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40.14 AHI with the Resmed airsense 10, need some advice please

Let's see if I got some of the info you all like to see, this is my first try so I'm open to suggestions

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First impression is leaks are way too high. You must get that under control first - the machines cannot cope with the levels of leaks you are showing and can't treat you effectively with them that high. Under such circumstances the other figures are rather meaningless.

Insist that your DME provide you a mask that will work without major leak. Don't take no for an answer.

Your machine is also set wide open, and that's almost always bad, but getting the leaks under control comes first.
Ed Seedhouse

Your brain is not the boss.

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Hi, Rich. Well, the leaks apparently aren't due to you switching masks. Smile

How about this? Maybe you have lost the knack of keeping the "tongue seal" that prevents air from the machine from going out your mouth instead of out your nose during the 2-3 months that you weren't using CPAP therapy.

I would switch back to the new pillows and buy a chin strap. The Bella mask looks very comfortable. I like the over-the-ear straps.

On another subject, some people mentioned confusion in SleepyHead about your S9 data. It looks like you imported the data from the S9 into the same SleepyHead profile that contains the data from your new machine.

If you want to keep the S9 data around for reference, I would purge the SleepyHead data, create a second profile, and put the S9 data into a separate profile. I have never done that myself, but I have seen the option in the SleepyHead menus.
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OK, thanks. I'll see about getting a chinstrap today. You are correct about the Bella with the ear strap. I prefer that by far over the head gear I was using with the older nose pillows. I thought when I first saw it that it would hurt my ears but it doesn't seem to bother me at all and I feel like I have a better seal. The leaking thing is hard for me to figure out. It must be coming out of my mouth if that's possible to cause the large leaks I'm having. I can't believe that the seal at my nose is breaking, it feels to secure. I'll try to get a chin strap on the way home from work today and if that doesn't work I do have a full face mask. Maybe I'll dig it out and give it a shot. I actually have three types of masks, The nose mask, full face mask, and nose pillows. I had a hard time figuring out what was most comfortable at the beginning and tried all three. LOL I stuck with what I tried first and got used to the nose pillows and used those the rest of the time with my S9.

I appreciate your help very much!
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I wanted you to see last nights data. I'm thinking I'll probably need to try the full face mask next. The chin strap that I added last night didn't seem to help a whole lot but it is slightly better. I 'll try another night or two with the chin strap and if it doesn't get much better I'll get a mask or dig out the one I think I still have. I'll let you know unless you think I should talk to the doc about a different machine?
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Hi Richflu,
As others have already said, you have to address your leak rate first. When you have a leak rate that high, it's not possible to know if the machine is flagging
apnea events correctly.
You may need to use a full face mask, if not then try the chin strap along with practicing the tongue seal technique.

Also, your machines minimum pressure is too low. Your 95% pressure is over 12, your minimum start pressure should be no lower than 10. You could also bring the max of 20 down to 15.
A range of 10 to 15 makes more sense, but still won't matter much if you don't control the leaks.

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            As always, thank you for the advice. I'll try adjusting the pressures a little but I think I may be on the right track to fixing my problems. Take a look at these pics. These are the last three nights and I used a chin strap (what a lovely piece engineering, my wife had a good laugh again) They seem better to me and I actually felt great after the fist night I used it and again I feel pretty rested today. I think I'll try the full face mask for a couple nights as well just to see if I get similar results with more comfort. The chin strap leaves lines in my face so I look like a tire when I first get up!! LOL
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The leaks are looking much, much better.

Your pressure needs seem to be higher in the later part of your sleep. I see the same pattern with my data.

Mrs. Richflu is making fun of your chin strap? She may need a sleep study. Bigwink

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