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Graph History
RE: Graph History
The breathing pattern has fully normalized in this last closeup. I think if we can deal with the high leak rate, you might find that sweet spot where you're more rested. I know you're not feeling the benefit yet, but this looks a lot better to me. Let's try PS 5.0 since you're still not meeting Tv objectives. Note tidal volume may be very under-estimated due to leaks. You can see in the chart that flow rate is much higher during periods where the leak is below large-leak threshold, and in those times I would suggest Tv rises well above objectives and perhaps in the 800-1000 range. We just can't tell with the leaks masking flow rate.
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RE: Graph History
My wife saw an ad for a mask on a site called Breathe Easy (something like that) and she said it was from ResMed.   Any ideas?

I think before I raise the PS to 5.0, I'll leave it alone and try it again tonight and see how it goes.  The previous night the Tv was 380 which is close to what my Dr. wants me at.

I think I am getting the hang of it, just need to have more experience at it.  Like I said before the, I could only stay on the Trilogy for about 1.5 to 2 hours max.  5 hours for this is a great improvement.

I'll upload tomorrow after trying it again tonight.

Your help is really appreciated...
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RE: Graph History
Have you tried using a recovery software such as recuva?
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RE: Graph History
Have not, will look and try...
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RE: Graph History
Supplier #30 on the supplier list is Easybreathe. They are a well known online DME vendor and even have sleep testing, prescription services and will do insurance claims. They have the full line of Resmed masks, so there is no way to know which one you're referring to. I think you are going to need a full-face or hybrid mask to resolve the leaks. Walla Walla recently reviewed the Resmed Quiet-Air vent that works with both the F20 AirTouch and F20 AirFit masks. http://www.apneaboard.com/forums/Thread-...#pid261501 It looks like a nice improvement.
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RE: Graph History
Here are last nights results...

Looks like we got the Tv up to the 400 and the Inspiration time to 1 sec.  AHI suffered.

I don't understand about how I could leak so bad until I get really asleep then it drops to none.  See from about 12:50 to about 1:30...

This added Tv and PS had an effect on my nose hurting in the morning and the early removal of the mask.  

Should I take the PS back to 4.2 like before to allow me to get the AHI back to more acceptible levels?

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RE: Graph History
You need to fix those leaks pronto! You can try a soft cervical collar or chin strap and see if that works. Otherwise you need to switch to a full face mask.
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RE: Graph History
I have to echo what Walla Walls says above.  Try a cervical collar.  If that sounds too cumbersome, a small crescent shaped neck pillow tucked under your chin may help.

I think you have a combination of mouth breathing and mask leaks.  The nasal pillow mask can move easily enough especially if not fitted correctly.  Try different size pillows,
and adjust the straps to pull a bit tighter.  If you can't resolve leaks with the pillow mask, then a Full Face Mask may be the answer.  

With a high leak rate, your machine cannot keep up with the flow and may not be flagging apnea events.  In other words, you can't trust your AHI with a leak rate that high.  

As far as masks go, search the supplier list at top of page.  Many suppliers will let you try a mask for 30 days and return it if it doesn't work out.  With some though, you have to pay shipping to send back.  

Hope you find a solution soon.
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RE: Graph History
What does not make much sense to me is that when I'm really asleep, the leakage is not there.  If the mask is at fault, then it should leak all the time not just when I'm in deep sleep mode.  I would think it would leak more then than when I'm getting there and partially awake.

The attached two sets of charts show this over two different days...

Notice June 1 from 12:30 to about 1:35 with AHI 1.85 and June 3 from about 12:50 to about 1:45 With AHI of 3.72.  

Agreed, leakage is a problem, but the lack of leakage when fully asleep puzzles me... Huh

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RE: Graph History
The flat top on the large leaks appears to be air pressure escaping through your mouth. When you are fully asleep your mouth relaxes and this is when air will hiss or pour from the mouth. Some people control this with a soft cervical collar that applies gentle pressure on the jaw and helps the sleeper maintain a closed mouth and the tongue seal. Others find they eventually need to move away from nasal therapy and use a full face. The charts are not lying. What you're doing now is not working.
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