Hybrid Mask - Lower AHI???

maskjkie · Post by **maskjkie** » Thu Jul 13, 2006 6:22 pm

I asked 3 patients who were using other masks previously (for 6 months or more) to report their AHI values after they started using the Hybrid mask. All the 3 patients are using the Resmed S8 Vantage EPR Auto CPAP and H3i Humidifier Combo.

***********************
Patient #1
With Ultra Mirage FF
Pressure: 8.6
AHI: 2.9
Leak: .25 l/s

With Hybrid
Pressure: 7.1
AHI: 0.6
Leak: .36 l/s

***********************
Patient#2
With F&P HC431 FF
Pressure: 12.4
AHI: 4.7
Leak: .39 l/s

With Hybrid
Pressure: 10.2
AHI: 1.3
Leak: .53 l/s

***********************
Patient#3
With F&P HC431 FF
Pressure: 9.3
AHI: 3.1
Leak: .08 l/s

With Hybrid
Pressure: 10.2
AHI: 1.6
Leak: .40 l/s

************************

Clearly, this Hybrid is doing something to lower AHI. Is it because it leaks less?

Bookbear · Post by **Bookbear** » Thu Jul 13, 2006 6:32 pm

But....but.......it doesn't leak less....according to the figures, it leaks more!

Snoozin' Bluezzz · Post by **Snoozin' Bluezzz** » Thu Jul 13, 2006 6:43 pm

My first night was like that but not the second. It leaks though, really leaks.

David

maskjkie · Post by **maskjkie** » Thu Jul 13, 2006 7:00 pm

Bookbear wrote:But....but.......it doesn't leak less....according to the figures, it leaks more!

Those leak values are higher because of strong flow rate from the exhaust ports, they are not because of leaks from around the mask. All the 3 patients reported that they could hardly detect any leaks around the oral cushion or around the nasal pillows.

Maryb · Post by **Maryb** » Thu Jul 13, 2006 7:41 pm

Maskjke-
What mask settings did they have their ResMed S8 Vantages set at?
Since the Hybrid is a non-ResMed mask, you have to choose one of the ResMed mask settings. And their results would be affected by this.

Maryb

Guest · Post by **Guest** » Thu Jul 13, 2006 8:02 pm

Maryb wrote:Maskjke-
What mask settings did they have their ResMed S8 Vantages set at?
Since the Hybrid is a non-ResMed mask, you have to choose one of the ResMed mask settings. And their results would be affected by this.

Patients #1 and #2 had the full face setting. I'm not sure about patient #3, I'll find out. Patient #3 also was congested, so I want to look at the data again after that is resolved.

birdiebaby · Post by **birdiebaby** » Thu Jul 13, 2006 8:15 pm

Hi Mask Junkie... I asked this very question a few days ago on this thread...

viewtopic.php?t=10975&highlight=

The low AHI continued to be the case until last night, when it was a bit above my normal with UMII. I ended up changing masks last night after not sleeping well. I can't really pinpoint what the problem was.

maskjkie · Post by **maskjkie** » Thu Jul 13, 2006 8:21 pm

birdiebaby wrote:Hi Mask Junkie... I asked this very question a few days ago on this thread...

viewtopic.php?t=10975&highlight=

The low AHI continued to be the case until last night, when it was a bit above my normal with UMII. I ended up changing masks last night after not sleeping well. I can't really pinpoint what the problem was.

Birdiebaby, were you congested last night? I have seen that even mild congestion can elevate AHI because the higher resistance due to congestion leads to hypopneas.

birdiebaby · Post by **birdiebaby** » Thu Jul 13, 2006 8:38 pm

I irrigated my sinuses right before bed, but one nostril was still stuffy. I usually need to do the irrigation an hour or so before I get hooked up. That may have been the reason.

