I have been using my Respironics M series Pro for just over 2 weeks. Got the card reader yesterday, and it shows that I am getting an average leak rate of about 40, with several times of max leak rates. I have an AHI of 5 over the 2 weeks, with a snore index of 1. I am not feeling like I did in the titration study, where they told me events were completely suppressed.

I tried a full face mask, and the report shows that the leak rate was higher during that time (which I knew already). My other masks are a Zest, and a FlexiFit 407. Still getting the sore nose from those, though.

So, question is where to go from here. My thoughts, although probably not in this order, are:

1. Shave my full beard (which my partner will not like!)
2. Try nasal pillows again - Activa LT or Swift LT. Tried something during the prep for my titration study, but can't remember which it was - I didn't like them.
3. Try the new Sleepweaver mask.
4. Keep trying to find the right fit for one of my current masks.

Let me know if you need more information.


_________________
SleepyToo
Philadelphia Area
Newly diagnosed, Respironics M Series Pro w\ humidifier
Zest nasal mask, also have Full Life ff mask, and FlexiFit 407
(Also have a FlexiFit 405 that damaged the bridge of my nose)

SleepyToo I have just started using the Respironics FitLife full face mask about 2 1/2 months ago and I get the best (lowest) leak rate that I have ever gotten with any mask I have used, it give me a reading of "Excellent fit" on my machine and I never have had that before with any mask I have used! I also have a full beard see attached link.

http://www.apneasupport.org/viewtopic.php?t=20162&start=15

No need to shave the beard! what I do is wash my face really well and wet my beard down really well where the mask touches it and I put the mask on with my beard wet and I get an excellent seal! I hope this helps you, any questions just PM me! Good Luck to You ....White Beard


_________________
White Beard with a White Beard
Resmed VPAP Adapt SV Enhanced, HumidAire 2i, ResLink with Model 8000 Flex sensor Pulse Oximeter, and ResScan 3.5 software. Respironic EverFlo OPI Oxygen Concentrator 3 lpm
EEP 9.0, min PS 6.0, max PS 16.0, FitLife Mask

SleepyToo with your mask you get a data sheet and it usually has a graph on it and it shows the recommended leak rate for the different pressures with that mask  so that will tell you what is acceptable.  I would like to add that the FitLife mask covers the entire face it goes from the forehead down to between your mouth and your chin, I will try and post a picture sometime this weekend of me with it on so you can see how it looks. Over the years I have tried many many masks and I had finally settled on the Hybrid and Liberty but I had to modify both of them to work with the high pressures I have. Even then I had comfort issues with them! This FitLife mask to me is perfect no mod needed and it is super comfortable! White Beard


_________________
White Beard with a White Beard
Resmed VPAP Adapt SV Enhanced, HumidAire 2i, ResLink with Model 8000 Flex sensor Pulse Oximeter, and ResScan 3.5 software. Respironic EverFlo OPI Oxygen Concentrator 3 lpm
EEP 9.0, min PS 6.0, max PS 16.0, FitLife Mask

White Beard wrote:

SleepyToo with your mask you get a data sheet and it usually has a graph on it and it shows the recommended leak rate for the different pressures with that mask  so that will tell you what is acceptable.

Gosh, amazing what you can discover if you read the manual! I learned that I am going outside the acceptable range for the mask. However, last night was interesting when I look at my smart card data. I started off with an acceptable leak rate, with no apneas/hypopneas. Then for some reason about an hour into the recording, the leak rate increased. Another couple of hours during which I had several events, and I apparently removed the mask - a gap in the recording for an hour. I do not remember that happening. Got the mask back on after a bathroom break (thought I had removed it just before getting up), with a similar starting pattern. The leaks also happened during my titration study, so it must be when I change position. At least during the study there was a tech standing by to come and correct the problem.

The other interesting thing last night was that I had quite a lot of moisture condensed inside the mask, which woke me up a couple of times. Even blocked the exhale holes, but I was able to clear that with a simple wipe on the outside with a tissue. I reduced the humidity right down and that seemed to help.

Thanks for your help - I would like to try the FitLife at some point, but not sure that my DME stocks them. He did tell me that he doesn't like them. Although he has apnea, not sure if he has tried that particular mask. He doesn't have a beard, so why would he need to try it other than to be able to advise patients from a better, more knowledgeable perspective? Even my beard is not as full as yours, though! Next month there is an AWAKE  group meeting in my area, with medical equipment vendors there. Hopefully, one of them will have a demo mask that I can try. Do I need to get a separate prescription for each mask? My sleep doc will probably be at the meeting too, so it should not be a problem if I do need a new prescription. Also, I have an appt with my sleep dr. before the meeting.

The good news is that now that I have the data from my machine I know that if I can get the leaks under control, the prescribed pressure _does_ suppress apneas and hypopneas, so any suggestion to increase the pressure needs to come with a gosh-darned good reason why it is going to help. You know, it would be really good if the software could give a percentage of time with no events that we could track and really assess the treatment.

The lack of information has been the most frustrating part of getting started. If only the DMEs and insurance companies could be made to see that making this information available would increase the chances of compliance. Not every patient is going to be able to interpret what they are seeing, but that could be the role of the DME. However, I will stop there to avoid this becoming a rant, which was not the purpose of this thread!


