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My Remstar Auto M Series is set to 8-12 and I average 9.2. When I try to take a nap, I wake up with a start just after drifting off, and again a few minutes later, and again with a gasp 25 minutes later. Why isn't the auto pap adjusting during this period? Can I expect it to increase pressure so I don't have another apnea after the first? This often happens at night too, although once I am asleep, I can go 4 hours.

Also, I am trying two new masks because my Swift II hurts my nose and is had to keep sealed. Anyone have experience with the Comfort Lite 2 or the OptiLife? Any tips?

Thank you.

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Are you using the ramp?

How long have you been using the Swift II?

Have you ever had your pressure checked on your machine to make sure it is blowing the correct pressure?
Heather, the ComfortLite 2 might be a good choice for you in that it comes w/2 sizes of nasal pillows AND 2 sizes of a simple nasal cushion so its rather like getting 2 masks in one and gives you a chance to try a nasal cushion since your experience has been w/a nasal pillows mask. I used the CL2 for about 3 months and rather liked it. But it wasn't as stable on my head as would be ideal and my scalp started getting a bit tender from the headgear. I liked that it had so many areas of adjustment for fit. And I really appreciated the introduction to the simple nasal cushion which led me to my favorite mask, also a simple nasal cushion.

Just out of curiosity I recently tried the Swift LT which is a DEFINITE improvement over the original Swift which I hated. The Swift LT has the hose attachment in the center rather than at one side or the other which was the feature I hated about the original Swift. I never tried the Swift II so can't comment on it.

I'm also just recently trying the OptiLife. So far I've only tried the cradle cushion but will be switching to the nasal pillows. I don't think the cradle cushion comes automatically w/the OptiLife tho. I had to ask specifically for it.

I rather like both of these masks altho I still prefer my favorite which is one of Respironics' oldest masks and not very popular. I seem to be one of the few who prefer it. The Simplicity simple nasal cushion.
Thanks for your reply, Judy. I am not using the ramp feature, as it seems to wake me as it ramps up.

I didn't think to have the pressure checked on the machine; I will ask how to do this.

And I wrote the wrong name; I am using the Swift LT, not Swift II, and I like it except for the fact that my nose is sore, and it tends to leak part way through the night.

Judy said:
Heather, the ComfortLite 2 might be a good choice for you in that it comes w/2 sizes of nasal pillows AND 2 sizes of a simple nasal cushion so its rather like getting 2 masks in one and gives you a chance to try a nasal cushion since your experience has been w/a nasal pillows mask. I used the CL2 for about 3 months and rather liked it. But it wasn't as stable on my head as would be ideal and my scalp started getting a bit tender from the headgear. I liked that it had so many areas of adjustment for fit. And I really appreciated the introduction to the simple nasal cushion which led me to my favorite mask, also a simple nasal cushion.
Just out of curiosity I recently tried the Swift LT which is a DEFINITE improvement over the original Swift which I hated. The Swift LT has the hose attachment in the center rather than at one side or the other which was the feature I hated about the original Swift. I never tried the Swift II so can't comment on it.
I'm also just recently trying the OptiLife. So far I've only tried the cradle cushion but will be switching to the nasal pillows. I don't think the cradle cushion comes automatically w/the OptiLife tho. I had to ask specifically for it.

I rather like both of these masks altho I still prefer my favorite which is one of Respironics' oldest masks and not very popular. I seem to be one of the few who prefer it. The Simplicity simple nasal cushion.
I use the optlife mask and love it. It should come with every different nasal attachment make sure your DSE gives you everything. Also you might talk to the sleep center you had your sleep study at. They get sample mask from all the rep's and they are the ones that told me what comes with the mask. I like the cradle more then the pillows but the pillows are great also. I also use right now a auto bipap m series with higher pressures then you are using and I do not have any problems with the mask. i have been on either a cpap or a bipap since 1998.
Judy: why is the Simplicity simple nasal cushion not popular? I wonder if it would work for me? I am going to try the OptiLife with cradle cushion tonight.

