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Anyone else experience this?
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PaytonA Offline
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Post: #21
RE: Anyone else experience this?
(07-16-2015 05:28 PM)richb Wrote:  
(07-16-2015 04:54 PM)PaytonA Wrote:  
(07-16-2015 10:52 AM)richb Wrote:  You are still getting a lot of leaks. You might want to try a chin strap to eliminate the leaks. The leaks are probably removing too much CO2 and causing the CAs.

Could you explain that a little more. I am having a senior day and am not following why that would be the case.

Best Regards,

PaytonA
According to your statistics your leak percentage is 12%. Leaks could be washing out CO2 which your body measures to control respiration. Your Ti time might well be a factor. I too am inclined to adjust mine for a longer inspiration time. You might have been experiencing arousals if you were trying to inhale during a transition from inhalation to exhalation. Do you feel that the Ti time change has made a specific difference?

richb,

They are not my leaks. What I was asking is for your logic behind the statement that , "leaks may be washing out CO2".

According to the OP he was having a problem with the transition from exhalation to inhalation not the other way around.

Ti max and Ti min do not control the inspiration pressure time, they set limits for it. Similar to max and min IPAP with an autoset.

The change that the OP made to the Ti max could not possibly have made a difference to the problem he was having with the transition from exhalation to inhalation because the Ti max only operates at the end of inhalation when it is time to transition to exhalation or for the inhalation to exhalation transition.

Best Regards,

PaytonA
07-16-2015 10:28 PM
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richb Online

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Machine: Resmed AirCurve 10 ASV
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CPAP Software: ResScan SleepyHead

Other Comments: Idiopathic Central Apnea

Sex: Male
Location: Vermont

Post: #22
RE: Anyone else experience this?
(07-16-2015 10:28 PM)PaytonA Wrote:  
(07-16-2015 05:28 PM)richb Wrote:  
(07-16-2015 04:54 PM)PaytonA Wrote:  Could you explain that a little more. I am having a senior day and am not following why that would be the case.

Best Regards,

PaytonA
According to your statistics your leak percentage is 12%. Leaks could be washing out CO2 which your body measures to control respiration. Your Ti time might well be a factor. I too am inclined to adjust mine for a longer inspiration time. You might have been experiencing arousals if you were trying to inhale during a transition from inhalation to exhalation. Do you feel that the Ti time change has made a specific difference?

richb,

They are not my leaks. What I was asking is for your logic behind the statement that , "leaks may be washing out CO2".

According to the OP he was having a problem with the transition from exhalation to inhalation not the other way around.

Ti max and Ti min do not control the inspiration pressure time, they set limits for it. Similar to max and min IPAP with an autoset.

The change that the OP made to the Ti max could not possibly have made a difference to the problem he was having with the transition from exhalation to inhalation because the Ti max only operates at the end of inhalation when it is time to transition to exhalation or for the inhalation to exhalation transition.

Best Regards,

PaytonA

I did get that wrong. I had just returned from a new titration and had very little sleep.

Rich.

Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here: http://www.apneaboard.com/wiki/index.php...SleepyHead
07-17-2015 06:28 AM
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quiescence at last Offline

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Post: #23
RE: Anyone else experience this?
leaks can only - very remotely - affect CO2 washout. Not washout per se, but amount of CO2 remaining in the breathed/rebreathed. More leakage (if not disruptive and not confusing to the machine algorithm) clears the air more. If there is some CO2 still stuck in the inhaled air, the CO2 that is washed out, then it is replaced by "less than pure" oxygen.

QAL

ps. this can lead you to come up with some strategies for adding trapped air which have potential hazards associated, so we will not discuss anyone you know having maybe done some of that.

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
07-17-2015 02:24 PM
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richb Online

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Post: #24
RE: Anyone else experience this?
(07-17-2015 02:24 PM)quiescence at last Wrote:  leaks can only - very remotely - affect CO2 washout. Not washout per se, but amount of CO2 remaining in the breathed/rebreathed. More leakage (if not disruptive and not confusing to the machine algorithm) clears the air more. If there is some CO2 still stuck in the inhaled air, the CO2 that is washed out, then it is replaced by "less than pure" oxygen.

