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Changed to resmed 10 auto, several questions
#1
Hi All,

Sorry this is so long.

Hoping to get some input. I was diagnosed with Obstructive sleep apnea with 27 incidents per night. I was prescribed a cpap, I went in to the titration study and they put my pressure at 11. However I had been having troubles with deviated septum and my nose blocking at night. So I decided to see the ENT. Before my CPAP came in, I ended up doing the UPPP surgery and tonsil removal. The stuffiness went away after I healed up. Getting my time in is always tricky as I only sleep 4 to 5 hours a night. I actually sleep worse after using the CPAP than before, but I still try to wear it every night.

When i got my cpap about 10 weeks after surgery, it was an F&P novo and it seemed to work okay but sometimes the pressure makes my ears get stuffy and sometimes the pressure will puff out my cheeks enough to push the corners of my mouth out of the mask, and I end up with bloating.

Over the last month I started finding my nose getting stuffy at night again, (when laying on my side the bottom nostril will block and the upper nostril will clear.) Allergy tests were negative.

I decided that I'd try a new auto machine instead. I just got the resmed 10 auto. So last night I did my best to set it up myself. (Still learning all the settings)

I turned off ramp and the setting that makes it pulse the pressure. I set the pressure to 7 and 12.

I'm using the amara face mask (I think that's what it's called).

It should 3 incidents per hour, and a leak or 8.

Since this is all new to me, does it sound like I have this set properly?

Also do any of you contact your provider to update them on the machine change? Or since I bought the other machine am I going to be going it alone from here on out?

Also has any one used the So Clean 2 cleaning system? is it worth it. Due to severe time constraints I'm only able to clean my mask and unit once a week but sometimes it ends up stretching to 2.

Thanks for any input.
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#2
Hi Shockwave,
WELCOME! to the forum.!
Hang in there for answers to your questions and good luck to you with your CPAP therapy.
trish6hundred
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#3
Let me give this a try. First welcome to the Apnea Board. My first suggestion is that you install the Sleepyhead software. It will give you and us a chance to see the detail of your nights use. It will show whether your settings are doing the job or if you need some tweaking. An AHI of 3 is considered treated but you might be able to do better. In particular you might need more sleep. Next the stuffy nose issue is somewhat common. It is especially common for the low side nostril to clog due to gravity. I use both Nasacort and Breathe Right Strips for this reason. Regarding the So Clean 2. There are some here who use the system but most people are using various implementations of soap and water. Do a search on this Board and you will find lots of discussion. You may want to discuss machine changes here (Apnea Board) before you discuss random changes with your DME Provider. That is why we suggest installing the Sleepyhead software. One or another members will recognize breathing patterns and data that could benefit from minor adjustments. Try to get more sleep. Keep us posted.

Rich

P.S. Mask issues are our most common problem. Search for your mask and leaks in the search panel.
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
Post from Imgur


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#4
ok, still figuring out the software, but here is some of the data from the details screen
Statistics
Channel Min Med 95% Max
PressureTherapy Pressure (cmH2O)
W-Avg: 8.23 4.20 8.14 11.32 12.00
EPAPExpiratory Pressure (cmH2O)
W-Avg: 6.43 4.02 6.56 8.50 9.00
Minute Vent.Amount of air displaced per minute (L/min)
W-Avg: 7.07 0.00 6.75 9.88 18.38
Resp. RateRate of breaths per minute (Breaths/min)
W-Avg: 19.45 0.00 19.60 22.80 38.60
Flow Limit.Graph showing severity of flow limitations (Severity (0-1))
W-Avg: 0.01 0.00 0.00 0.09 0.57
Leak RateRate of detected mask leakage (L/min)
W-Avg: 3.25 0.00 2.40 9.60 120.00
SnoreGraph displaying snore volume (?)
W-Avg: 0.00 0.00 0.00 0.00 2.14
Insp. TimeTime taken to breathe in (Seconds)
W-Avg: 1.35 0.26 1.28 1.80 10.28
Exp. TimeTime taken to breathe out (Seconds)
W-Avg: 1.79 0.08 1.76 2.30 5.36
Tidal VolumeAmount of air displaced per breath (ml)
W-Avg: 369.63 0.00 340.00 580.00 1420.00

Total time in apnea 00:03:34
Time over leak redline 0.270%
Machine Settings

ModeCPAP Mode APAP
Pressure MinMinimum Therapy Pressure 4.20 cmH2O
Pressure MaxMaximum Therapy Pressure 12.00 cmH2O
Antibacterial FilterAntibacterial Filter No
Climate ControlClimate Control Manual
EPRResMed Exhale Pressure Relief Full Time
EPR LevelExhale Pressure Relief Level 3cmH2O
Humidifier StatusHumidifier Enabled Status On
Humidity LevelHumidity Level 4
MaskResMed Mask Setting Full Face
Patient AccessPatient Access No
RampRamp Enable Off
Smart StartMachine auto starts by breathing On
TemperatureClimateLine Temperature 27 ºC
Temperature EnableClimateLine Temperature Enable 2
Session Information
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#5
The leak appears to be when I took off my mask in the morning, I was expecting it to turn off automatically but it didn't I let it run for awhile and then I ended up manually turning it off.

