.

Madbear wrote:Hi 49er - yes I wasn't sure if I had that right regarding the relationship between EPI and leaks with a full face mask. Do you think a raised EPI with a full face mask could indicate a minor leak on exhale only? Perhaps turning the Smartflex back on might ease the pressure inside the mask on the exhale or perhaps with the Smartflex off the mask needs to be a little tighter? Or perhaps it was just one of those nights where the mask leaks no matter whay you do

Regarding mask liners, I thought I read a post once where someone was cutting their own liners from some sort of clean dish cloth (or perhaps it was unscented, alcohol free baby wipes) but I cant find it now. Might be worth experimenting with if postage to South Africa is slow or expensive. Good luck Alex - looks like you are making steady progress.

It is definitely possible Madbear that a raised EPI with full face mask indicates a minor leak on exhale only. That would make total sense. Ok, I really do need to review my EPI facts.

Chunky Frog was cutting those mask liners out of cloths that had dried up. I am such a klutz with even simply cutting tasks so I wouldn't be doing anything like that.

49er

alexchetty wrote:27October2013
95th Percentile Pressure 13.5
90th Percentile Pressure 13.5
AHI 4.5
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 0.25
EPI 4
Lower: 9.0
Upper: 15.0
Smartflex: off
Delay: 0
Delay Pressure: 8.0
Mask: Full Face Mask

-I'm not feeling as tired this morning as I did yesterday.
-Face mask did not leak as much.

Great news alexchetty. You're definitely on the right track.

49er

28October2013
95th Percentile Pressure 13.0
90th Percentile Pressure 12.5
AHI 7.0
Pressure Plateau Time 0%
High Leak Flow Time 2%
NRI 0.25
EPI 5
Lower: 9.0
Upper: 15.0
Smartflex: off
Delay: 0
Delay Pressure: 8.0
Mask: Full Face Mask

-Slightly tired this morning.
-Face mask leaked a lot. (wife complained about noise even though she slept in the next room).
-Could someone, please send me Karens from padacheek's email details.

alexchetty wrote:28October2013
95th Percentile Pressure 13.0
90th Percentile Pressure 12.5
AHI 7.0
Pressure Plateau Time 0%
High Leak Flow Time 2%
NRI 0.25
EPI 5
Lower: 9.0
Upper: 15.0
Smartflex: off
Delay: 0
Delay Pressure: 8.0
Mask: Full Face Mask

-Slightly tired this morning.
-Face mask leaked a lot. (wife complained about noise even though she slept in the next room).
-Could someone, please send me Karens from padacheek's email details.

Hi alexchetty,

Here is the link to her contact information. She is very prompt about responding.

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

49er

29October2013
95th Percentile Pressure 13.0
90th Percentile Pressure 12.5
AHI 7.0
Pressure Plateau Time 0%
High Leak Flow Time 1%
NRI 0.25
EPI 3
Lower: 9.0
Upper: 15.0
Smartflex: off
Delay: 0
Delay Pressure: 8.0
Mask: Full Face Mask

-Not tired this morning.
-Face mask still leaks.

alexchetty wrote:29October2013
95th Percentile Pressure 13.0
90th Percentile Pressure 12.5
AHI 7.0
Pressure Plateau Time 0%
High Leak Flow Time 1%
NRI 0.25
EPI 3
Lower: 9.0
Upper: 15.0
Smartflex: off
Delay: 0
Delay Pressure: 8.0
Mask: Full Face Mask

-Not tired this morning.
-Face mask still leaks.

Hi alexchetty,

Did you hear back from Karen?

Normally, I would suggest raising the pressure to see if you could lower the AHI. But since you're not tired and the mask is still leaking, I would rather you wait and work on solving the problem with the leaks.

Another option to consider is try another full face mask. Forum member mcdover sells alot of the name brand ones for $30.00. The only caveat is I am not sure if he ships overseas and if he does, how much of an additional fee that would be.

49er