QAL

ps. this can lead you to come up with some strategies for adding trapped air which have potential hazards associated, so we will not discuss anyone you know having maybe done some of that.

There is some experimental work using a device that traps some exhaled air to raise CO2 levels. And yes I have also seen only a little reference to washout caused by leaks.

Rich

Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here: http://www.apneaboard.com/wiki/index.php...SleepyHead
07-17-2015 02:37 PM
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PaytonA Offline
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Machine: ResMed S9 VPAP Auto
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CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Orange County,California

Post: #25
RE: Anyone else experience this?
I can see where leaks could clear more CO2 out of the mask and where it might be a concern for the larger volumes of FFMs. With any of the nasal masks there is not that much air volume inside the mask, so it would seem to me that the effect would be minimal but that is just my thinking. Another thing that occurs to me is that most of the masks are designed so that the air entrance is close to ones nose and I would think that most of the air inhaled is fresh from the hose. Again, just my thinking.

Best Regards,

PaytonA
07-17-2015 03:45 PM
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richb Online

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Other Comments: Idiopathic Central Apnea

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Post: #26
RE: Anyone else experience this?
I was just re-titrated and will be put on a new setting of Exp 11 Insp 15. I had a difficult titration meaning it was difficult to fall asleep and difficult to stay asleep. Lots of CAs, many during sleep onset which woke me up. I felt like the Ti time of 2 sec. was too short for recovery after a CA. I felt like the machine was stuck between Insp and Exp offering me no air. That was just my feeling and may not have been the case. In any event I will be looking at my results in the morning to see if my new settings return much lower CAs.
07-17-2015 04:08 PM
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quiescence at last Offline

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Machine: REMstar System One with Autoflex
Mask Type: Full face mask
Mask Make & Model: Quattro AirFit F10
Humidifier: yes typical setting = 4
CPAP Pressure: 5-13 Autotritrating CPAP
CPAP Software: SleepyHead EncoreBasic

Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing

Sex: Male
Location: US

Post: #27
RE: Anyone else experience this?
note - there is no PAP machine that forces your exhale. exhale is a balloon deflating. the EPAP is a pressure that acts to *slow* the exhale. The less the EPAP, the more the natural deflation can occur. So, when I say I do not have a pressure relief, what I am really saying is the pressure that helps me breathe in is there to resist my breathing out. So all the breathing is basically mine to do. The air pressure just keeps the airway walls from collapsing.

QAL

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
07-17-2015 10:07 PM
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richb Online

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Other Comments: Idiopathic Central Apnea

Sex: Male
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Post: #28
RE: Anyone else experience this?
First night after new titration. AHI 30 all CAs. Machine set for Bi-Pap 11 15. No improvement since start of treatment. There is a nearly 2 hr period at the end of the night where the AHI is nearly 70 all CAs. I have tried the following pressures Bi-Pap 5-9, CPAP 9, Auto averaging 13, and Bi-PAP 11 15. None of these settings has produced any significant improvement.

Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here: http://www.apneaboard.com/wiki/index.php...SleepyHead
07-18-2015 07:49 AM
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Sleeprider Online
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Post: #29
RE: Anyone else experience this?
What was the explanation that you weren't prescribed ASV?
Does your sleep clinic doctor have some kind of conflict of interest in prescribing less expensive machines?

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07-18-2015 07:56 AM
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richb Online

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Post: #30
RE: Anyone else experience this?
(07-18-2015 07:56 AM)Sleeprider Wrote:  What was the explanation that you weren't prescribed ASV?
Does your sleep clinic doctor have some kind of conflict of interest in prescribing less expensive machines?

I have a new appointment with the Sleep Doc on July 30. I expect to get either an ASV machine medication or both. The Doc and techs haven’t seen the "Cheyne Stokes" type of breathing (during titration) seen by my machine every single night. My BP is elevated every morning. I check BP several times a day. Elevated in the morning and normal to very low the rest of the day. I will stay on the current settings for 2 more nights. Then I will be calling the Sleep Center to go over my latest numbers. Starting Monday I will go off the machine for a few days and compare morning BP. I expect my BP to show some better numbers without the machine just like before starting treatment.

Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here: http://www.apneaboard.com/wiki/index.php...SleepyHead
07-18-2015 08:17 AM
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