I generally don't have a ton of leak issues, although I'm using a new mask that I had to buy as an emergency while traveling. Starting to get the hang of it, but still haven't quite got it right, and it sometimes gets dislodged when I roll over.
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#6
A little of my findings from my titrations. When they say 11cm/h2o they mean 11 cm both inhale and exhale. If you set a pressure relief of say 3, that means than on exhale the pressure drops to 8 cm. If you get a apnea during this time the pressure stays at 8 cm which may not be enough to bring you out of the apnea. In this case, if you want pressure relief a setting might be better as 14cm with the relief of 3 which keeps you up at the prescribed pressure.
I have had several instances where I credit CPAP with saving my life, as it became extremely difficult to breathe on my own. The pressure relief was extremely helpful. But I am learning to be concerned about DME's whom turn pressure relief on and set the pressure to the prescribed pressure and thinking nothing of it.
I am so thankful for Sleepyhead software and this board for providing software and manual to those of us whom need them. My life is so much better than last year at this time.
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#7
thanks, I'll check on the pressure settings. I thought I had the pressure relief turned off.

I think that first set of data is probably not the best. I think I was messing with everything too much and still adjusting things.

I have to wait till I get home, but the data was a lot different this morning.

AHI of .7

I would guess that the leak is going to be less as well. I don't think I had any leaks other than when I created one myself when I had an inch and it took me a couple minutes to get the mask situated.
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#8
A couple links to help you organize and post your sleep data without all the transcribing:
https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

Overall, things look good for someone starting CPAP therapy. The AHI is not so bad, but it would help to know the breakdown of events (OA, CA, H). You are using EPR (exhale pressure relief) at 3 which is the highest setting. Nothing wrong with that at all, but be aware is reduces pressure significantly during exhale, and can lead to clear airway events in some people. Given that your flow limitation, snores and other indicators of obstruction are almost non-existant, i think you have the machine properly tuned to your needs. I don't see any pressing need to change anything for now, and you should know that things generally improve as you adapt to the therapy.
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#9
Ok I think this is better data. I am almost positive the leaks were when I messed with the mask.

Statistics
Channel Min Med 95% Max
PressureTherapy Pressure (cmH2O)
W-Avg: 8.22 4.20 7.96 11.68 12.00
EPAPExpiratory Pressure (cmH2O)
W-Avg: 6.08 4.02 5.50 8.76 9.00
Minute Vent.Amount of air displaced per minute (L/min)
W-Avg: 7.36 0.00 7.12 9.75 18.75
Resp. RateRate of breaths per minute (Breaths/min)
W-Avg: 19.09 0.00 19.40 22.60 43.20
Flow Limit.Graph showing severity of flow limitations (Severity (0-1))
W-Avg: 0.01 0.00 0.00 0.08 0.62
Leak RateRate of detected mask leakage (L/min)
W-Avg: 0.33 0.00 0.00 1.20 36.00
SnoreGraph displaying snore volume (?)
W-Avg: 0.00 0.00 0.00 0.00 0.68
Insp. TimeTime taken to breathe in (Seconds)
W-Avg: 1.38 0.20 1.30 1.92 6.24
Exp. TimeTime taken to breathe out (Seconds)
W-Avg: 1.86 0.44 1.80 2.48 5.12
Tidal VolumeAmount of air displaced per breath (ml)
W-Avg: 395.25 0.00 360.00 600.00 1580.00

Total time in apnea 00:00:40
Time over leak redline 0.022%
Machine Settings

ModeCPAP Mode APAP
Pressure MinMinimum Therapy Pressure 4.20 cmH2O
Pressure MaxMaximum Therapy Pressure 12.00 cmH2O
Antibacterial FilterAntibacterial Filter No
Climate ControlClimate Control Manual
EPRResMed Exhale Pressure Relief Full Time
EPR LevelExhale Pressure Relief Level 3cmH2O
Humidifier StatusHumidifier Enabled Status On
Humidity LevelHumidity Level 4
MaskResMed Mask Setting Full Face
Patient AccessPatient Access No
RampRamp Enable Off
Smart StartMachine auto starts by breathing On
TemperatureClimateLine Temperature 27 ºC
Temperature EnableClimateLine Temperature Enable 2
Session Information



CPAP Sessions
On Date Start End Duration
ResMed Session #1472612683
Click to disable this session. 8/30/2016 22:04:44 03:11:44 05h 07m 00s
20160830_220443_PLD.edf
20160830_220443_BRP.edf
20160830_220443_SAD.edf
20160830_220440_EVE.edf
STR.edf


Therapy Efficacy
AHI 0.78
Obstructive Index 0.20
Hypopnea Index 0.59
Clear Airway Index 0.00
RERA Index 0.20
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#10
These are really good numbers. Check them every so often to see how you are doing. Look at your wave forms and do some reading to be able recognize the waveforms associated with events. Just for the fun of it.

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
Post from Imgur


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