Sierra

The DreamWear Nasal Pillow mask may be an option. Two tubes go up the side to a hose connection at the top of the head. Some like that design better. It is a mask system that can be converted from a nasal gel pillow to a nasal or to a full face.

Yes an AHI of 17 is not in the mild 5-15 category, and is a bit high to not treat.

The nasal pillow type masks tend to be the most comfortable, but the easiest to remove. Full face can be the least comfortable but are harder to remove. Nasal masks are somewhere in between. Some people get used to them by watching TV or something else distracting during the day.

What was the diagnosis AHI? In the UK for example, a CPAP is not prescribed until AHI is over 15.

They are working on the image upload functionality. You may want to try using https://imgur.com/ as an image upload method. I have not tried it, but I have seen others using it. The built in method here was working very well, and I hope it gets fixed.

I don't think your issue is due to using Flex. My suggestion is actually to turn Flex off, or set it at 0. It is not as bad as EPR on a ResMed, but it can elevate your needed pressure in Auto. It reduces your exhale pressure some. The problem is that reducing the exhale pressure while it can feel good, it is a bit of a double edged sword. If apnea events occur during this pressure reduction, the Auto function will just elevate pressure more, so you gain nothing in using it, and have to put up with a higher pressure on inhale.

Having air come back to your mouth or opening your mouth often can be caused by higher pressure. When you look at your daily report on OSCAR how high does it go during the night? Is it staying a long time at the maximum pressure? Possibly it is higher now than it used to be?

Using a chin strap may help stop it. The best chinstrap that I tried is called a BreatheWear Halo. However, now I use mouth taping. See this video on mouth taping.

I just checked my P10 mask. With the hose disconnected from the CPAP hose I find it very easy to breath through the hose. If I put my hand over the hose to force air flow through the vents, it does feel a little constricting when I breathe in, and out, but I can still breathe in and out reasonably comfortably, but not as easy as when my hand is not blocking my hose.

My mask is over two years old and I clean it every few weeks using vinegar and then soap and water. If you think the vent mesh is blocked, I would suggest using a tooth brush and pure vinegar. Follow that with dish soap and water. That is all I have ever done.

All of the masks will have a controlled flow through the vents. If they flow is too high out the vent, the CPAP will not be able to produce pressure to control your apnea. So, I am not so sure a new mask is the solution. It is possible to buy a replacement part for the mask, but it is almost as expensive as a new mask. I would spend some try trying to clean it with a toothbrush and vinegar first. But here is a link to the part if you want to replace it.

P10 Mask Part

Other options for masks would be the Swift FX, but I can't recommend it as it has a really high velocity air exhaust. There is also the F&P Brevida but I can't really recommend it as it has kind of flimsy exhaust diffuser. It is easier and cheaper to replace though. I have had both, and I adapted the Swift headgear only to my P10. My wife uses the Brevida and likes it.

I have noticed the same thing. I just sent an e-mail to the website support address, which can be found under the Help Center link at the top of the page. Will see what happens.

When it did work, most image file formats worked. You just left clicked on the image file in File Explorer and dragged it into the message. Used to work fine.

The P10 mask controls the air flow out the vent very well and it is sometimes hard to feel it coming out. That said there should be air flow through the mesh vent. If you disconnect the mask from the machine and breath in and out does that feel OK? If you cannot breathe freely you may have the mask too tight and you are collapsing the cone shaped piece that fits inside your nasal passages. It is usually best to fit the mask as loose as it can be without it leaking. Then lift the mask away from your nose to let the nasal part inflate, then release it.

The next step would be with the mask disconnected from the machine, hold you hand over the end of the tube. You should still be a ble to breathe in and out fairly freely, but with some restriction. Air should flow in and out of the mesh vent.

Let us know what you find.

I suspect the hospital will have their own mask and machines, and they probably will not allow the use of your own machine in the hospital, if it comes to that.

Things are not very good in Canada. About 50% of deaths are occurring in seniors homes. Almost all homes are now locked down so nobody, including relatives, cannot visit. It has also uncovered some home mismanagement in addition to COVID, and in some cases police are now conducting criminal investigations. In one home of 60 residents, half have now died of COVID.

If you know anyone in a long term care home, you may want to think about getting them out, until this is over. If the virus gets into a Home, it goes through the place like a wildfire. My mother is in a home, that is now locked down, and getting her out is not an option. Thankfully there have been no deaths in care homes in the province where she is located.

The column is getting a bit narrow, so I will post here. From what you describe it sounds like minimum pressure could be increased some more and the maximum reduced to 10 cm. If you are OK with the minimum pressure higher, you may be best to have a minimum of 9 cm and maximum of 10. However you are probably best to increase the minimum in steps of 1 cm to see how you are liking it. Reducing the max to 10 could be done right away. Just watch that you are not hitting that max very often. It really only needs to be increased if you are hitting it and still having some obstructive events when it is at that maximum.

With increasing minimum pressure you should see fewer flow limitations and fewer obstructive events as the up and down cycle in pressure is reduced.

If you have a DreamStation you will not be able to follow those suggestions exactly. They are for a ResMed machine. The DreamStation does not have the ability (to my knowledge) to use Flex on the ramp only. I believe you have to set it on or off. Turning Flex off may keep your pressure a little lower when in Auto.

What I would suggest is looking at OSCAR's Daily report, and look to see when obstructive events are occurring relative to the pressure. Unfortunately the ability to upload a screen shot to this site seems to have been disabled. However, if you look at the period of time when the pressure is in auto mode after the ram is over, there may be times when the pressure is not very high, but you are still having obstructive events. The DreamStation machine tends to bump the pressure up when it sees an event. Then after the pressure goes up, the pressure goes down fairly shortly later. It waits to see if more events occur. It keeps testing to see if the pressure can be lowered. The net result of this is that a DreamStation machine ramps the pressure up and down very often. This can cause more events to occur than if it just ramped pressure up and held it longer. That is basically what a ResMed does. You can take this up and down pressure out of the machine by boosting the minimum pressure to prevent the machine from doing it.

The other thing to check for is if the pressure goes up to your maximum and you still see obstructive events when at this maximum pressure. This suggests your maximum pressure may be too low, and needs to be increased. This said I would suggest getting the minimum pressure optimized first. Then if that is not enough, then as a second stage adjust the maximum if necessary

Ok, for an 8 hour sleep the 12 hypopneas and 4 OA's would work out to an AHI of about 2. That is a bit high for most, but well under the <5 guideline for treatment. I would worry less about the flow limitations, and not at all about the VS2's. Nobody is really sure what they mean. I gather you have a DreamStation machine?

What you might consider is downloading the OSCAR software to have a more detailed look at when you are having your events, and at what pressures you are having them. It should give you some idea if there is any opportunity for improvement. The software is free, but you need a PC or Mac and a SD card reader to get the data off your SD card in your machine.