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CPAP Pressure
#1
My AHI's have jumped all of a sudden from an years average of around 2.0 to a startling 8-17.0 for two nights straight. I run 12.0 cm of H20. Can the REsMed S9 Elite machine have stopped supplying the 12 cm of H20? The filter is OK.

I gave the results to me lung doctor and he had no physical reason why the AHI would take that drastic jump all of a sudden.

What is the cheapest and best water manometer available. I have seen some but don't see how they connect to the hose or the machine. They all seem to have a small diameter port on them. Can the pressure be measured at the oxygen port of the Respironics mask?

Is the 12 cm H2O the static pressure when the hose is deadheaded or is it the pressure that is at the actual mask oxygen port when there is flow?

Thanks, Bob.
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#2
Bob, can you just put your machine in the car and run it down to your friendly local DME to be checked out? That would seem to me to be quicker than acquiring a manometer.

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#3
Since it is Easter weekend, here is a DIY pressure check that our fearless leader Supersleeper posted about: http://www.apneaboard.com/forums/Thread-...ew-dollars
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#4
(04-04-2015, 01:20 PM)retired_guy Wrote: Bob, can you just put your machine in the car and run it down to your friendly local DME to be checked out? That would seem to me to be quicker than acquiring a manometer.

Thanks. I did that yesterday but my DME is so bad I do not trust anything from them. Bob.

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#5
(04-04-2015, 01:50 PM)Sleeprider Wrote: Since it is Easter weekend, here is a DIY pressure check that our fearless leader Supersleeper posted about: http://www.apneaboard.com/forums/Thread-...ew-dollars
Thanks. That looks good but I'd like a simple portable manometer or gauge that I can carry on trips to check the machine if I suspect a problem. Bob.
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#6
BobF,
Check the supplier list at top of page. Supplier #26 sells them, also Supplier #1 has a smaller gauge type.
OpalRose
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#7
(04-04-2015, 11:46 AM)BobF Wrote: My AHI's have jumped all of a sudden from an years average of around 2.0 to a startling 8-17.0 for two nights straight. I run 12.0 cm of H20. Can the REsMed S9 Elite machine have stopped supplying the 12 cm of H20?

Yes. Or maybe you are having mouth leaking? Or maybe your hose has a leak and needs to be replaced, or maybe your mask has an oxygen port cap which has fallen off. Or maybe "normal" mask leaks are higher. Or maybe your sleep position has changed. Or maybe there have been changes in your diet or over-the-counter nonprescription medicines, or prescription meds. Or maybe you have moved to a higher elevation, increasing the number of central apneas.

Are all the additional apnea events obstructive in type? Has the amount of Leak changed much? Are you sleeping flat on your back more often?

Quote:What is the cheapest and best water manometer available. I have seen some but don't see how they connect to the hose or the machine. They all seem to have a small diameter port on them.

12 cm H2O is very small (0.17 psi), so you can simply use tape (if needed) between the hose and the manometer.

Quote:Can the pressure be measured at the oxygen port of the Respironics mask?

The small O2 port could used if the manometer was one which did not require airflow through the manometer. Without airflow through the manometer (and through the narrow tube to manometer) there would be no pressure drop between the mask and the manometer, so the manometer would accurately report the mask pressure.

Quote:Is the 12 cm H2O the static pressure when the hose is deadheaded or is it the pressure that is at the actual mask oxygen port when there is flow?

If the hose type is correctly set in the machine settings, the machine will correctly compensate for the pressure drops caused by airflow in the humidifier and hose, and the pressure the CPAP machine reports will be mask pressure.

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#8
Please put your machine type in your profile. i.e. ResMed S9 Elite instead of just ResMed.

Download SleepyHead if you haven't already. One of the things it reports is "Mask Pressure." I believe mask pressure is a report of the actual pressure delivered and it will spot SOME possible failures where the machine won't be delivering the correct pressure.

Note that it is possible that the pressure sensor is working poorly and that's causing the machine to deliver the wrong pressure, but if the mask pressure graph is reporting the wrong pressure, you DO have a problem.

One really poor "manometer" is to get a big pot of water, and stick the hose down deeply into the water. Turn the machine on, then slowly pull the hose up until it starts blowing bubbles. The depth below the surface where it starts blowing bubbles is your pressure in cmH2O.