Last night went ok with the ComfortLite 2, slept about 4 hours straight with it, but had trouble the rest of the night. Felt hot under the padding and the squeezing bothered me. I did like the fact that my nostrils we getting a break!

Judy said:
Heather, the ComfortLite 2 might be a good choice for you in that it comes w/2 sizes of nasal pillows AND 2 sizes of a simple nasal cushion so its rather like getting 2 masks in one and gives you a chance to try a nasal cushion since your experience has been w/a nasal pillows mask. I used the CL2 for about 3 months and rather liked it. But it wasn't as stable on my head as would be ideal and my scalp started getting a bit tender from the headgear. I liked that it had so many areas of adjustment for fit. And I really appreciated the introduction to the simple nasal cushion which led me to my favorite mask, also a simple nasal cushion.

Just out of curiosity I recently tried the Swift LT which is a DEFINITE improvement over the original Swift which I hated. The Swift LT has the hose attachment in the center rather than at one side or the other which was the feature I hated about the original Swift. I never tried the Swift II so can't comment on it.

I'm also just recently trying the OptiLife. So far I've only tried the cradle cushion but will be switching to the nasal pillows. I don't think the cradle cushion comes automatically w/the OptiLife tho. I had to ask specifically for it.

I rather like both of these masks altho I still prefer my favorite which is one of Respironics' oldest masks and not very popular. I seem to be one of the few who prefer it. The Simplicity simple nasal cushion.
I'm not sure why others don't like the Simplicity, there are just a few of us that do. There just is nothing to it, its lightweight, you can read, wear your glasses, whatever w/it. The headgear is rather large, the center strap especially is too long but that is easily remedied. I've "fixed" two of them now.

Its that light weight that I like about the OptiLife and the Swift LT, I prefer less rather than more on my head and face, thank you! I think Respironics and Resmed are on the right track w/these two masks, especially Respironics w/that cradle cushion on the OptiLife, tho I do think they need to re-think that chin stabilizer.
DIfferent brands of AutoCPAP use different algorithms to decide when to raise and lower pressure.REMstars compare your current breath cycle to a moving average of the previous cycles as part of its decision-making process. This tends to make transitions smoother, but also means that it can't turn on a dime to raise or lower pressure. The ResMed algorithm evaluates your breathing on a breath by breath basis, and looks for "flattening" of the breath cycle to raise pressure. As a result, it is a bit more "aggressive" in its pressure changes and the 95th percentile pressure delivered tends to be a bit higher. I personally don't believe one is better than another, just different. You did not mention your overal AHI while using the REMstar. If you are at 5 or less, it could be argued that it is performing as expected. It is also possible that you'd do better with a ResMed AutoSet II.
Thanks Daniel. It may be that a 20 minute nap is not enough time for the auto pap to adjust like you said. Maybe I should set it at a continuous pressure of 10 for my nap?

Also, my AHI says 1.5. And it didn't change after the nap with the three "episodes." That could be because it is averaging over the whole time my card has been recording, right? So 2-3 events may not change that average. I guess when I am falling asleep at night, I only have 1-2 "events."

Last night I tried the Optilife with nasal cushion. It was ok, I fell asleep, but woke up at 4 AM to hissing and tried and tried to adjust the cushion but couldn't get it to seal again. It was moist from condensation. Is that why I couldn't get it to seal? This is an on-going problem; I had the same thing happen with the ComfortLite II and my Swift LT. I do have a snuggle hose, and the dial is only set to 2 on the humidifier. Our room is about 60 degrees and I really don't want to have to heat the room every night to avoid condensation.
One question, what height is your cpap at ? is it at the same height or higher then you are ? if so that might be your problem. It should be lower then you are, so you won't get that much moister around your connections. Just a thought.

Heather said:
Thanks Daniel. It may be that a 20 minute nap is not enough time for the auto pap to adjust like you said. Maybe I should set it at a continuous pressure of 10 for my nap?

