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Getting worse..
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Terry Offline

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Machine: Philips Respironics RemStar Auto with A-Flex (560P)
Mask Type: Nasal pillows
Mask Make & Model: P/R Nuance & Pap Cap
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CPAP Pressure: Auto
CPAP Software: SleepyHead

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Sex: Male
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Post: #11
RE: Getting worse..
Well, everybody else did, so I'll toss in my own two cents. 8-)

You're leaking like crazy. It's difficult or impossible for the machine to do it's job with leaks that size. Also the leaks are disturbing even with no other problems.

I'm with JustMongo and Ghost. If you can get your leaks under control and bump up the upper limit and the lower limit I think you'll be feeling a lot better.

Smaller pressure changes and few leaks will give you a better night's sleep.

Also, everybody feels like crap sometimes, so don't give up.
12-26-2015 04:00 PM
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justMongo Offline

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Machine: ResMed VPAP Auto (S9)
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CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

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Sex: Male
Location: Калифорния

Post: #12
RE: Getting worse..
Keeping in-mind it's a PR machine, there are two leak traces on the graph. One is total leak and the lower is the true unintended leak.
The 95% unintended leak rate is 23 LPM at which the machine can still provide adequate pressure for therapy.

Now, I cannot stand leaks because they disturb me. My full-face mask does the "face-fart" thing; and it wakes me.
It's just that I have managed to tame the FFM and get essentially a zero leak rate.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-26-2015 05:00 PM
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Ghost1958 Offline

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Posts: 957
Joined: Aug 2014

Machine: PRS1 Series Sixty Auto Aflex
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: PRS1 with Heated Hose
CPAP Pressure: 10.5 min 16 max
CPAP Software: SleepyHead EncoreBasic

Other Comments: Moderate to Severe SA Obstructive. Rapid O2 desat off the machine.

Sex: Male
Location: KY

Post: #13
RE: Getting worse..
On the Pr machine it will flag a large leak at the point it cant accuately pick up events or maintain full pressure.

That happens at about 70.
His large leak while it needs serious improvement is only .42 or something of his night.
The machine can deal about all the time but like Mongo says the lwaks themselves could be disturbing.
12-26-2015 05:41 PM
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Terry Offline

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Machine: Philips Respironics RemStar Auto with A-Flex (560P)
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Sex: Male
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Post: #14
RE: Getting worse..
(12-26-2015 05:00 PM)justMongo Wrote:  Keeping in-mind it's a PR machine, there are two leak traces on the graph. One is total leak and the lower is the true unintended leak.
The 95% unintended leak rate is 23 LPM at which the machine can still provide adequate pressure for therapy.

I'm probably just reading it wrong, but it looks like a bunch of leaks way above 40 LPM.
12-26-2015 10:51 PM
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justMongo Offline

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Machine: ResMed VPAP Auto (S9)
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CPAP Software: Other Software

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Location: Калифорния

Post: #15
RE: Getting worse..
(12-26-2015 10:51 PM)Terry Wrote:  
(12-26-2015 05:00 PM)justMongo Wrote:  Keeping in-mind it's a PR machine, there are two leak traces on the graph. One is total leak and the lower is the true unintended leak.
The 95% unintended leak rate is 23 LPM at which the machine can still provide adequate pressure for therapy.

I'm probably just reading it wrong, but it looks like a bunch of leaks way above 40 LPM.

That's the total leak line which includes the mask venting.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-26-2015 11:52 PM
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GTOdude Offline

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Joined: Dec 2015

Machine: RemStar Auto APAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFIT P10
Humidifier: Unsure
CPAP Pressure: 7-14
CPAP Software: SleepyHead EncoreBasic

Other Comments: Other Dx: cabg x3 '94. Hypothyroid '15 and other maladies.

Sex: Male
Location: Central Valley, Left Coast

Post: #16
RE: Getting worse..
(12-26-2015 11:52 PM)justMongo Wrote:  
(12-26-2015 10:51 PM)Terry Wrote:  
(12-26-2015 05:00 PM)justMongo Wrote:  Keeping in-mind it's a PR machine, there are two leak traces on the graph. One is total leak and the lower is the true unintended leak.
The 95% unintended leak rate is 23 LPM at which the machine can still provide adequate pressure for therapy.

