EndlessFields (Therapy Thread)

[EndlessFields]

Well he's my chart for night #1 on the AirSense.

   

[EndlessFields]

Night #2.
Only change here was moved to the large size nasal pillows on the P30i to try them. I feel like they did fit better but the graphs shows a few large leaks, so maybe not?

   

[EndlessFields]

Night #3, moved back to the medium pillows as the larges caused to many leaks it seems. Looking really good I think here.
   

[SarcasticDave94]

I agree that the Large cushions didn't do something quite right. The ones you're tagging as Medium seem to be an improvement in the leak department, but do note you're right at the leak rates that improving further will be a big help.

Teaching nugget, ResMed has 1 trace line on the chart versus Respironics 2. Respironics had a total, accumulated leak on top and unintentional at the bottom. The ResMed shows what is the unintended only, meaning above the vent/exhale calculated rate. And ResMed has a leak redline of 24. Your recent Max leak 18 is getting pretty close, so maybe pay a bit of attention to the strap adjustment as you've already tried cushion sizes.

Other than leaks, you'll eventually want to wean yourself from the Ramp. Here on ResMed, the Ramp that you set happens every time the start button is pressed versus a dedicated Ramp button on Respironics. Some find the Ramp transition or the Ramp's artificial holding pressure down to be a bit disruptive. Worse yet is sometimes events sneak past the gatekeeper when he's cuffed to Ramp control.

[EndlessFields]

I agree that the Large cushions didn't do something quite right. The ones you're tagging as Medium seem to be an improvement in the leak department, but do note you're right at the leak rates that improving further will be a big help.

Teaching nugget, ResMed has 1 trace line on the chart versus Respironics 2. Respironics had a total, accumulated leak on top and unintentional at the bottom. The ResMed shows what is the unintended only, meaning above the vent/exhale calculated rate. And ResMed has a leak redline of 24. Your recent Max leak 18 is getting pretty close, so maybe pay a bit of attention to the strap adjustment as you've already tried cushion sizes.

Other than leaks, you'll eventually want to wean yourself from the Ramp. Here on ResMed, the Ramp that you set happens every time the start button is pressed versus a dedicated Ramp button on Respironics. Some find the Ramp transition or the Ramp's artificial holding pressure down to be a bit disruptive. Worse yet is sometimes events sneak past the gatekeeper when he's cuffed to Ramp control.

Thank you Dave! I will check the strap adjustment tonight and see if I have things to loose. I honestly wasn't aware I had Ramp enabled, must have missed that in the settings. I will turn that off tonight and just stay with my minimum pressure of 6 with an EPR of 2. I never used the ramp button on my DreamStation.

[SarcasticDave94]

PS I think there's an Auto setting in Ramp. Maybe transition to that for a bit.

[EndlessFields]

Night #4 - I loosened the headgear a bit to see if the leak rate was due to me having it too tight. It doesn't seem like that was the answer, much worse leaks last night.
   

[SarcasticDave94]

It appears the leak section earlier had the mouth leak pattern, rounded or elevated elongated. The later leaks appear more like mask leaks, spikey jagged pattern.

As this chart as representative, you have some work needed both mouth and mask leaks. Mouth leaks could be your mouth dropping open, not managing a tongue seal, etc. Sometimes tape or a chin strap might help. The mask leaks mean either sizing, strap adjustment or mask type isn't as good as it could for your particular needs.

[multicast]

I loosened the headgear a bit 

Keep in mind that the P30i is very sensitive regarding the setting of the headgear.  Only change it millimeter by millimeter.

[EndlessFields]

Still struggling with the P30i and leaks. Decided to try the N30i and see if it would do any better. Here is last night's report. Used the small wide N30i cushion.