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Hello:

 

I have been using the ResMed S8 Elite II machine with a Mirage Micro mask. I had been waking up tired still, and I noticed some drool (yuck) so I switched to the Mirage Quattro full face mask.

 

I've been switching back and forth between them and I can't decide which one I prefer. When the full face mask is "sealed" it works great but if I move at all, the thing makes a loud whistling noise and I have to readjust it.

 

My latest stats for the past week are:

Leak 1.84 L/s

AHI 11.4

AI 3.6

HI 8.2

 

Those all seem pretty high, can anyone suggest anything to help? Oh, my pressure level is 14 and it starts at 6 and ramps up over 5 minutes.

 

Thanks!

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Hi Dan,

At your pressure setting of 14 cmH2O it can sometimes be difficult to get a really good seal with a full mask. Hopefully you were fitted with the appropriate size Quattro because that can make a big difference in leakage. It is usually better to err on the side of the mask being a bit smaller than larger. Other than than, try adjusting the headgear when you are lying down - not sitting upright. Don't tighten the headgear straps any tighter than necessary to create a seal - sometimes overtightening (a newbie mistake) can actually bend the cushion in a way that creates leaks to say nothing for the discomfort that causes. Also, be sure to wash the silicone cushion with a basic liquid dish soap daily - having a clean cushion makes a big difference.

You may want to try using a chin strap with your Micro Mirage nasal mask. I know a lot of people that use chin straps with their nasal masks and they often help - but - it is one more piece of hardware on your head that you have to contend with. But I think it would be worth a try and they don't cost that much... $20-25.00. I like the Respironics Premium chin strap if you check them out.

I wouldn't worry too much about your data stats... especially if you are new to CPAP. As you acclimate to using CPAP those numbers usually will trend down. Realize that CPAP machines are not measuring this data as accurately as the more sophisticated equipment used in sleep labs. This info is most helpful for trending purposes (if you make a pressure change).

Hope this has been a little bit helpful.
Thanks -- that was very helpful!

Brian Judy said:
Hi Dan,

At your pressure setting of 14 cmH2O it can sometimes be difficult to get a really good seal with a full mask. Hopefully you were fitted with the appropriate size Quattro because that can make a big difference in leakage. It is usually better to err on the side of the mask being a bit smaller than larger. Other than than, try adjusting the headgear when you are lying down - not sitting upright. Don't tighten the headgear straps any tighter than necessary to create a seal - sometimes overtightening (a newbie mistake) can actually bend the cushion in a way that creates leaks to say nothing for the discomfort that causes. Also, be sure to wash the silicone cushion with a basic liquid dish soap daily - having a clean cushion makes a big difference.

You may want to try using a chin strap with your Micro Mirage nasal mask. I know a lot of people that use chin straps with their nasal masks and they often help - but - it is one more piece of hardware on your head that you have to contend with. But I think it would be worth a try and they don't cost that much... $20-25.00. I like the Respironics Premium chin strap if you check them out.

I wouldn't worry too much about your data stats... especially if you are new to CPAP. As you acclimate to using CPAP those numbers usually will trend down. Realize that CPAP machines are not measuring this data as accurately as the more sophisticated equipment used in sleep labs. This info is most helpful for trending purposes (if you make a pressure change).

Hope this has been a little bit helpful.
Goood advice, Brian Judy.

Dan, after you find the right mask and get acclimated to CPAP therapy you will want to look for a Leak rate 0.4 L/s (or 24 L/M) and an AHI less that 5.0 and AI less than 1.0 - but MOSTLY you will know by how rested you FEEL when your presure and mask are "right" for you.

You may find that extending your Ramp period a little longer than just 5 minutes "might" help reduce Leaks and improve mask fit. I think the Ramp can be set up to 45 minutes if that long is needed to usually fall asleep. Even 10 minutes allows you some time to fuss w/your mask to get it adjusted just right w/o sending the pressure skyrocketing. 15 minutes is usually a good Ramp time for many people. As the mask warms to your face it starts to fit better.

Like everything else our facial tissue is subject to the law of gravity. As Brian Judy said, laying down to fit your mask tends to give a much better fit.

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