I'm probably just reading it wrong, but it looks like a bunch of leaks way above 40 LPM.

That's the total leak line which includes the mask venting.
I only used the machine for just over 3 hours last night. Woke up with a sore nose. Took it off and slept on my tummy rest of the night. Still feel like hell. Gonna get in the cardio hopefully tomorrow. Here's the print out. Still dealing with leaks, but a better looking AHI?

Mark
[attachment=2007]
12-27-2015 11:47 AM
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PaytonA Online
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Machine: ResMed S9 VPAP Auto
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Mask Make & Model: Resmed Mirage Quattro
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CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Orange County,California

Post: #17
RE: Getting worse..
Goat Boy Big Grin (GTOdude),

You are reacting too quickly to the data. On the other hand, the way you are feeling needs investigation but, as it looks like you are beginning to suspect, it needs to be investigated with your doc and not your CPAP.

The first set of graphs in this thread (the day that your AHI was 5.03) was a good night's sleep. All of the events after 5:00 AM look like sleep/wake junk to me and should be ignored. Most of that night you had a good one going.

As for your leaks, are you using a chin strap? It looks to me like you may be getting some mouth leaks. Your leak rate on the first chart was actually fine. Not quite as good on the second one but not bad.

It is like restoring an old GTO. You ain't going to do it in one day.

Best Regards,

PaytonA
12-27-2015 12:49 PM
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vsheline Online

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Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
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Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

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Location: California, USA

Post: #18
RE: Getting worse..
(12-26-2015 11:57 AM)Crimson Nape Wrote:  It appears that the pressure changes are disturbing you. Have you tried a straight pressure? I have a problem with variable pressure and setting it to a single value greatly improved how I feel. This is just a WAG but since your 50% is 8.7cm, it'd set the pressure at 9 and give her a try. If nothing else, this would give you a proof of concept.

Hi Crimson Nape,

When changing from APAP mode to fixed pressure CPAP mode, conventional wisdom is to find the 90% or 95% pressure, and set the fixed pressure to that.

To find the 90% or 95% pressure (the pressure which the machine was at or below at least 90% or 95% of the time) the Max Pressure setting needs to be high enough that the pressure does not reach (or rarely reaches) the Max Pressure, and the Min Pressure should not be much lower than the median (50 percentile) pressure. Preferably, a long term average (for a month or at least a week) of the nightly 90% or 95% pressures is used.

For some patients, this might be uncomfortably high or might cause excessive air swallowing or other problems, but a few patients do even better with a fixed pressure slightly higher than the 95% pressure, giving them an AHI near zero most nights.

But if a patient is having a bothersome amount of RERA (Respiratory Effort Related Arousal) events, bilevel therapy (or preferably bilevel Auto therapy) is the best.

RERA events are caused by the pressure being too low during Inhalation (during IPAP). Obstructive Apnea events are most commonly caused by the pressure being too low at the End of Exhalation (during EPAP or at EEPAP).

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 12-27-2015 03:37 PM by vsheline.)
12-27-2015 01:49 PM
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Sleeprider Online
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Machine: Resmed Aircurve 10 Vauto
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Post: #19
RE: Getting worse..
(12-27-2015 01:49 PM)vsheline Wrote:  But if a patient is having a bothersome amount of RERA (Respiratory Effort Related Arousal) events, bilevel therapy (or preferably bilevel Auto therapy) is the best.

RERA events are caused by the pressure being too low during Inhalation (during IPAP). Obstructive Apnea events are most commonly caused by the pressure being too low at the End of Exhalation (during EPAP or at EEPAP).

Very clear and succinct! like

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12-27-2015 02:21 PM
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justMongo Offline

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Machine: ResMed VPAP Auto (S9)
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Post: #20
RE: Getting worse..
For those of you wondering, the GTO was sometimes referred to as the Goat.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-27-2015 02:33 PM
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