(03-28-2015, 10:31 PM)J McCoy Wrote: EPR: FULL_TIME
EPR Level: 1.0 cmH2O EPR Enable: OFF EPR Patient Enable: OFF
Ramp Time: 45.0 Minutes Essentials: ON
Leak - L/min
Median: 3.6 95th Percentile: 31.2 Maximum: 49.2
Respiratory Indices - events/hr
Apnea Index: 3.7 Hypopnea Index: 0.2 AHI: 3.9
Obstructive: 0.4 Central: 3.1 Unknown: 0.0
% Time in CSR: 0.0
Hi J McCoy,
I suggest you edit your previous post to delete personal info such as birth date.
Welcome to Apnea Board. I think you are off to a great start.
Your Median Leak is small (3.6 Liter/minute) which is great, and your 95th Percentile Leak (31.2) is not huge and is not too bad. We try to keep the 95% Leak below 24 L/min).
Mathematically, a 95% Leak of 31.2 means the Leak was 31.2 OR LOWER for AT LEAST 95% of the time while the machine was operating at your normal therapy pressure of 13. (The Ramp period does not count.)
Mathematically, a 95% Leak of 31.2 also means the Leak was 31.2 OR ABOVE for AT LEAST 5% of the time.
For ResMed machines, only the Unintentional Leak is reported. (The air flowing through the mask vent holes is intentional leak and is not reported by ResMed.) Other manufactures may report the "Total Leak", meaning the sum of the intentional airflow through the mask vents plus all other leaking.
It is not uncommon for new patients to have a small amount of Central Apneas like are shown in your statistics (CAI, Central Apnea Index, of 3.1 per hour) and for the CAI to gradually keep decreasing over the first few weeks or months of therapy. But even your present CAI of 3.1 is not excessive and is nothing to worry about (and it will likely gradually decrease).
It looks like EPR is turned off (EPR Enable: OFF) and normally I would suggest requesting for EPR to be enabled (or enabling it yourself), and also changing EPR Patient Enable to "ON" or "PATIENT" so you will be able to adjust it without having to enter the Clinician Menu.
However, in your case your CAI is the dominant component of your AHI (Apnea Hypopnea Index) and turning on EPR or increasing the amount of EPR often increases the CAI. So if you are managing to get enough sleep now, without EPR, then I suggest leaving EPR disabled. If you are having difficulty breathing out against the pressure then I suggest enabling EPR but keep an eye on the CAI and if the CAI skyrockets then I think it would be best to disable EPR again.
Also, it looks like the Ramp may be adjusted to a long time (45 minutes). Not shown is what the Start Pressure is. If the low pressure at the start of the Ramp time is uncomfortably low, making you feel slightly smothered, the Start Pressure should be increased closer to your therapy pressure (13), or the Ramp period may be reduced to zero to completely skip the Ramp.
If the Ramp time is set to "Auto" (instead of 45 minutes) this would mean the pressure would stay fixed at the Start Pressure until your breathing pattern makes it seem like you have fallen asleep (or until a fairly long period has passed) and then the pressure would gradually increase until it reaches 13.
Take care,
--- Vaughn
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