4 months in, horrible OA after changing from nasal to full face. Please help.

[Deborah K.]

In your first chart, your flow limits are really high. If you use EPR full time that will help with those. I'd set it at 3 and see how you do.

[dataq1]

I've been using F30's since 2020, when I have to, and don't have the sealing problems I had with FFM's that go over your nose.

Unfortunately, I've the had the opposite experience. I've been using a FFM (Fischer Paykel 431) for probably 10 years now, and then recently bought and tried the Resmed F30 for about a for about a month. My leaks were much worse with the F30. TBH, I think it has to do with how much I move around while sleeping, the F30 seemed to be much less stable (easy to dislocate) as compared with the Fischer. However, another friend of mine swears by his F30 - however he sleeps in a recliner, semi supine, and the chair prevents his roll to either side. Looking at his leaks (at 6-11 pressures), they are passable.

My conclusion (for me ) is the that leaks are associated with 1) head movement and 2) pressures above 15.

Take it for what you will, just my personal experience.

BTW, I've also concluded that Flow Limitations, and identification of events that occur during leakage are (generally) garbage. Just not reliable AHIs during those periods.

[palerider]

When using a nasal or pillow mask, the pressure can push your jaw a little forward which opens up your airway more. a FFM keeps the jaw pressed backwards, narrowing the airway.

Not sure why the nasal would push the jaw forward, but a tight FFM could surely press the jaw towards the spine, unnecessarily narrowing the airway. Seems like a logical explanation!
Thanks

Simple, if your airway is inflated, it can (depending on your individual anatomy) push your jaw forward as it expands.

(be careful about insinuating that a FFM could press the jaw back, because one of our members is a militant denier of that, apparently her jaw is hinged firmly and doesn't float like normal peoples jaws do.)

[Miss Emerita]

I agree with Deborah K. that you might benefit from experimenting with EPR. Flow limitations can interfere with restful sleep for some people. You'd want to raise your minimum by the same amount as your EPR. You could start out with 1 or 2 to see how you like it.

Yeah, that bed with the arm holes.... You may face a trade-off between pain and the best AHI you can score. As long as your AHI doesn't include OAs taking you above an AHI of 2 or so most nights, you might do best avoiding the pain, if that's what it takes to have restful sleep. Keep careful track of how rested or unrested you feel after each night's sleep, along with information about your sleep position, AHI, and pain level. You'll probably soon see what the best balance is for you.

Would this sleep position work for you? wiki/index.php/Sleep_Positions

[Max46]

Simple, if your airway is inflated, it can (depending on your individual anatomy) push your jaw forward as it expands.

Yeah, sounds logical, but that seems to contradict the popular theory that the Pap can't expand a toy balloon at max pressure, so it would seem dubious that the Cpap pressure is sufficient to push the jaw forward.
OTHO, the mechanical tension of FFM straps against the lower jaw, yea, I can definitely see that it would be possible to displace the jaw slightly.

[palerider]

Simple, if your airway is inflated, it can (depending on your individual anatomy) push your jaw forward as it expands.

Yeah, sounds logical, but that seems to contradict the popular theory that the Pap can't expand a toy balloon at max pressure, so it would seem dubious that the Cpap pressure is sufficient to push the jaw forward.
OTHO, the mechanical tension of FFM straps against the lower jaw, yea, I can definitely see that it would be possible to displace the jaw slightly.

Well then, I guess CPAP doesn't do anything at all then, eh?

[chunkyfrog]

I don't care that I don't fully understand why it works, but cpap helps me sleep.
And I trust it also helps me wake up alive.

[zonker]

I don't care that I don't fully understand why it works, but cpap helps me sleep.
And I trust it also helps me wake up alive.

because waking up dead SUCKS!!!

[aquamike]

I agree with Deborah K. that you might benefit from experimenting with EPR. Flow limitations can interfere with restful sleep for some people. You'd want to raise your minimum by the same amount as your EPR. You could start out with 1 or 2 to see how you like it.

Yeah, that bed with the arm holes.... You may face a trade-off between pain and the best AHI you can score. As long as your AHI doesn't include OAs taking you above an AHI of 2 or so most nights, you might do best avoiding the pain, if that's what it takes to have restful sleep. Keep careful track of how rested or unrested you feel after each night's sleep, along with information about your sleep position, AHI, and pain level. You'll probably soon see what the best balance is for you.

Would this sleep position work for you? wiki/index.php/Sleep_Positions

Hi there this is great advice thank you so much.

I dig the falcon position! I'm already doing something very similar sometimes but with a pillow. I'll try it without the pillow and see what happens.

I like the idea of really making the prone work as much as possible while minimizing ahi- I just got a oximeter so I hope to use that as a tool to fine-tune pressure and position. I don't have much control over my shoulders at this point but I do have control over my position, breathing and pressure. Seems the lesser of both evils and I somehow feel like the shoulder pain is causing more arousals than apnea at this point, but I need to start paying closer attention to it.

[Miss Emerita]

It sounds as though you're on a good path here. Keep us posted, would you?

[Max46]

Yeah, sounds logical, but that seems to contradict the popular theory that the Pap can't expand a toy balloon at max pressure, so it would seem dubious that the Cpap pressure is sufficient to push the jaw forward.

Well then, I guess CPAP doesn't do anything at all then, eh?

Not even close… what I questioned was ‘cpap develops sufficient pressure to push the mandible forward’.

[palerider]

Yeah, sounds logical, but that seems to contradict the popular theory that the Pap can't expand a toy balloon at max pressure, so it would seem dubious that the Cpap pressure is sufficient to push the jaw forward.

Well then, I guess CPAP doesn't do anything at all then, eh?

Not even close… what I questioned was ‘cpap develops sufficient pressure to push the mandible forward’.

Well, I missed your failure in terminology the first time through, but I caught it this time.

There's no "theory", the *fact* is that 20cmH₂O is not enough pressure to Inflate a balloon. "expand" has a different meaning.

[Max46]

There's no "theory", the *fact* is that 20cmH₂O is not enough pressure to Inflate a balloon. "expand" has a different meaning.

Semantics aside, the question is: Does cpap pressures exert sufficient force to push the lower mandible forward. In the alternative, are the pressures employed by cpap machines simply intended to splint the airway. “Splint” in the sense to maintain a position.

[palerider]

“Splint” in the sense to maintain a position.

If it "maintained a position" and that "position" was it's normal (closed) with apnea, then cpap wouldn't do anything.

Why am I even discussing this?

Tell ya what, instead, argue with chicagogranny who says that (in defiance of all evidence) FFMs don't pull/hold/keep the jaw backwards, thus restricting the airway.

[Max46]

Why am I even discussing this?

Ah, because you said:

When using a nasal or pillow mask, the pressure can push your jaw a little forward

And I questioned that the force of cpap pressure (4-20 cm) would be sufficient to actually push the mandible forward.