_________________
SleepyToo
Philadelphia Area
Newly diagnosed, Respironics M Series Pro w\ humidifier
Zest nasal mask, also have Full Life ff mask, and FlexiFit 407
(Also have a FlexiFit 405 that damaged the bridge of my nose)

SleepyToo My DME told me that I would not like the mask and they did not want to give me one, but I insisted and told them I had just seen my Sleep Doc and he wrote the script for it ans had it faxed over. Suer enough they just got the fax and since they had the script they could not refuse me. Anyway they had a loaner that I could try as they did not have them in stock, they let you try it for up to ten days, after the second day I went back to them and told them to order me one, they were amazed that I liked it! I told them that it was the best mask I had evr had, and that I wasn't going to give them their mask back till they got me one. So they waived the 10 day rule, it took them a little over 2 weeks to get me the mask. Honestly I don't know why people don't like this mask, if you read  on this forum about people who have tried it they all seem to think it is a fantasitc mask! Since January of 2007 I have tried a heck of allot of masks  and I had finally settled on the Hybrid mask but I had to modify it, and then the Liberty mask and I had to modify it to.  see attached link,  I thought these mask were the best I could get with a beard but even with those mask my machine said mask fit poor and I always had a very high leak rate. Up untill I got this FitLife mask, my leak rate is well below the average and my mask fit is excellent! And the comfort level better than anything I could ever dream of! Anyway get a script for it from your Doctor  then your DME can't turn you down if they want your bussiness! You might want to look at some of the other post on this forum about this mask Good luck to you White Beard

http://www.apneasupport.org/viewtopic.php?t=16079&start=15&postdays=0&postorder=asc&highlight=liberty


_________________
White Beard with a White Beard
Resmed VPAP Adapt SV Enhanced, HumidAire 2i, ResLink with Model 8000 Flex sensor Pulse Oximeter, and ResScan 3.5 software. Respironic EverFlo OPI Oxygen Concentrator 3 lpm
EEP 9.0, min PS 6.0, max PS 16.0, FitLife Mask

Thanks very much, WhiteBeard. I'll give the doc a call on Monday and follow your lead. I see there could still be problems with sizing, but I will try it anyway.

Good night!


_________________
SleepyToo
Philadelphia Area
Newly diagnosed, Respironics M Series Pro w\ humidifier
Zest nasal mask, also have Full Life ff mask, and FlexiFit 407
(Also have a FlexiFit 405 that damaged the bridge of my nose)

I realized early this morning that the leaks arise when I tilt my head toward my chest. So, it all depends on the straps rather than the mask alone. With the strap over the head on the FitLife, looks like it might stay in position better during my head movements. Any thoughts on that? Interestingly, the most comfortable mask for straps has been the FullLife mask - maybe I should try again with that mask while I am waiting to try the FitLife ...

Interesting science research project in getting the right mask, and head straps for this xPAP journey! There are so many variables - head shape, nose size (in various forms), fullness of face (body weight-related, I am sure), sleeping positions - back, side, head up, head down. Wow, I would hate to have to engineer a "perfect" mask for everyone!

I discovered that there is another new mask type being launched next month - I searched on "fully adaptable cpap mask." There are no pics or anything about it yet, but definitely one to keep an eye on. Looks like it may be an oral "mask." FDA approval may take a while longer, though. Will be interesting to see how it does in the real world where xPAP patients live and breathe! And for those like me who choke easily.


_________________
SleepyToo
Philadelphia Area
Newly diagnosed, Respironics M Series Pro w\ humidifier
Zest nasal mask, also have Full Life ff mask, and FlexiFit 407
(Also have a FlexiFit 405 that damaged the bridge of my nose)

SleepyToo another thing to connsider as you sleep your facial muscles relax and thus that could be responsible for you increase in your leak rate! Also Make sure your mask is clean I wipe the seal that touches my face with a CPAP Mask  citrus  wipes, and I also wash  my face and beard really well and for me I leave my beard wet and then put on my mask, it make a better seal! Any  oil on your skin can affect the seal of your mask, that it why it is important to have your skin squeaky clean! Good Luck to You!! White Beard


_________________
White Beard with a White Beard
Resmed VPAP Adapt SV Enhanced, HumidAire 2i, ResLink with Model 8000 Flex sensor Pulse Oximeter, and ResScan 3.5 software. Respironic EverFlo OPI Oxygen Concentrator 3 lpm
EEP 9.0, min PS 6.0, max PS 16.0, FitLife Mask

Thanks for the advice, WhiteBeard. I do keep my beard clean. I have started using bits of an old t-shirt, with a hole cut in them for my nose, put between the mask and my face/beard. That does seem to keep the leaks under control. The thing that is now keeping me awake nights is the humidity - I tried cranking it up a couple of nights ago to relieve the nasal congestion, and was rewarded with water in the mask. Ahead of getting a hose warmer I wrapped the hose in old towels last night. I raised the humidity half a notch. I still woke up with the stuffed-up nose, and the hypopneas were definitely increased (AHI was up to 5). However, there was no water in the mask from what I recall. I'll try another half notch tonight. Also, keep on with the nasal irrigation. I'll beat this thing yet!


_________________
SleepyToo
Philadelphia Area
Newly diagnosed, Respironics M Series Pro w\ humidifier
Zest nasal mask, also have Full Life ff mask, and FlexiFit 407
(Also have a FlexiFit 405 that damaged the bridge of my nose)