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[Equipment] ResMed AirCurve10 VAuto blockage
#21
RE: ResMed AirCurve10 VAuto blockage
The mask is new.  It has a hole in the mask between the pillows that I guess allows for the exhale.  (See pics) and where the hose connects to the top of the mask it leaks air there also.

I'm going to try to fix the leak at the top.

I'll make the changes and send an update in the morning...


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#22
RE: ResMed AirCurve10 VAuto blockage
The leak a the top is a second vent that's suppose to be there. You don't want to cover them up. By the way the mask you have is a Dreamwear pillow mask if you want to put it in your profile.
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#23
RE: ResMed AirCurve10 VAuto blockage
OK, last night was the best night subjectively yet...

Once I fell asleep, I did not wake until about 3:35 this morning.  Nose was somewhat tight, but not hurting.  Since it was close to my normal 4:00am rise time, I did not put the mask back on.  After a few minutes my nose cleared and I felt totally refreshed.

I have a right knee that has a partial cartilage loss that has been repaired but usually gives me some pain as I arise.  This morning very little pain and stiffness.  Not sure if this has anything to do with it.

I've attached the screen shot for last night.

If you could would you give me an analysis of each sections of the chart.  I'm an engineer by trade and would like to understand what I am seeing on the charts.

My doctor has prescribed the Trillogy in January and since then I have not been able to stay on it for more that about 2 hours any night.  I have told him about acquiring the device and he is ok with me trying it.

I would like to generate a report for him on this device once we get it tuned into my needs so I can show him in July when he and I talk at my appointment.

I am a little surprised that my AHI was 4.5 since I slept all night without waking.

Do we still need to tweak the settings a little for the slight nose blockage?  Can we get the AHI to zero with more tweaks?

I am very impressed with the help you guys have given me and thank you...

Please advise....


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#24
RE: ResMed AirCurve10 VAuto blockage
You had one cluster of events that may of been caused by your position. Example would be tucking your chin down and cutting off your airway. Other than that your events weren't bad. Zero events doesn't happen very often for anyone including those who don't have Sleep Apnea. An AHI under 2 is a reasonable goal though.

I think you'd be better off with a full face mask. You have about the worse mouth leaks I've ever seen.
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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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#25
RE: ResMed AirCurve10 VAuto blockage
I have several full masks but it is difficult for me to wear them all night.  The mouth leaks are a problem.  I may try the full tonight.
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#26
RE: ResMed AirCurve10 VAuto blockage
It looks like you only had UA and CA events turned on.  I would expect to see H, OA and LL , and suspect these are turned off in the lower left corner of the chart (you can see LL has a red flag and is turned off).  It's pretty obvious there is a great deal of variable breathing and recovery breathing in the flow rate, and so I would expect some events or leaks associated with that.  I don't see nasal therapy working for you with the prevalence of your leak problem.

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#27
RE: ResMed AirCurve10 VAuto blockage
I've turned on the flags and re-uploaded...

Walla Walla suggested using the full face mask...

Questions:

The high leakage rate is from mouth breathing?  I'm not seeing or feeling any excess from the pillows...

How does the hypopnea work?  Does it infer (calculate) it from the graph?  

Subjectively this is the first night I have slept the whole time without waking up.

Should I adjust the PS now or wait for the results of the full face mask tonight?


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#28
RE: ResMed AirCurve10 VAuto blockage
Hypopnea is just a reduction in respiratory volume, in the case of Resmed it is at least a 30% decrease in airflow for 10 seconds or more. With leaks this extensive, the detection may not be accurate.

I don't think you are mouth breathing, but you are not effectively blocking air from escaping your airway through the mouth. The back of the tongue can prevent air from entering the mouth, but if that seal habitually fails, then the airway pressure is lost. You can practice controlling the air pressure. The main technique is to place the tongue behind the upper front teeth and suck to achieve a seal on the airway. Controlling that pressure can be learned by drinking water through a straw, talking, even opening your mouth while maintaining the air pressure with your tongue. If you learn the control of your pressurized airway, that may translate to sleep, or not. Some people resort to chin straps and tape, but the real-deal is when you just use the back of your tongue against soft palate to block the pressure.
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#29
RE: ResMed AirCurve10 VAuto blockage
Yes I do block it, but I find that sometimes I relax the tongue and it does leak into my mouth and out my lips.  I've tried chin straps and it makes me feel like I'm being tortured.  I don't like it.  

I do have an Amara mask that covers my nose and mouth.  I haven't tried it lately but I can.  The only problem is that I really get dry mouth with it and that wakes up.

In the past with the Trillogy, all the volume and pressure would lift the mask off my face and wake me up.  With the reduced pressure I will try the Amara mask tonight and see how it goes.

I want to get enough history with this device that my doctor will see that we have it set correctly.  He is worried that I will get into the same situation as I was in at the end of last year and in the hospital with CO2 build up in my blood.

I've lost 61 pounds, walk 2.5 miles every morning and have not had any issues like last year.  Blood O2 is always 95-96 when I check it.
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#30
RE: ResMed AirCurve10 VAuto blockage
An alternative to chin straps is a soft cervical collar or neck roll that gently applies pressure to the back of the jaw. Placed properly it will work better than a chin strap and can give you just enough control to keep your mouth from falling open and allowing your tongue to lose the seal. All of the exercises I listed above will work to train you to maintain that airway seal, even with your tongue out of position.
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