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[Health] Still Sleepy
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Peter_C Offline

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Machine: System One DS960HS
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro "MED"
Humidifier: Attached
CPAP Pressure: Auto mode-script is:15/3/3
CPAP Software: EncoreBasic Other Software

Other Comments: Severe obstructive sleep apnea 1999/Just got an ASV machine

Sex: Male
Location: Akron, Ohio USA

Post: #21
RE: Still Sleepy
What's interesting to me as I chase leaks (0.64L/s last night) my machine did not raise the pressure above 15 (since I can't use software, I assume the pressure it states is the max), so I *guess* that means that even with the leaks, it felt no need to raise the pressure, or, the leaks skewed the data so much that it gave up??

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
10-23-2013 08:15 PM
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me50 Offline

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Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #22
RE: Still Sleepy
(10-23-2013 08:15 PM)Peter_C Wrote:  What's interesting to me as I chase leaks (0.64L/s last night) my machine did not raise the pressure above 15 (since I can't use software, I assume the pressure it states is the max), so I *guess* that means that even with the leaks, it felt no need to raise the pressure, or, the leaks skewed the data so much that it gave up??

I forgot or I never knew why you can't use software. You know, that is scary b/c we cannot count on our docs, RT, DME, etc. to enlighten us so we have to monitor it ourselves. If I couldn't look at my data, I would never have figured out why for the past 2 plus years, I never felt better in the morning after I slept using cpap therapy.
10-23-2013 08:23 PM
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Peter_C Offline

Advisory Members

Posts: 1,308
Joined: Sep 2013

Machine: System One DS960HS
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro "MED"
Humidifier: Attached
CPAP Pressure: Auto mode-script is:15/3/3
CPAP Software: EncoreBasic Other Software

Other Comments: Severe obstructive sleep apnea 1999/Just got an ASV machine

Sex: Male
Location: Akron, Ohio USA

Post: #23
RE: Still Sleepy
My machine (Resmed "VPAP Auto 25') Came out around 2007-8 (remember, please, I am really bad on dates!!) and I got it around that time. My last sleep study was in 2009, the last time I saw my sleep doc was 2010. I have not seen or spoken with a DME since about 2008 (when I got this machine). Since then, my DME was bought by Apria. So, if I am a patient to any DME, it would be on online one (where I have bought my supplies from for cash). My most recent script for supplies was *not* written by my sleep doc. I hope to have medical coverage around next July, at which point I will start seeing my sleep doc again.

My machine uses a proprietary card, and reader - and I am not able to find a source to buy the parts, much less even get a price for the parts. So, the only data I have is what I can get from the LCD screen on my machine, combined with how I feel, and more importantly, data from my lovely wife whom notices any change during the night.

As my goto mask seems to be leaking at the swivel too much, sadly I had to order a new mask last night, as while I have parts, I learned I do not have a main unused mask 'frame'. I do have a brand new mask of the type I used many years ago, and learned late last night that I am too spoiled to use this type any longer.

One Question?
I wonder how to learn the expected leak rate of a given mask, and, how does one tell the machine that XX leak is to be expected?

My machine reports leaks in L/s. My range lately has been 0.34 to 0.64 L/s or, 20.4 to 38.4L/m which seems to be high enough to **possibly** create/cause errors/issues and/or data errors to occur - so I need to work on this.

Coupled with the fact that after so many years with OSA, my knowledge is sadly rather minimal, I decided to do some learning, and felt this great forum to be a good place to start! Also, while I am sleeping most nights, I do not feel that I am sleeping *well*, nor dreaming as much, or waking refreshed, as I once was in the beginning of my machine use - hence the search to see if I can do anything to improve.

Anyhow, I am sorry, I do not mean to go off-topic on someone else's thread.

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
10-23-2013 09:00 PM
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me50 Offline

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Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #24
RE: Still Sleepy
(10-23-2013 09:00 PM)Peter_C Wrote:  My machine (Resmed "VPAP Auto 25') Came out around 2007-8 (remember, please, I am really bad on dates!!) and I got it around that time. My last sleep study was in 2009, the last time I saw my sleep doc was 2010. I have not seen or spoken with a DME since about 2008 (when I got this machine). Since then, my DME was bought by Apria. So, if I am a patient to any DME, it would be on online one (where I have bought my supplies from for cash). My most recent script for supplies was *not* written by my sleep doc. I hope to have medical coverage around next July, at which point I will start seeing my sleep doc again.

