Just got my APAP machine yesterday -- Resmed S8 Auto Vantage with Mirage Swift Nasal Pillow System.  Sidenote:  The nasal pillows are SOOO much better than even the gel nasal mask that I used during the sleep study.  I slept pretty well.  I was conscious of the headgear/hose, but I think I slept better than I usually do.  Some questions:

(1) Swift nasal pillows:  Does anyone notice that the vents on these (the little holes that constantly blow air out) blow quite a bit of air?  I compared it to the vent on the respironics gel mask that I got as a party favor during the sleep study, and the pillows release more air.  Could this affect the pressure on the APAP?

(2) I was titrated at 6 during my study, but my APAP spent most of the night closer to 11.  Does this make sense?  Linked to number (1) above?  Will this go down over time?

(3) According to the "efficacy data" on the apap, my AHI was just under 5 last night.  Should this go down over time?  

(4) Is there a difference between one's AHI when they're not on XPAP and when they are on XPAP?  In other words, during the sleep study, AHI ment that you had so many apneas/hypopnea's per hour.  But once you're on XPAP, does the AHI mean that you acutally had e.g. an apnea (i.e. not breathing for 10 seconds)?  Or does this just mean that you would have had an apnea, but the XPAP machine kicked in and took care of it?  

Thanks!

sleepydog wrote:

Just got my APAP machine yesterday -- Resmed S8 Auto Vantage with Mirage Swift Nasal Pillow System.  Sidenote:  The nasal pillows are SOOO much better than even the gel nasal mask that I used during the sleep study.  I slept pretty well.  I was conscious of the headgear/hose, but I think I slept better than I usually do.  Some questions:

(1) Swift nasal pillows:  Does anyone notice that the vents on these (the little holes that constantly blow air out) blow quite a bit of air?  I compared it to the vent on the respironics gel mask that I got as a party favor during the sleep study, and the pillows release more air.  Could this affect the pressure on the APAP?

(2) I was titrated at 6 during my study, but my APAP spent most of the night closer to 11.  Does this make sense?  Linked to number (1) above?  Will this go down over time?

(3) According to the "efficacy data" on the apap, my AHI was just under 5 last night.  Should this go down over time?  

(4) Is there a difference between one's AHI when they're not on XPAP and when they are on XPAP?  In other words, during the sleep study, AHI ment that you had so many apneas/hypopnea's per hour.  But once you're on XPAP, does the AHI mean that you acutally had e.g. an apnea (i.e. not breathing for 10 seconds)?  Or does this just mean that you would have had an apnea, but the XPAP machine kicked in and took care of it?  

Thanks!

Hi Sleepydog,

(1) Apparantly not. At a conference in November 2004 I asked The ResMed people that exact question. The answer was that it has no effect. Pressure is maintained within the nasal/airway cavity throughout and ehether or not you use a mask or pillows is immaterial...............personally I'm still not convinced, but that is the 'industry' answer.

(2) & (3). The APAP supposedly releases sufficient air to clear apnoea events, however this is governed by an algorithim. Currently there are 2 algorithims in use, one is based on air flow, the other is based on obstructions. A fairly recent study showed that APAPs do NOT always clear all apnoea events and use of them might leave a patient with 5 or less apnoea per hour (I think those were the figures). For this very reason there are a substantial group of sleep specialists who will NOT prescribe APAP. In theory, APAP will adjust to your requirement on an ongoing basis...........but again this action is governed by the algorithim................bloody confusing, but that's the way it is.

(4). The idea in CPAP is that it clears all (or almost all) AHI. If you have an AHI while using CPAP (or any PAP) it means that your machine/therapy is NOT clearing your apnoea events. I would suggest that you contact your sleep doctor and discuss these concerns with him/her.

Daniel.


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

Following up to (1):  Is it necessary to let the apap know that you're using the swift nasal pillows?  There's an option to tell it what kind of mask you're using in the settings.  It lists the various resmed masks and has "standard" for non-resmed masks.  My DME chose standard.  He said the only effect was that "standard" would be listed under "mask" on any data print outs.  But I just saw a post that suggested that the unit's algorythm depends on this setting.  Makes sense to me.  Anyone know for sure?  Thanks.

sleepydog wrote:

Following up to (1):  Is it necessary to let the apap know that you're using the swift nasal pillows?  There's an option to tell it what kind of mask you're using in the settings.  It lists the various resmed masks and has "standard" for non-resmed masks.  My DME chose standard.  He said the only effect was that "standard" would be listed under "mask" on any data print outs.  But I just saw a post that suggested that the unit's algorythm depends on this setting.  Makes sense to me.  Anyone know for sure?  Thanks.

Sleepydog,

The more info the machine has the better. As you are using a ResMed interface I would suggest that you inform the machine.
From my recollections it is important to 'key in' the correct mask data.

Daniel


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

Hi Sleepydog,

I am using a Resmed Spirit Autoset Autopap unit.  According to the directions that came with the unit  it says if you're using the Swift Pillows to set the mask type to "Mirage".  Mine originally came set to standard also.  I cant say that I notice any difference on either setting, but I did change and keep the setting at "Mirage" .  Read through your manuals and see if it specifies anywhere.  I don't recall if it was in the machine manual or the nasal pillows manual.  Hope this helps.

Linda (roseinpa57)