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Jeanne68
Unread post  Post subject: DW nasal mask increasing CAs  |  Posted: Fri Oct 11, 2019 9:34 am

Joined: Sat Sep 21, 2019 11:26 am
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I have been using a F&P Eson 2 mask and a Mirage FX, and getting good AHI...usually around 2 lately. The problem is, even though I try to wear these cushions (small size) fairly loose, I still wake up looking like a basset hound!!! I get sunken eyes and flaccid eyelids down to my lashes! It's horrible! I thought I might try the DW nasal mask to relieve the pressure on my face, but I get quite a lot of CAs that I don't get with the other masks. I was wondering if I should decrease my minimal pressure from 8.5 to 8 on my Dreamstation Auto. I feel like the nasal mask delivers a more intense air flow, since it is directed straight into the nostrils, and I thought this pressure difference might be initiating these central apneas? Any thoughts would be appreciated. Thanks


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LSAT
Unread post  Post subject: Re: DW nasal mask increasing CAs  |  Posted: Fri Oct 11, 2019 10:06 am

Joined: Tue Sep 05, 2017 9:40 am
Posts: 439
Location: WI
PAP Mask: Simplus
PAP Machine: Airsense 10 Autoset
Pressure Setting: 12-20

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What is your AHI and how many CAs are "a lot?"


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Jeanne68
Unread post  Post subject: Re: DW nasal mask increasing CAs  |  Posted: Fri Oct 11, 2019 11:22 am

Joined: Sat Sep 21, 2019 11:26 am
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OK...My doctor put me on an Auto CPAP June 13. The pressure was set at 8-12. I increased that to 8.5 about a week ago, to see if my hypopneas would decrease. My AHI for the last 7 days has been the best so far, averaging 1.8, which is a fantastic improvement for me. The CA's averaged 4.6 per night. The 3 days I tried the DW nasal, my CA's were 23, 26, and 20, with average AHI of 6.8. The Eson 2 and Mirage FX have been giving me great stats this last week, but my face looks SO awful in the morning...saggy and baggy!! I try to wear them as loose as possible. They don't always do this to me, though. I would like to use DW nasal sometimes and get equally good statistics. Any ideas? Do you think going from small nasal cushions to medium might help with the Mirage FX and Eson 2? Thank you for your help.


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Pugsy
Unread post  Post subject: Re: DW nasal mask increasing CAs  |  Posted: Fri Oct 11, 2019 3:07 pm
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1376
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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Are you using the Flex exhale relief option? If you are, at what setting?
I have a couple of ideas to try but this one is the easiest.
If you are using Flex...either reduce it or even turn it off with the DreamWear and lets see what (if anything) happens with the number of CAs/centrals you get.

Reducing the minimum pressure is unlikely going to be a productive solution because it's unlikely that the pressure itself is causing the CAs.


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Jeanne68
Unread post  Post subject: Re: DW nasal mask increasing CAs  |  Posted: Fri Oct 11, 2019 5:45 pm

Joined: Sat Sep 21, 2019 11:26 am
Posts: 7

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Thank you, Pugsy, for your reply. I have the Flex set at 3...so I will turn it off tonight and see how it goes. Or, if I need a little relief, I'll try it at 1.


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Pugsy
Unread post  Post subject: Re: DW nasal mask increasing CAs  |  Posted: Fri Oct 11, 2019 8:01 pm
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1376
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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Report back tomorrow as to status of the number of centrals/CAs.


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Jeanne68
Unread post  Post subject: Re: DW nasal mask increasing CAs  |  Posted: Sat Oct 12, 2019 5:11 am

Joined: Sat Sep 21, 2019 11:26 am
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I tried turning off the Flex completely for about an hour and twenty minutes, and finally got up and put it on Aflex "1", which was much better for me, and I went to sleep. My AHI for the 6 1/2 hours (I usually sleep closer to 9 hours) was 3.58 for time asleep and only 5 CAs. Much better where the CAs are concerned, but if I had slept 9 hours, there would probably have been more. I had 7 OAs. 12 hypopneas, and 17 RERAs.


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Pugsy
Unread post  Post subject: Re: DW nasal mask increasing CAs  |  Posted: Sat Oct 12, 2019 6:11 am
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1376
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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Sounds like you are using DreamMapper for your data.

Go here and read about more detailed data. Watch the videos especially the last one.
http://freecpapadvice.com/sleepyhead-free-software
While this talks about SleepyHead there is an offshoot of SleepyHead called OSCAR so same instructions for either since OSCAR is based on SleepyHead you can get OSCAR here.
https://www.sleepfiles.com/OSCAR/

How about one more night with Flex at 1 and see what happens.
Since you had a lot of trouble going to sleep last night with it off there's a real good chance that some of your flagged events aren't real.
Meaning you weren't asleep when they were flagged and if you aren't asleep they don't count.