My machine uses a proprietary card, and reader - and I am not able to find a source to buy the parts, much less even get a price for the parts. So, the only data I have is what I can get from the LCD screen on my machine, combined with how I feel, and more importantly, data from my lovely wife whom notices any change during the night.

As my goto mask seems to be leaking at the swivel too much, sadly I had to order a new mask last night, as while I have parts, I learned I do not have a main unused mask 'frame'. I do have a brand new mask of the type I used many years ago, and learned late last night that I am too spoiled to use this type any longer.

One Question?
I wonder how to learn the expected leak rate of a given mask, and, how does one tell the machine that XX leak is to be expected?

My machine reports leaks in L/s. My range lately has been 0.34 to 0.64 L/s or, 20.4 to 38.4L/m which seems to be high enough to **possibly** create/cause errors/issues and/or data errors to occur - so I need to work on this.

Coupled with the fact that after so many years with OSA, my knowledge is sadly rather minimal, I decided to do some learning, and felt this great forum to be a good place to start! Also, while I am sleeping most nights, I do not feel that I am sleeping *well*, nor dreaming as much, or waking refreshed, as I once was in the beginning of my machine use - hence the search to see if I can do anything to improve.

Anyhow, I am sorry, I do not mean to go off-topic on someone else's thread.

I don't know how to answer your questions but I do hope in July you get a new machine for yourself as well as a sleep study FIRST. Sorry that you are going through this. Also, in the interim, hope you can get state medical coverage! I feel for you and your lovely wife. Honestly, I do!
10-23-2013 09:10 PM
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zonk Offline

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Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #25
RE: Still Sleepy
(10-23-2013 09:00 PM)Peter_C Wrote:  One Question?
I wonder how to learn the expected leak rate of a given mask, and, how does one tell the machine that XX leak is to be expected?
ResMed masks http://www.resmed.com/assets/documents/s...sa_eng.pdf

Respironcis masks http://www.healthcare.philips.com/asset....111027.pdf

But its not applicable to your machine
ResMed machines works out unintentional leak but you only need to tell the machine type mask that you,re using
10-23-2013 09:23 PM
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me50 Offline

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Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #26
RE: Still Sleepy
Is 39 acceptable at a pressure of 20%?
10-23-2013 09:29 PM
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Peter_C Offline

Advisory Members

Posts: 1,308
Joined: Sep 2013

Machine: System One DS960HS
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro "MED"
Humidifier: Attached
CPAP Pressure: Auto mode-script is:15/3/3
CPAP Software: EncoreBasic Other Software

Other Comments: Severe obstructive sleep apnea 1999/Just got an ASV machine

Sex: Male
Location: Akron, Ohio USA

Post: #27
RE: Still Sleepy
Thanks for the links, AND, for the commiseration as well Smile

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
10-23-2013 10:05 PM
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robysue Online
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Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #28
RE: Still Sleepy
(10-23-2013 09:00 PM)Peter_C Wrote:  My machine (Resmed "VPAP Auto 25') Came out around 2007-8 (remember, please, I am really bad on dates!!) and I got it around that time. ...
One Question?
I wonder how to learn the expected leak rate of a given mask, and, how does one tell the machine that XX leak is to be expected?

My machine reports leaks in L/s. My range lately has been 0.34 to 0.64 L/s or, 20.4 to 38.4L/m which seems to be high enough to **possibly** create/cause errors/issues and/or data errors to occur - so I need to work on this.
Remed draws the Large Leak line at 24 L/min or 0.4 L/sec in the ResScan software. Resmed has long maintained that their machines can compensate for leaks up to 24 L/min without any real problems. But once leaks get to that level their machines start having problems maintaining therapeutic pressure and recording accurate data. Short lived large leaks are usually not that big of a problem in terms of quality of therapy or data, but the longer the large leak lasts, the more likely it is to adversely affect the quality of the therapy and the data.

On the S9 machines (which are the current generation of Resmed machines), there is a mask fit feature on the machine's LCD. Mr. Green Smiley face shows up indicating that the Large Leaks are short enough to NOT affect therapy whenever the 70% leak rate is less than 24 L/min. Mr. Red Frowny face shows up when the 70% leak rate is greater than or equal to 24 L/min and Mr Red Frowny indicates that the leaks are both large enough and long enough to be a serious problem. In other words, the Resmed engineers are not particularly worried about Large Leaks above 24 L/min unless they are lasting at least 30% of the night on the newer machines.

But I don't think the machines are as old as yours have a feature similar to the Mr. Green Smiley/Mr Red Frowny twins on the LCD's sleep quality report.

