(05-06-2013, 05:29 PM)racprops Wrote: I am using:
Max Pressure= 25cm
EPAP Min and Max 10/15
PS Min and Max 0/10
BiFex settings 3.
For reference, these were the original settings you reported your machine had when you started using it:
Min EPAP: 10.0
Max EPAP: 15.0
Min Pressure Support: 0.0
Max Pressure Support: 15.0
Max Pressure: 25.0
Flex Setting: 2
Backup Rate: Auto
Your leak sometimes gets too high but overall I think you are doing well controlling leaks, considering the high pressures you are using and this is still your first month of using your machine.
I think there is little-to-no reason to think that excessive leaks have anything to do with the problem we see, that your machine has not been eliminating your Central Apneas (CAs). Whether your total leak is very large (and it usually is not) or whether your total leak is low, it looks to me like the machine acts about the same.
When you are having CAs we see from the Mask Pressure waveform that the IPAP often quickly shoots up to 9 higher than the EPAP. This means the Pressure Support (PS) has shot up to 9. When you are having CAs, the PS stays at 9 much or even most of the time. Since you say you have the Max PS set to 10, I don't understand why SleepyHead indicates the PS never goes higher than 9, even during the times when you are having many central apneas.
Perhaps something is preventing your machine from going as high as it needs to, to eliminate your CAs.
Just to be sure the PS is not maxing out and needs to be allowed to go higher, I suggest you set the Max PS to your doctor's prescribed setting of 15, rather than the 10 you have been using. If you set the Max PS to 15, the PS won't necessarily ever go as high as 15, since it will not go higher than is needed.
I suggest making that change, in order to be able to rule out that the problem is that the Max PS needs to be higher.
Hang in there. You'll beat this yet.