Sometimes with some people with some masks there ends up being a situation where the body blows off too much carbon dioxide when exhale relief is used. I am unsure if you are one of these people with this new mask.
It's possible....but it is also possible that some of your flagged events aren't real asleep events.
To fix a problem we have to know what causes the problem first.

So lets try to figure out if those centrals/CAs that worry you are even real asleep events first.

A few centrals are normal and not a big deal. I know that these number of centrals bug you but they really aren't alarmingly high and not a problem.
Sleep onset centrals are normal and not a big deal or worry unless a person has so many of them that they can't ever really fall asleep or they cause desats.
Anything flagged that is arousal or awake related isn't a worry. Must be asleep before anything flagged really matters.


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Jeanne68
Unread post  Post subject: Re: DW nasal mask increasing CAs  |  Posted: Sat Oct 12, 2019 7:51 am

Joined: Sat Sep 21, 2019 11:26 am
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Hi, Pugsy! I do have Dreammapper, but I also use the Oscar software. I can dismiss the first "while awake" portion of the night, and then look at the "asleep" part, to see what was going on then. I see what you mean by so many flagged events while awake. When I delete that part, then what is left is this...


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Jeanne68
Unread post  Post subject: Re: DW nasal mask increasing CAs  |  Posted: Sat Oct 12, 2019 7:54 am

Joined: Sat Sep 21, 2019 11:26 am
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I will give it another go tonight. I am thinking about trying CFlex instead of AFlex....I'll try that this afternoon before bedtime. Any suggestions about which might be better? Thanks, again. B


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Pugsy
Unread post  Post subject: Re: DW nasal mask increasing CAs  |  Posted: Sat Oct 12, 2019 8:43 am
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1376
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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CFlex was the older of the 2 Flex options but there really isn't a "better"....there's only what fits you the best. You may or may not even notice much difference but try each and see.
I couldn't tell that CFlex did anything at all when I tried it but I actually felt and liked the AFlex because to me it felt more natural.
But that's me and my own respiration and you and I might like totally different things. Doesn't mean much except that not everyone likes the same thing. Try both and see what feels the best to you.

The goal is good quality sleep and feeling better....being comfortable plays an important part of that goal. The best numbers in the world don't mean squat if we don't sleep good and/or feel good.

I rarely have a really low AHI in terms of overall numbers. I have a lot of arousals from my old arthritic back and pelvis...pain.
My AHI will run usually between 1.5 and 3.5 but when I go look at the flow rate and remove arousal related flagged events my real asleep AHI is usually less than 0.5. 80 to 90% of my flagged events aren't real.
One night not long ago I had an AHI of 3.5 and every single flagged event was so obviously related to awake breathing a blind man could see it.
So my asleep AHI was 0.0. The flagged events were mainly telling me that I had a crappy night of sleep due to the arousals from pain and not so much related to the OSA side of things.

Your machine can and will flagged awake/arousal breathing irregularities as some sort of apnea event...even the PB flagging you see can be awake related. While we can't always do anything about the sleep quality itself we can at least look at things and say to ourselves "I wasn't really asleep when that got flagged so it really doesn't matter"....at we shrug our shoulders and move on.


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Jeanne68
Unread post  Post subject: Re: DW nasal mask increasing CAs  |  Posted: Sun Oct 13, 2019 8:15 am

Joined: Sat Sep 21, 2019 11:26 am
Posts: 7

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Pugsy! What a difference with the number of CAs. I slept over 8 hours and had only ONE CA. I used the CFlex on 2, and for me, it was much more comfortable than the AFlex 3 that I have been using. With the DW nasal cushion, the AFlex almost felt like it was "nudging" me to take the next breath during a normal (for me, at least) pause at the end of my exhalation. The CFlex makes it easier for me to breathe, and lets me start the next breath when it's normal for me. My problem now is with the awful eyes I wake up with! I found a medical journal article about this, and it showed 2 people with the saggy, swollen eyelids like I have in the morning. They were FFM users (I have been using nasal masks,but there is still pressure beside the nose), and it seems that their masks were blocking lymphatic/venous drainage from the eyelids that normally happens at night. This is rare, but does happen. Their symptoms resolved when they went to a nasal pillow mask. I have a P10 that was my husband's, and he didn't like it...so, I will try that for a few nights. Thanks, again, for the suggestion to change the FLEX option. I think this is really going to help me! Hopefully, I'm on the way to better nights.


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Pugsy
Unread post  Post subject: Re: DW nasal mask increasing CAs  |  Posted: Sun Oct 13, 2019 8:32 am
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1376
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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Swollen facial tissue or dents in the face or bags under the eyes are indeed related to fluid dispersal. Pressure from masks or headgear restricts the normal fluid dispersal and you get fluid accumulation in areas where it just looks ugly.
Strap covers will help somewhat with the dents in the cheeks but not always totally perfectly eliminate them.
Some people just get dents and bags easier than others.
I know because I am one of those people myself.

There's a reason that I use the Bleep...no headgear nasal mask. I don't like dents or bags under my eyes.


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