The leak numbers on your machine's LCD are 95% leak numbers. In other words, the leak rate was AT or BELOW the reported number for 95% of the night and it was AT or ABOVE the reported number for 5% of the night. Hence if the leak rate on your LCD is strictly less than 0.4 L/sec, then you know that your leak rate was in LARGE LEAK territory (AT or ABOVE 0.4 L/sec) for no more than 5% of the night. And so on any night that your reported leak rate is STRICTLY less than 0.4 L/sec, you can conclude that Large Leaks probably were not too much of an issue.

But on any night where your machine's leak rate is AT or ABOVE 0.4 L/sec, you really have no idea just how bad the leaks really were based only on the machine's LCD data. It could be that your leak rate was AT or ABOVE 0.4 L/sec for exactly 5% of the night (and leaks really aren't that big of a deal) OR it could be that your leak rate was AT or ABOVE 0.4 L/sec for 90% or more of the night (and leaks were a VERY big deal. You just don't have enough data to figure it out.

To make it easier to understand what I'm saying, let's look at three very simplified data sets each containing 20 data points and pretend that they're the whole leak data for the entire night.

Data set 1:
0.0, 0.0, 0.0, 0.0, 0.0, 0.0, 0.0, 0.0, 0.1, 0.1, 0.1, 0.1, 0.1, 0.1, 0.1, 0.2, 0.2, 0.2, 0.3, 0.4

Data set 2:
0.0, 0.0, 0.0, 0.0, 0.0, 0.0, 0.0, 0.0, 0.0, 0.0, 0.0, 0.0, 0.0, 0.0, 0.1, 0.2, 0.2, 0.3, 0.4, 0.4

Data set 3:
0.0, 0.0, 0.0, 0.1, 0.1, 0.2, 0.2, 0.3, 0.4, 0.4, 0.4, 0.4, 0.4, 0.4, 0.4, 0.4, 0.4, 0.4, 0.4, 0.5

Note that in data set 1 the 95% is the the RED 0.3 number, which is the 19th number on the list. The only number on the list that can exceed this number is the 20th number on the list. If the 20th number on the list is 0.4, then we hit Large Leak territory for 5% of the night. If that 20th number is another 0.3, we don't.

In both data sets 2 and 3, the 95% value is the RED 0.4 number. It is the 19th number on both of these lists. 95% of the data points in each of these sets have values that are AT or BELOW that number. (And 5% of the data points---i.e. the 20th number in the data set--have a value that lies AT or ABOVE the 95% level.)

But if these data sets represented leak numbers, in data set 2, the large leaks last only 10% of the night, whereas in data set 3, the large leaks last 60% of the night. Big difference.
10-23-2013 10:17 PM
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robysue Online
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Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #29
RE: Still Sleepy
(10-23-2013 09:29 PM)me50 Wrote:  Is 39 acceptable at a pressure of 20%?

me50, where are you getting these numbers and what are their units???

Your signature reports that you are using a Resmed S9 Auto which reports only EXCESS leak rate numbers that are reported in L/min. The Pressure is reported in cm H20.

On any Resmed machine at ANY pressure, a leak over 24 L/min (or 0.4 L/sec) is considered a LARGE LEAK. If a large leak is very short lived it's not a huge issue, but if you're leaking at a rate of 39 L/min most of the night, then that's a huge issue.

So--is that 39 from the machine's LCD or from ResScan or from SleepyHead?

And when you look at the sleep quality report in the morning are you seeing Mr. Red Frowny Face or Mr. Green Smiley Face on the LCD?
10-23-2013 10:24 PM
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me50 Offline

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Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #30
RE: Still Sleepy
(10-23-2013 10:24 PM)robysue Wrote:  
(10-23-2013 09:29 PM)me50 Wrote:  Is 39 acceptable at a pressure of 20%?

me50, where are you getting these numbers and what are their units???

Your signature reports that you are using a Resmed S9 Auto which reports only EXCESS leak rate numbers that are reported in L/min. The Pressure is reported in cm H20.

On any Resmed machine at ANY pressure, a leak over 24 L/min (or 0.4 L/sec) is considered a LARGE LEAK. If a large leak is very short lived it's not a huge issue, but if you're leaking at a rate of 39 L/min most of the night, then that's a huge issue.

So--is that 39 from the machine's LCD or from ResScan or from SleepyHead?

And when you look at the sleep quality report in the morning are you seeing Mr. Red Frowny Face or Mr. Green Smiley Face on the LCD?

It was information about the leak rate at 20% pressure of the mask I ordered on Oct 15 and am still waiting for
10-24-2013 04:47 AM
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