Switching from a Full-Face Mask (Resmed Quattro FX) to a Nasal Pillow (RespCare Aloha)

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Aloha

I’ve been sleeping with a CPAP device for several years and during the entire time I’ve always used a full-face mask. It’s worked alright but I still have several bad nights every now and then along with several moderate sleep nights. I know what it’s like to have great sleep so I’ve been aware for a while that perhaps it was time to try something new.

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The Pitfalls of Relying on CPAP Machine Stats

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I’ve been managing obstructive sleep apnea for several years and I’ve learned a great deal over time. One of the more recent things I’ve come to realize in the past couple of years is that CPAP machine stats aren’t the only factor that should be used to determine how effective a treatment is working.

If you take the time to browse CPAP patient forums you’ll soon learn that the various machines calculate statistics in different ways. Between two different models in the same line I can estimate there’s at least a difference of two or three units for the value of the nightly AHI numbers. For example, my wife’s S9 appears to be lower than my own S8. Obviously I can’t account for the difference in severity between our cases of sleep apnea but I’m fairly certain, based on forum posts, that the S9’s reported numbers are typically lower. In my opinion, lower values reported by the S9 make it more difficult to pin-point problems because it offers a narrower range in which swings can be detected.

There are several factors to consider. For example, though an AHI may appear low this can be misleading if the leak rate is very high. I consider the AHI value more reliable when I have a very low leak rate.

One should also be mindful of the fact that home devices do not track the same array of data that is gathered in a sleep study. It’s possible that some information won’t reveal problems that might be obvious when compared against data collected in a lab setting (O2 levels, sleep stages, etc).

Sleep stats aren’t enough and simply don’t reveal everything. The quality of the sleep isn’t something that I can track at home. Yes, I can see if there were severe problems with leaks or high AHI values, but my machine can’t really track sleep stages (these can only be inferred to a minor degree) or the quality of my sleep.

I think most experienced CPAP users will agree that statistics are helpful but the most important factor for determining effectiveness is simply how good you feel in general.

With my machine I’ve learned that I’ll feel alright with an AHI below 3 and I typically feel very good if it’s below 2. Anything consistently above a 4 will begin to wear me down. Note that these numbers are well within the “normal” range.

Updated 06/25/2012: But the stats can be very helpful at times as well. If you look at the pressure a machine is using to stop events then you may figure out that your lowest pressure setting should be increased. Over in relevant forums many users have stated that what often happens is that a machine doesn’t ramp up to the necessary pressure in time to stop many events. For example, if your minimum pressure is 6 (with a max of 15) and the majority of your logged events require a pressure of 12 then it’s possible that there are several events at or above that pressure and the machine simply isn’t ramping up enough in time. For example, if the machine is at 6 and only reaches 9 before the event naturally ends (your brain tells your body to breathe, thus disrupting your sleep) then it may not be effective enough. In such a case it may be wise to have your lowest pressure increased to a value closer to the average pressure needed to prevent events.

Sophos AntiVirus for Mac Home Edition & iMac Standby Issues

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Several weeks ago I installed Sophos AntiVirus for Mac Home Edition on my iMac. I chose it because I was somewhat familiar with Sophos and I knew that I needed a working malware program (I was using an older version of McAfee Security on my previous iMac but that version wasn’t compatible with Lion).

Since I installed it I began to notice odd issues with bringing my Mac out of standby. It could have been a coincidence but the only other changes I’ve made to the system were some recent system updates.

Today, once again, the system didn’t wake. Previous issues also included the system partially waking but the mouse cursor would change to a spinning wheel and I couldn’t do anything except move the cursor.

After I restarted the iMac the system offered to send a crash report to Apple. I went ahead and let it but I viewed the details before sending. While I didn’t read the information closely it looked like it was possibly caused by the Sophos updater process.

To try to work around the problem I changed some Energy Saver settings. My iMac is on a UPS and I noticed the UPS configuration options were a little different from the standard power options. I disabled the option to allow the hard drive to sleep and then saved the changes.

With those changes in place it’s now just a matter of waiting to see if it happens again.

RemZZZs – CPAP Mask Liners

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Updated 09/15/2011: I’ve reversed my opinion of the liners since I wrote this post. I began to have less effective rest after a few days. Last night I removed the liner and ended up sleeping well despite only having about five hours of rest. It’s still possible it was a fluke but in the end I’m not sure these really add much. I can’t say with certainty whether or not they improve or inhibit rest but for the cost and uncertainty I’m ruling that they just don’t make much of a difference for me. I still have 28 more liners left so I may try them again. If my opinion changes I will update this note.

Updated 10/25/2011: I’ve tried them a few more times since my last update and I still haven’t seen that they help me. However, my wife tried one (that wasn’t even fitted for her mask) one night and thought that it made a big difference with her medium ResMed Quattro FX mask). I’m going a different route. I’ve ordered a Pad-a-Cheek Mask Liner. I’ll add a new post after it arrives and I’ve had a chance to use it a few nights.

After recent spell of a few nights of bad sleep I started looking into anything that might help prevent mask leaks. Fortunately, I managed to make a few changes that let me sleep well without any new CPAP equipment. Yet, I had already ordered some mask liners after reading various product reviews and a few forum posts.

Last week I purchased a set of RemZzzs Padd Full Face CPAP Mask Liners from CPAP.com for $24.95 (before shipping). Note that you can purchase these from other suppliers but it’s important to ensure that they’ll fit the mask and mask size that you use. CPAP.com has a chart on the mask liner page that will match up different masks with the appropriate liner sizes. In my case, since I use a Resmed Quattro Full Face Mask (Large) the chart listed the “Large A” mask liners as my preferred size.

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Tricking a Hotel Room Air Conditioner/Occupancy Sensor

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Several months ago I stayed in a hotel in which the room used an “occupancy sensor” to automatically shut off the air conditioner if no movement was detected after a brief delay. I didn’t consider it a true occupancy sensor. Instead, this seemed more like a simple motion sensor.

In my opinion an occupancy sensor shouldn’t shut off the A/C if someone is still in the room. For example, it should be able to detect the body heat of a room’s occupants. After one night of sleeping in a warm room I cobbled together a simple solution.

The core concept is to generate movement that will continuously trigger the motion sensor.

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