Once I put my UMII on at 2:30, I slept like a rock and woke up without congestion.

inacpapfog · Post by **inacpapfog** » Sun Jul 16, 2006 10:06 am

I definitely have been experiencing lower ahi's and pressure needs using the Hybrid!
I've used it on both autos (Resmed's Spirit and Respironics m-series auto) and my new pressures are running 2 points lower! (was 9.5, now 7.2)
and new ahi's are also running 2 points lower (was 3.0, now 1.0)

I have also noticed that I am sleeping 8 hours straight with no wake ups!
(Pre-Hybrid, I would wake up once or twice)

With all of this said, I believe that the Hybrid is able to be so much more effective for me because its use frees me of chin strap and tape use. I had to employ both in order to use the Swift, While using the Swift for the last 15 months, I felt OK during the day it's just that ahi's were higher and I would wake up during the night . (Perhaps over time, I would have felt daytime effects of these sleep interrupting issues?) In any case, the new Hybrid seems to be working for me now!
Has anyone else discovered this pattern?

maskjkie · Post by **maskjkie** » Sun Jul 16, 2006 3:39 pm

inacpapfog wrote:I definitely have been experiencing lower ahi's and pressure needs using the Hybrid!
I've used it on both autos (Resmed's Spirit and Respironics m-series auto) and my new pressures are running 2 points lower! (was 9.5, now 7.2)
and new ahi's are also running 2 points lower (was 3.0, now 1.0)

I have also noticed that I am sleeping 8 hours straight with no wake ups!
(Pre-Hybrid, I would wake up once or twice)

With all of this said, I believe that the Hybrid is able to be so much more effective for me because its use frees me of chin strap and tape use. I had to employ both in order to use the Swift, While using the Swift for the last 15 months, I felt OK during the day it's just that ahi's were higher and I would wake up during the night . (Perhaps over time, I would have felt daytime effects of these sleep interrupting issues?) In any case, the new Hybrid seems to be working for me now!
Has anyone else discovered this pattern?

Inacpapfog,

I don't know if you have read my earlier post that 2 out of my 3 patients reported lower AHI and pressure. Patient #3 also reported a lower AHI but reported a higher pressure. But he was congested, so I want to get the data again after he recovers.

Now, Patient #4 is also reporting lower pressure and AHI with Hybrid mask on Resmed S8 Vantage EPR Auto CPAP and H3i Humidifier Combo. Like you, He was earlier using the Swift with a chin strap (no tape however).

Patient #4
With Swift and Chin strap
Pressure: 9.8
AHI: 4.1
Leak: .11 l/s

With Hybrid
Pressure: 8.2
AHI: 1.3
Leak: .39 l/s

I will soon get data from Patient #5. That should complete my study. Seeing the results, the pulmnologist wants to do an in depth study. He will work with Teleflex Medical to get whatever support he needs.

DME_store · Post by **DME_store** » Sun Jul 16, 2006 4:17 pm

We have already setup over 15 patients with the Hybrid. I will ask my RT to follow up with the patients who also got the Resmed S8 Auto CPAP and see if they are experiencing the same thing.

So far all the patients seem to be doing fine. There was one woman who had a difficult time getting the clips on. I think this will be an issue fpr patients with arthritiis

inacpapfog · Post by **inacpapfog** » Sun Jul 16, 2006 4:19 pm

maskjkie
Sure seems to be a trend here about the Hybrid and lower numbers!

I'm just so glad that I have an autopap that makes this adjusment for me! I can only imagine how I would feel if I had been using a standard cpap when I chose to use this new mask!

Keep us posted as you find related info!

maskjkie · Post by **maskjkie** » Fri Jul 21, 2006 10:02 am

inacpapfog wrote:maskjkie
Sure seems to be a trend here about the Hybrid and lower numbers!

I'm just so glad that I have an autopap that makes this adjusment for me! I can only imagine how I would feel if I had been using a standard cpap when I chose to use this new mask!

Keep us posted as you find related info!

Inacpapfog,
I just got data from Patient #5:

***********************
Patient #5

With Swift + chin strap + mouth tape
Pressure: 10.7
AHI: 3.9
Leak: .07 l/s

With Hybrid
Pressure: 9.5
AHI: 1.6
Leak: .29 l/s

***********************

The big change was the reduction in AHI. I have left a voicemail asking patient #5 if she felt any different since using the Hybrid. The pressure did go down by a little over 1 cm but not that dramatically.

Machine	Mask

Additional Comments: Avg. AHI .4