(07-03-2017, 10:45 AM)Scott C. Wrote: "opalrose" Does the flow rate cause the pulses too?
No. In general the Dreamstation does not send out a PP in response to a FL.
PP are used to determine whether the airway is clear or obstructed when the machine thinks it may need to score an apnea.
PP are also used to determine what's going on in the presence of a leak that is both high enough and long enough to make the machine worried about whether it is tracking the breathing correctly.
PP can also be used if the machine is having trouble tracking the breathing even if there is little or no leaking going on. If my mask slips in just the "wrong" way, the seal is somehow maintained, but the airflow that my machine can record drops substantially for many minutes at a time. And I'll see lots of PPs during that period. If things get "bad enough" the machine loses track of my breathing altogether in something my DME derisively and inaccurately calls a "patient disconnect." I don't get them often, but I'll see if I can post one for you to see what I mean.
Quote:Sleepyhead says I had major air leak last night see my c-pap advisor. So here is last nights graph.
Yep. That looks like "mouth breathing". Or more correctly, mouth leaking since you're taping.
However, it is worth noting that the DreamStation did not flag this as an official Large Leak. (It's close to the fuzzy line where DreamStations do flag things as official Large Leaks.)
How much to worry about it? Well it depends.
If you see a leak like this every now and then and you're feeling fine (in general) and the rest of the data looks good, it's not worth worry about.
If you see leaks that are this long and this large frequently (several times a week) AND if you feel pretty lousy the next day every time one of them happens, then it's worth trying to figure out if there's a way of reducing them.
Quote:same settings for last 4 nights.
I would continue running with those same settings. Changing the settings is not likely to fix the leak problem, and it creates yet another variable to deal with. Your current settings are giving you good numbers in terms of AHI, snoring, FL AND
most of the time your leaks are reasonably under control.
Quote:A couple observations Found out I can still exhale through microfiber tape which I think would explain the major leak and dry mouth.
You are not going to be able to prevent all instances of air leaking out through your mouth through taping. Your leaks are not great, but they are acceptable, even with an occasional night like this.
Switching to a FFM may fix the leaks. Or not: When your face relaxes during deep sleep, maintaining a seal on a FFM is can be more difficult than maintaining a seal on a nasal pillows or a nasal mask since the foot print is so much larger. In other words, opening your mouth in a FFM due to jaw relaxation can break the seal even if your mouth is under the mask.
Moreover, switching to a FFM is not likely to fix the dry mouth problem. The dry mouth problem is caused by air entering (and blowing around) your oral cavity. Using a FFM does not prevent that: A FFM only prevents that air moving in your oral cavity from contributing to the excess leak.
Quote:But also seem to be swallowing air via the burping and passing gas. As someone posted on this thread could happen. Should I be concerned?
If your tongue does not prevent air from entering your oral cavity, then that excess air in your mouth has to go somewhere.
If your lips crack open even a tiny bit, the air will (mostly) escape in a hiss of a mouth leak. It could show up in the data as a small leak or a large one, depending on how much air is leaking out of your mouth, which can depend on how wide you open your mouth.
If your lips stay firmly closed so no air escapes that way, the air still has to go somewhere. And the only other way of getting the excess air out of your mouth is to swallow it. Which leads to the burping and passing gas. The "air in the stomach" problem is called
aerophagia around here.
Should you worry about the aerophagia? Like so many other things with CPAP therapy, the answer is:
It depends.
In general: If you are bothered by the extra burping and farting AND you're not in any pain from getting the air in your stomach, then it's fine to just ignore it. But if you are experiencing pain from the air trapped in your stomach or if it's waking you up at night, then the aerophagia is a huge issue. If you're between the two extremes, it's a matter of figuring out how bothersome it is for you.
In my case, aerophagia is and has been one of my most significant CPAP related issues right from the start. A large part of my CPAP-induced insomnia stemmed from the fact that I get physically very uncomfortable once even a small amount of air winds up in my stomach. And I've woken up with my stomach visibly distended from the air trapped inside and doubled over in pain. Aerophagia at low pressure is, in fact, what was used to justify switching me to a bi-level machine after I spent 4 months in agony trying to adjust to CPAP back in 2010.
But most people don't get the kind of severe aerophagia that I experience. My husband is happy to fart and burp it all out when he gets a bit of air trapped in his stomach and so he doesn't have to worry at all about it.
Final comment: Last night's data looks good, in spite of that hour long leak. So the questions continue to be:
How are you feeling in the morning? And do you have enough energy to get through the day?
How are you sleeping at night? Still having night time wakes? If so, how many?