sleeptech

If you do have CSA, then CPAP will almost certainly not treat it. You need a Bilevel device of some sort. CPAP holds you upper airway open, but nothing more. When you have central sleep apnoea, the muscles around your lungs aren't pushing the air in and out. It doesn't matter how much you open up your airway if your breathing muscles aren't moving the air. ASV is a subgroup of BiPAP which was designed specifically for treating Cheyne-Stokes respiration (a particular kind of CSA) in the setting of hypocapnia (low CO2 levels).

You may need to consider as different mask, as the other posters suggest. You could try a standard nasal mask, such as the Eson 2, which is still pretty small but won't hurt your nostrils. Or you could look at the DreamWear Under nose mask, which has the same sore of minimal contact configuration as an intranasal mask, but sits under your nose rather than sealing against your nostrils. Google a picture and it'll make more sense.

It is possible that a further increase could result in further improvement. It is important that any adjustment is done in careful consultation with a respiratory specialist. Increasing oxygen can cause an increase in carbon dioxide levels which can be harmful. Having said that, as it is being added to your VPAP that should help minimise the risk of such a thing occurring. Still, always be careful with oxygen.

It can be rather individual. What was your initial AHI before treatment. If it was 120, the < 15 is pretty darn great. If it was 20 then < 15 is not much of an improvement. Less than 5 is generally the goal, but in the real world there must sometimes be compromises. Also, do you have restless legs? That can artificially inflate the AHI indicated by a PAP device.

You are right Snuffie. Weight is probably the most common contributing factor to OSA, but it is far from the only one. There are a great many OSA sufferers who are not overweight at all. Especially in South East Asia, interestingly.

Has anyone checked you CO2 levels while on O2? Using oxygen on it's own can often lead to CO2 increasing, which can become dangerous. It is general protocol in most hospitals not to prescribe oxygen without assessing it;s affect on CO2 first.

Hi... er... Mantis.

I can tell you that in certain instances, adding some supplemental oxygen to VPAP (or CPAP) can have very positive results. It's a very individual thing. Do you have a specific question about it? I don't use it myself, but I do use it with a significant number of my patients.

Simplus is a model of mask made by Fisher & Paykel. The size should correspond with the size of your F20, if that was fitted correctly. I have never used CPAP liners because where I work we would have to throw them away after one use and it would get too expensive, so I know nothing about them. Others on this forum can fill you in there. If you struggle to adjust the mask yourself, when you are at the lab make sure you test the mask at 15 (your max pressure) and lying down as this will affect the shape of your face. Have a bit of a roll around and see how easy it is to introduce a leak. Adjusting yourself is better, but this will get you as close as possible in the lab. I also don't use Sleepyhead, but the consensus here seems to be very positive. I should be able to help you out with some of the terminology though.

Perhaps you could try a Simplus. I generally prefer them to the F20 (but horses for courses). I'm a little surprised that the Amara View hurt your face that much. Perhaps it was too tight? Do you adjust your own mask while using it, as required? I have lots of patients who have masks leaks because they don't want to adjust their mask straps.

It is not uncommon to feel worse when you have just started using CPAP. When you brain has not been able to sleep properly because of OSA and then the OSA is suddenly removed (by CPAP) what can happen is that your brain gets really excited and has a little party. Instead of getting the normal amount of each stage of sleep, it tries to make up for lost time and get way more of the stages it has been missing out on than you would normally have in one night. This is called rebounding. This can leave you feeling very tired and thick headed until you brain settles down into more normal sleep architecture. Hopefully it will pass in a little time.

By the way, I think the "game changing" thing is probably more rule than exception (based on my many thousands of patients), but that a site for people struggling with OSA and CPAP will not reflect that. This is where people come when they have problems (or to offer help, obviously).