Hello Everyone

[madmike]

New Guy  here.  I have been enjoying all the information that you have posted here and wish I had found it 5 years ago.  your wisdom would have solved many situations for me.  
I have used this S9 for almost 5 years having no problem until it was sent to Resmed for an intermittent shut down problem a couple of ments ago.  the machine would just stop work for a few minutes and they were unable to find the problem. Bcos I am a mouth breather I have used a Fisher and Paytel 431 or an AirFit 10 most effectively for the entire time.  I think they made some changes to the machine bcos now the pressure range of 6-16  always leaks and AHI of 22.02  purchased a new f&s 432 and reduced the pressure 6-12 and have an AHI of 10.98.  it could be that my facial structure will no longer support a cpap mask.  I have decided on a different mask with Nasal Pillows and built in chin flap.  medicare will allow an Airsense 10 in another 2 months so i'm waiting for that.
any input on what I might change? Perhaps a close-up on some of the trouble areas? Any insight would be greatly appreciated.
Thank You

[Sleeprider]

Madmike, welcome to Apnea Board! Boy do I ever have a couple suggestions for you. First, your pattern of persistent obstructive apnea, all night long or in clusters is typical of what we call positional obstructive apnea. It is so common, we wrote a wiki about it. http://www.apneaboard.com/wiki/index.php...onal_Apnea Take a look, and you will see some graphs that look like yours, and what the same person looks like after treating it with a soft cervical collar. You very likely can experience the same good results and enjoy much better sleep at lower pressure.

Take a look at the wiki, and let's talk about what you can do to really transform your results.

[madmike]

Thank You SleepRider,  I have lowered the pressure to 11 and spent a much better night last night except for the mask leaks and the soreness on the bridge of my nose.  i suspect the leaks occur whillle i am on my back. i will order the nose pillow mask next week after i receive the prescription from my lung doctor.l   any other thoughts that i can do to improve my sleep?

[Melman]

I agree with Sleeprider. A soft cervical collar should reduce your obstructive apnea. You can buy them at a pharmacy, big box store, or amazon for around $10. I use the OTC collar from Amazon and its made a significant difference. I also note from one of your charts that you have EPR on full time but with a setting of 0. I suggest you change it to 2 or 3. It will lower your exhale pressure for greater comfort and more importantly help reduce your flow limitations and obstructive apnea.

[madmike]

just finished changing epr to three.  i assume my machine is the same with full or ramp.    i thought i had a cervical collar here from earlier days, but i must order one tomorrow and will have it soon.
thank you both.

[Sleeprider]

The biggest change to your results will come with the collar, and it should be great.

EPR should be set to Full-time, not ramp only or off, and the setting at 3 would be best.

[Melman]

If you havn't already read it please see the map primer (Link below). You may find some tips to help you get your leaks better controlled.

[madmike]

ran several mask fitting tests with good results .   have spent the night with the cervical collar having some interesting results.  received the perscription for the nasal mask and ordered it.  one change at a time

[Sleeprider]

The collar made some differences for you, but needs more optimization. Try increasing maximum pressure as you can tolerate it. You clearly need more than 11 cm pressure to get better results.