It's a really crude measurement, but might be useful. It can also spray water around when it bubbles if you aren't careful, especially if you use something narrow like a water glass. It could show you if the pressure is seriously wrong.

It also suffers from the problem that you're measuring pressure at zero flow rate. Pressure might be OK at no flow, but then be wrong when you have air flowing.

The "right" way to use a manometer is to put a "t-fitting" inline with the hose, and run a smaller tube off of the t-fitting to the manometer while you're using the machine. Some of the sellers include a t-fitting and a hose with the manometer.

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#9
(04-04-2015, 04:40 PM)archangle Wrote: Please put your machine type in your profile. i.e. ResMed S9 Elite instead of just ResMed.

Download SleepyHead if you haven't already. One of the things it reports is "Mask Pressure." I believe mask pressure is a report of the actual pressure delivered and it will spot SOME possible failures where the machine won't be delivering the correct pressure.

Note that it is possible that the pressure sensor is working poorly and that's causing the machine to deliver the wrong pressure, but if the mask pressure graph is reporting the wrong pressure, you DO have a problem.

One really poor "manometer" is to get a big pot of water, and stick the hose down deeply into the water. Turn the machine on, then slowly pull the hose up until it starts blowing bubbles. The depth below the surface where it starts blowing bubbles is your pressure in cmH2O.

It's a really crude measurement, but might be useful. It can also spray water around when it bubbles if you aren't careful, especially if you use something narrow like a water glass. It could show you if the pressure is seriously wrong.

It also suffers from the problem that you're measuring pressure at zero flow rate. Pressure might be OK at no flow, but then be wrong when you have air flowing.

The "right" way to use a manometer is to put a "t-fitting" inline with the hose, and run a smaller tube off of the t-fitting to the manometer while you're using the machine. Some of the sellers include a t-fitting and a hose with the manometer.
Hi. Thanks. I revised my profile.

I have Sleepyhead and will look at it. I always use ResScan.

I tried the water in a bucket method. I am going to make my own manometer out of plastic tubing. I need to get some food coloring. I plan to use the oxygen port which is in the same cavity as the tube outlet. Bob.

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#10
(04-04-2015, 04:02 PM)vsheline Wrote:
(04-04-2015, 11:46 AM)BobF Wrote: My AHI's have jumped all of a sudden from an years average of around 2.0 to a startling 8-17.0 for two nights straight. I run 12.0 cm of H20. Can the REsMed S9 Elite machine have stopped supplying the 12 cm of H20?

Yes. Or maybe you are having mouth leaking? Or maybe your hose has a leak and needs to be replaced, or maybe your mask has an oxygen port cap which has fallen off. Or maybe "normal" mask leaks are higher. Or maybe your sleep position has changed. Or maybe there have been changes in your diet or over-the-counter nonprescription medicines, or prescription meds. Or maybe you have moved to a higher elevation, increasing the number of central apneas.

Are all the additional apnea events obstructive in type? Has the amount of Leak changed much? Are you sleeping flat on your back more often?

Quote:What is the cheapest and best water manometer available. I have seen some but don't see how they connect to the hose or the machine. They all seem to have a small diameter port on them.

12 cm H2O is very small (0.17 psi), so you can simply use tape (if needed) between the hose and the manometer.

Quote:Can the pressure be measured at the oxygen port of the Respironics mask?

The small O2 port could used if the manometer was one which did not require airflow through the manometer. Without airflow through the manometer (and through the narrow tube to manometer) there would be no pressure drop between the mask and the manometer, so the manometer would accurately report the mask pressure.

Quote:Is the 12 cm H2O the static pressure when the hose is deadheaded or is it the pressure that is at the actual mask oxygen port when there is flow?

If the hose type is correctly set in the machine settings, the machine will correctly compensate for the pressure drops caused by airflow in the humidifier and hose, and the pressure the CPAP machine reports will be mask pressure.
Thanks.
No hose leaks. Already checked it.
No abnormal leakage. Already checked it.
No O2 port open. Already checked it.
Sleep position on side as always.
No diet or meds changes.
I have not moved.
In ResScan it shows a constant pressure of 12 cm H20. I am going to check it with SleepyHead.
They are all obstructive events.
My nose or throat are not obstructed.
I am going to measure the pressure at the mask O2 port while the mask is on.

Very strange. It was a very sudden change from years of AHI's in the range of 0.1 to a max of 4.0 (usually around 0.5.

Thanks, Bob.
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