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[CPAP] Help with Devilbiss DV6 CPAP data and settings
#31
RE: Help with CPAP data and settings
(01-17-2020, 11:02 AM)Osiris357 Wrote: You have to get those leaks under control! Until you do those hypopneas will continue. Your leaks are so high that you machine couldn’t possibly compensate. You have a large leak almost all night long. Once you get your leaks to around 12 or so then you’ll have a much better idea of where you stand. Your getting all those because it’s almost like you’re not wearing it because you basically have no pressure in your airway. Until that’s fixed no setting change will help because you’re not getting proper therapy. Just my opinion but I almost positive I’m right

Ok, let's assume I have to get those leaks under control.
How do I do that?

I also reposted the data from 9 to 11th of January

   
   
   

data from 12 to 14th of January

(01-17-2020, 01:20 AM)Melman Wrote: Many of your hypopnea are clustered suggesting a positional issue such as tucking the chin to the chest which restricts the airway. See the link below on soft cervical collars and the link in the article to positional apnea.

can you send me a private message with some recommendations for the type of cervical collar that would help?


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#32
RE: Help with CPAP data and settings
Catalynux, you might try a soft cervical collar first. These are fairly inexpensive and probably available at any large drug store. You don't need to immobilize your neck; adjust the collar just so it would prevent you from tucking your head down toward your chest.

If that doesn't work, just google "anti-snore collars." Some people like The Eliminator; others, the Releaf. I like the Dr. Dakota, but it isn't clear whether they're still in production. The Eliminator looks pretty similar.

A collar might help with leaks as well as positional-related apneas -- if your leaks are from your mouth and not your mask. Do you know which is more likely? And could you check what brand and model of mask you have?

I would focus especially on the areas marked LL. It isn't clear what leak values are "excess" for your particular machine; on my machine, your leaks would be horrible, but on my machine, a lot of perfectly OK Phillips Respironics leak numbers would also be horrible.
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#33
RE: Help with CPAP data and settings
I'm using a nasal pillow from DeVilbis but I do not know the exact model.

The DeVilbis machines also have an app called smart link that measures "time spent in exhale puff" as they call it and lately the exhale puff reported is close to zero.
I'm more inclined to say that the mask might be leaking but either one of the options are possible.
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#34
RE: Help with CPAP data and settings
If your exhale is saying zero you are having a lot of mouth leak. A soft cervical collar or a chin strap or both will help keep your mouth closed. If the air still escapes you will need to tape your mouth closed. If that isn’t something you want to do you will need to get a full face mask. Those are your only options unfortunately. I had to go full face just for that reason. I also use a soft cervical collar to stop my chin from going to my chest. It killed two birds with one stone by also keeping my mouth closed so I get the benefits of nose breathing only while wearing a full face mask.
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#35
RE: Help with CPAP data and settings
(01-17-2020, 12:37 PM)Osiris357 Wrote: If your exhale is saying zero you are having a lot of mouth leak. A soft cervical collar or a chin strap or both will help keep your mouth closed. If the air still escapes you will need to tape your mouth closed. If that isn’t something you want to do you will need to get a full face mask. Those are your only options unfortunately. I had to go full face just for that reason. I also use a soft cervical collar to stop my chin from going to my chest. It killed two birds with one stone by also keeping my mouth closed so I get the benefits of nose breathing only while wearing a full face mask.

I attached the description for the exhale puff and some data from the smart link.
It is easier than explaining it as english is not my native language.


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#36
RE: Help with CPAP data and settings
Interesting, if that’s the case I have no idea why that chart is saying you have more than 25 l/min leak all night long. With a resmed machine 24 is the cutoff. After that the machine can’t make up for the leak as well. But according to this your not mouth breathing and you have no leaks. I’m at a loss. Does your machine have a flow limitation chart available in Oscar?
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#37
RE: Help with CPAP data and settings
But large leaks are what explains your low tidal volume and high minute vent. Something is being accurate here and I have no idea which one
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#38
RE: Help with CPAP data and settings
The "no puff" data indicate that the leakage is from the mask, I think.
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#39
RE: Help with CPAP data and settings
(01-17-2020, 02:14 PM)Osiris357 Wrote: Interesting, if that’s the case I have no idea why that chart is saying you have more than 25 l/min leak all night long. With a resmed machine 24 is the cutoff. After that the machine can’t make up for the leak as well. But according to this your not mouth breathing and you have no leaks. I’m at a loss. Does your machine have a flow limitation chart available in Oscar?

Resmed somehow accounts for normal mask venting and doesn't include it in leak rate. Philips Respironics and apparently these Devilbiss include the mask leakage in their reported leak value and thus never start at 0 but rather are larger number correlating with the normal leakage for the mask. 

Here is an example from Philips Respironics.

https://www.continuedcare.com/wp-content...-ports.pdf

From a random Devilbiss document 

Quote:Leak Rates All recorded leak rates are shown so that clinicians can observe the trending of any excessive leak rates. Most masks expiratory port leak rates are between 30-40 LPM. The IntelliPAP AutoAdjust considers leak rates greater than 95 LPM to be excessive.

I don't fully comprehend how this machine reports leak and am not sure what the difference between leak rate and max leaks is but I am fairly certain that he does not have a consistently high large leak.

There are moments of leakage, probably mouth breathing, but I do not think those are a serious problem. The large leak flag makes no sense either and I would just ignore it. 

I think pressure is too low, that lack of EPR is not helping and that there may be an aspect of positional apnea (or hypopnea in this case) which a cervical collar might help with. 

Catalynux, can you confirm if smartflex is on in any of this data?
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#40
RE: Help with CPAP data and settings
Smart Flex is on only when it says the machines was used in APAP mode.

I've been using the Smart Flex for the last three to four days days (for data on them I need to wait three days in order to be synced in OSCAR) but I keep waking up with a sore and dry throat.
I'm not sure why the Pressure still shows up as constant.


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