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Determining leak with a "nonsupported" mask?
#11
RE: Determining leak with a "nonsupported" mask?
I can't find the resistance X setting to speak of. Any tipsn on finding it?

Made some adjustments to the mask and it was a better night,  but still a 4.12 AHI when his untreated AHI is 5.0 which hardly seems worth all this. That said, it was his best night so far. The BND bit at the end is because the mask came disconnected from the hose. 

The leak looks like it is under control for last night, right? Anything else you notice? What else do I need to do to help him?


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#12
RE: Determining leak with a "nonsupported" mask?
It does look like the leaks are down now.  This will help.

When you said it's his best night so far, is that just numbers, or how your child feels?  If your child feels better, even if only a little, it is an encouraging sign.

My older Respironics System One (560) has a menu item called "System One resistance" which allows the change.  In the display, you can't read all the characters in the menu, but if you highlight the setting "System On..." it starts to scroll and you can see the full name.  Maybe your machine has a menu item that starts "Dreamstation ..."  Try highlighting that to see if the display scrolls to see the word resistance.
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#13
RE: Determining leak with a "nonsupported" mask?
I think they must have disabled my access to a lot of settings.

Under setup, I have ramp, ramp time, tube type, modem, bluetooth, time, and back to main menu.

The main menu has only setup, info, and provider. Info only gives 1, 7, and 30 day average hours. Provider gives serial number, model, software number, an upload screen, and a performance check.

That's it.


As far as how he feels, he doesn't really give details. After the first few days he was VERY hyper, like unable to control himself, impulsive and bouncing off the walls. That seems to have settled down. I ask him how he slept and he says 'fine' but that's it. It's really hard with him being a little kid.
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#14
RE: Determining leak with a "nonsupported" mask?
Are you able to get into the Clinician Menu? It is different from the regular menu. If you do not have a copy for your machine, go to the top of this page and look in the banner and click on CPAP Setup Manuals. Typically one needs to push down two buttons at the same time and hold them down for at least 3 seconds. I do not know how to do this on your machine, but the link above will get you started. If you cannot find the clinician manual to directly download, you may find in a list. Follow the instructions and the website will email it to you.

Yes, it's hard to get good descriptions with kids. Mine were the same. Maybe ask him if it's easier for him to do things that he likes? Basically any kind of question to get him to talk. Often direct questions about feelings are hard for kids to answer. Settling down is probably a good sign.
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#15
RE: Determining leak with a "nonsupported" mask?
From the link I mentioned:
CPAP Manuals

Philips-Respironics DreamStation Series Machines (DreamStation Auto BiPAP, DreamStation BiPAP Pro, DreamStation Auto CPAP, DreamStation CPAP Pro, & DreamStation CPAP): For Setup Instructions with pictures, click here. Supply power to the device: first, plug the socket end of the AC power cord into the power supply. Then plug the pronged end of the AC power cord into an electrical outlet that is not controlled by a wall switch. Finally, plug the power supply cord's connector into the power inlet on the back of the device. Once the device is powered, press and hold both the control dial and the Ramp button on the device for at least 5 seconds. You are now in Provider Mode. To adjust a setting, rotate the control dial to your desired menu option, then press the control dial to select that setting. Rotate the control dial to change the setting. Press the control dial again to save the change. Select the "Home" icon to exit Provider Mode and return to Patient Mode. (note: setup manuals for these machines are available by email, below)

There's more at the link.  Hope this helps.  If you already have the manual, my apologies for assuming otherwise.
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#16
RE: Determining leak with a "nonsupported" mask?
As you noted, it appears your service provider has locked some menu items to keep you from accessing them. Mask Type, Mask Type Lock and Mask fit can all in the Comfort section of the Provider menu as well. You can access the Provider’s menu by following the instructions in the post by happydreams.

The intentional leak rate for the mask you are using is in the same range as Respironics full face masks.  A resistance setting of either X1, the setting for Respironics full face masks, or the recommended setting of X0 for none Respironicss masks could be used for your mask. I would personally use the X1 setting.

The leak rates in the last screenshot you posted are very good. I don’t worry too much about large leaks unless they occur over 10% of the session, disrupt sleep or are leaking into the eyes.

I can’t help much with your concerns with the treatment results other than to say most providers consider any AHI less than 5 as treated. Maybe someone else on the forum can give you more information on the results. 

It’s helpful if you will keep all questions regarding your son’s treatment in this thread. Doing so will make it easier for members to help you.
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#17
RE: Determining leak with a "nonsupported" mask?
For adults, I know under 5 is normal. But for kids, it is supposed to be under 1. Because his untreated AHI is just 5, it just seems so hard to know if this is all "worth it."  

I successfully got in to the more advanced settings. Can someone explain more to me about what difference the resistance setting makes?

I believe I found it under comfort>mask type? Settings are off, x1, x2, etc. Tried to attach a pic but couldn't. Is the pic limit for the whole thread? I'm confused about that.

Currently it is set to off. What does changing this setting do? What are pros and cons?
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#18
RE: Determining leak with a "nonsupported" mask?
Sorry about the mixup about treatment level. 

There has been some discussion on the forum whether the mask setting actually does anything as well as whether it affects treatment. As I understand it, the mask setting sets the threshold where the machine starts reporting leaks over the intended leaks built into the mask for venting purposes. I have forgotten to change the mask setting when changing between the full face mask and and the nasal pillow mask I use while using both my DreamStation Pro and my ResMed A10 Autoset. There was no notable difference in the night to night levels of AHI.

I checked the vent rates at 7cm, which is the pressure your son is running, on several ResMed full face mask. They range between 20 and 30 L/min and have a recommended mask setting of X1. The Pixi pediatric mask your son uses has a vent rate of 28 L/min at 7cm which indicates it could also be set at X1. Respironics does, however, recommend setting to mask setting to “off” for non Respironics masks.
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Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#19
RE: Determining leak with a "nonsupported" mask?
I really appreciate you answering my questions! I'm still unclear though!

So would setting it to x1 change the pressure he would get? Does it make it a little higher or a little lower? That's maybe what I'm struggling to understand.
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#20
RE: Determining leak with a "nonsupported" mask?
Resistance is not the same as leak rate or therapy pressure.

The machine can only measure pressure and flow rate at the machine’s end of the hose. If there is no airflow, the pressure in the mask will be the same as the pressure in the machine. However, if air is flowing (and it usually is) the resistance of the mask means the pressure in the mask will be different.

That can lead to or aggravate the sensation of breathing through a straw. If the mask sucks in closer to the face when inhaling, or pushes out when exhaling, then the pressure in the mask is NOT the therapy pressure.

The resistance setting tells the machine how to compensate. This has little effect between breaths, but during high flow it tells the machine how much pressure must be delivered into the hose to get the right pressure in the mask.

In a nutshell, if it feels like breathing through a straw, the resistance setting may be too low. If it feels like drinking from a fire hose, like there’s a whoosh when you inhale, the resistance setting may be too high.

The higher settings on Respironics get fairly extreme, so unless you are using something like an inline filter or heat/moisture exchange device, X1 is a good bet for most masks.

For similar reasons, it is important for the hose diameter setting on the machine to match what you are actually using.
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