Also, my AHI says 1.5. And it didn't change after the nap with the three "episodes." That could be because it is averaging over the whole time my card has been recording, right? So 2-3 events may not change that average. I guess when I am falling asleep at night, I only have 1-2 "events."

Last night I tried the Optilife with nasal cushion. It was ok, I fell asleep, but woke up at 4 AM to hissing and tried and tried to adjust the cushion but couldn't get it to seal again. It was moist from condensation. Is that why I couldn't get it to seal? This is an on-going problem; I had the same thing happen with the ComfortLite II and my Swift LT. I do have a snuggle hose, and the dial is only set to 2 on the humidifier. Our room is about 60 degrees and I really don't want to have to heat the room every night to avoid condensation.
thanks Rich. I have it on the desk; I will try lowering it tonight.

RichM said:
One question, what height is your cpap at ? is it at the same height or higher then you are ? if so that might be your problem. It should be lower then you are, so you won't get that much moister around your connections. Just a thought.

Heather said:
Thanks Daniel. It may be that a 20 minute nap is not enough time for the auto pap to adjust like you said. Maybe I should set it at a continuous pressure of 10 for my nap?

Also, my AHI says 1.5. And it didn't change after the nap with the three "episodes." That could be because it is averaging over the whole time my card has been recording, right? So 2-3 events may not change that average. I guess when I am falling asleep at night, I only have 1-2 "events."

Last night I tried the Optilife with nasal cushion. It was ok, I fell asleep, but woke up at 4 AM to hissing and tried and tried to adjust the cushion but couldn't get it to seal again. It was moist from condensation. Is that why I couldn't get it to seal? This is an on-going problem; I had the same thing happen with the ComfortLite II and my Swift LT. I do have a snuggle hose, and the dial is only set to 2 on the humidifier. Our room is about 60 degrees and I really don't want to have to heat the room every night to avoid condensation.
If you nap for two hours and have two major apnea events and no other events, by definition you have and AHI of 1.0, which is considered normal breathing. You idea to increase the pressure during a nap is an interesting one and may have merit, as long as the higher pressure doesn't disturb your sleep.

Condensation at the OptiLife nasal pillows can be from the moisture of your exhalation, I'm not sure if that would be the cause of your leak woes, but if it is, a quick wipe with a tissue should solve it. You could try reducing the heat even more. Some people turn off the heat completely. As long as you don't feel too dry as a result, that could take care of the problem. You just have to experiment. And remember, spring is on the way soon...

As for setting the CPAP lower than the mattress, I think people make way too much of that. It only makes a difference if you have condensation in the tube and it is dripping into your mask or nose. It will still make noise, even if the water rolls back into the chamber. Doesn't it make more sense to eliminate the condensation, by either reduce the heat level, increasing the temperature in the bedroom, or insulating the tube from the cooler bedroom air?

Daniel


Heather said:
Thanks Daniel. It may be that a 20 minute nap is not enough time for the auto pap to adjust like you said. Maybe I should set it at a continuous pressure of 10 for my nap?

Also, my AHI says 1.5. And it didn't change after the nap with the three "episodes." That could be because it is averaging over the whole time my card has been recording, right? So 2-3 events may not change that average. I guess when I am falling asleep at night, I only have 1-2 "events."

Last night I tried the Optilife with nasal cushion. It was ok, I fell asleep, but woke up at 4 AM to hissing and tried and tried to adjust the cushion but couldn't get it to seal again. It was moist from condensation. Is that why I couldn't get it to seal? This is an on-going problem; I had the same thing happen with the ComfortLite II and my Swift LT. I do have a snuggle hose, and the dial is only set to 2 on the humidifier. Our room is about 60 degrees and I really don't want to have to heat the room every night to avoid condensation.
Good thought I was saying about the height because of what she said about the condensation and she did say she had a snuggle hose (doesn't that have a insulated fleece cover on the hose?) since that might get rid of some of the build up with a setting of 2 I did not think that it would be that warm.

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