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Anyone used a Sefam S.Box machine?
#21
RE: Anyone used a Sefam S.Box machine?
Here is a close up for you. Last night once again I had two of these CA events and I woke up just before 02:00 so it could have been after the first CA event. What puzzles me looking at the chart is that the pressure was up just before this event. What triggered the pressure to go up? I will turn the ramp off as you suggest. Does the ramp only apply to the start of the treatment?


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#22
RE: Anyone used a Sefam S.Box machine?
Look at Flow Limits and Snore charts.
Your close up in not close enough to see flow limits or snores. But does show mild PB
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#23
RE: Anyone used a Sefam S.Box machine?
I have not had one good night's sleep with my machine and yesterday after having around 3 hours of nodding on and off, I was totally knackered. Last night I resorted to a sleeping pill and I was hoping that my mask would stay well sealed. This is the longest sleep that I've had in months but I do know that taking sedatives don't actually give you a ood sleep that helps to heal the body. I've attached the full chart and then a close up of one of my Clear Airway (CA) events. Juts btw, what is the actual difference between a CA event and Obstructive event?

My next obvious question is why did my machine not react to theses events by a sudden increase in pressure? Surely that is the purpose of these machines, or do I have an incorrect understanding here? The other question I have is on that graph showing Leak Rate. Does that only indicate that the mask is leaking or can it be that I'm opening my mouth? I am using a nasal mask so this is possible even though it has a soft gel seal. I always say that I do not sleep with my mouth open, but maybe it happens anyway.

Keith R


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#24
RE: Anyone used a Sefam S.Box machine?
Hi Keith.

Clear airway v obstructive: In an obstructive apnea, your body is trying to breathe, but the airflow is obstructed (hence the name) by your tongue, soft palate and other upper airway tissues which collapse while you're asleep. A central (clear airway) apnea is very different - the signal from the brain to the lungs which says "breathe now" doesn't get through. Either the brain doesn't generate it (most common) or it is interrupted or the lungs don't react. So your body isn't even trying to breathe for a short time. A central apnea may be idiopathic, or caused by a neurological condition or by drugs such as some painkillers. It can also commonly occur in CPAP users as the level of CO2 in the blood is disturbed by the pressure and the brain doesn't see enough CO2 to make it worth trying to breathe.

Why didn't the machine react? Autoset machines are specifically set not to react to central apneas. Doing so is likely to further reduce CO2 which will further delay the brain sending the breathe signal. In other words, increasing the pressure under these circumstances can make the apnea worse.

Mouth leaking: Is a very common occurrence. Many people persist with nasal pillows or nasal mask then have to resort to chin straps, collars etc to keep the mouth closed. IMHO the easiest and best way to overcome this is to use a full face mask.
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#25
RE: Anyone used a Sefam S.Box machine?
Thanks DB, how does this ResMed machine know the difference between the clear airway and obstructive apnea? All I see from the charts is a drop in the airflow pulses, so it would be interesting to know how this machine can differentiate between the two. So what should I do as far as setting go on my machine? Lower the pressure or maybe set it to constant as in cpap mode?

Keith R
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#26
RE: Anyone used a Sefam S.Box machine?
(07-16-2019, 09:53 AM)KeithR Wrote: . . . how does this ResMed machine know the difference between the clear airway and obstructive apnea?

The simplest answer is the Resmed sends out pulses of air, much like a sonar signal. If it there isn't a return pulse then the airway must be open, meaning a clear airway event. If a pulse is returned or sensed, then something is obstructing the airway.
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#27
RE: Anyone used a Sefam S.Box machine?
Most here prefer to start with auto mode. then adjust depending on the results.  Without any solid data this is a good set of numbers to start with.  Expect them to need adjusting.

Min pressure 7 
Max pressure 20
EPR on full time
EPR=2
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#28
RE: Anyone used a Sefam S.Box machine?
Hi Fred,

Thanks for the info. My neurologist and his clinician recommended my settings to be a max of 8 and min of 4. At present I set the min to 6 and the max to 8. The EPR is set as you stated. "DeepBtreathing" wrote "increasing the pressure under these circumstances can make the apnea worse." You recommend setting the pressure up to a max of 20, so my question then is will this not make my condition worse?. Thanks.

Keith R
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#29
RE: Anyone used a Sefam S.Box machine?
KeithR Wrote:"DeepBtreathing" wrote "increasing the pressure under these circumstances can make the apnea worse."

Hi Keith, this was in response to your specific question about why the machine didn't increase pressure after the central apneas. In general you can increase your maximum as suggested but you do need to keep an eye on the centrals to make sure they don't increase excessively. With the low number you're experiencing I wouldn't expect it to be a problem.

I also wouldn't expect to see the max pressure go up to 20 either - the machine will take it as far as it needs to go, so a setting of 20 is just giving the machine space to see what is actually required.
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#30
RE: Anyone used a Sefam S.Box machine?
O.K. thanks again. I'll try a few more setting. I'm just wondering why I'm waking up regularly after a few hours each night. The longer chart I post I cheated and used a sleeping pill like Immovane. I don't take these things regularly but I really battle to stay sleeping, and now I'm not sure if it's due to using the machine or not. My wife says that I need more patience............. Wink
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