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Help with my stats please!
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jpchartrand Offline

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Posts: 5
Joined: Apr 2014

Machine: Resmed s9 autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Quattro Air
Humidifier: Resmed
CPAP Pressure: 5-16
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #1
Sad Help with my stats please!
Hi! I really don't understand my stats. I've just had a really good night sleep or so it seems. I don't remember waking up because of any leaks...yet my stats are off the chart. My pressure seems to always be as high as it can get...

I've taken a screenshot to show you exactly what I mean.

Can someone please help me understand this?


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04-12-2014 09:55 AM
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Dgsr Offline

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Posts: 49
Joined: Jan 2014

Machine: S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro
Humidifier: H5i
CPAP Pressure: I - 18, E - 14
CPAP Software: ResScan SleepyHead

Other Comments: Beard

Sex: Male
Location: Alabama

Post: #2
RE: Help with my stats please!
First, maybe a little background? Did you go to a sleep study, and are you using the prescribed pressure?

Also, how new are you to using the cpap? I'm noticing on your screen capture that it looks like you've been using it sporadically (2nd, 4th, 5th, 7th, 9th, 11th.)


There are people that will be able to explain it much better than myself.

That being said, we'll start with your AHI. It shows an AHI of 25.84, which is an average of 25 sleep disruptions per hour. PAP treatment aims to get you under 5, most people consider under 1 to be the ultimate. You'll notice yours goes up and down, and got really high after 2am. Any time you have a high leak rate, your AHI data is suspect. The machine cannot properly report on events with high leaks.

Your leak rates are pretty high at times. The leak rate depends on your mask (brand/type), but generally in the low 20s is the highest you want to see for most mask types. It looks like you're breaking into the 30s for a good portion of the night, and after 2:30 it went through the roof.

Your pressure climbs straight to 16 (your highest setting indicated by your information on your profile) and never stops.

My guesstimation would be that you need to get your leaks under control, and speak with your sleep doctor about the max pressure setting being adjusted.
(This post was last modified: 04-12-2014 10:27 AM by Dgsr.)
04-12-2014 10:14 AM
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justMongo Offline

Monitors

Posts: 3,844
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #3
RE: Help with my stats please!
You must get your leaks under control before your other stats are meaningful.
Look at the mask pressure graph -- you are leaking so much that the machine cannot keep up; and the pressure is dropping.

Then you can address your true AHI and any needed tweaks.

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.
04-12-2014 10:52 AM
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jpchartrand Offline

Members

Posts: 5
Joined: Apr 2014

Machine: Resmed s9 autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Quattro Air
Humidifier: Resmed
CPAP Pressure: 5-16
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #4
RE: Help with my stats please!
Thanks a lot for the feedback. So it looks like leaks are the problem here. I don't understand how I'm getting so much leakage. I'm at my second mask and I'm using a cpap pillow and a chinstrap. I've tested my mask at a pressure of 17 and I had no leakage... I guess it moves when I sleep?

Any tips to reduce leakage?

edit: my machine says my mask fit is good... Confused
(This post was last modified: 04-12-2014 10:58 AM by jpchartrand.)
04-12-2014 10:57 AM
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justMongo Offline

Monitors

Posts: 3,844
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #5
RE: Help with my stats please!
(04-12-2014 10:57 AM)jpchartrand Wrote:  Thanks a lot for the feedback. So it looks like leaks are the problem here. I don't understand how I'm getting so much leakage. I'm at my second mask and I'm using a cpap pillow and a chinstrap. I've tested my mask at a pressure of 17 and I had no leakage... I guess it moves when I sleep?

Any tips to reduce leakage?

edit: my machine says my mask fit is good... Confused

IIRC: The machine scores mask fit based on 70% time.

A mask that seems to fit well at the start of the night is often loose by morning. Perhaps do to fluid shifts or the straps stretching.
I am awakened by the slightest leak, so I cinch down my mask straps rather tight. I'd rather wake up with strap marks than have a leak.

Everyone's face is different; and so there are so many masks to choose from (and so many opinions as to which is best.) Until I found my FFM, I was not compliant on xPAP.

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.
04-12-2014 11:16 AM
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Dgsr Offline

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Posts: 49
Joined: Jan 2014

Machine: S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro
Humidifier: H5i
CPAP Pressure: I - 18, E - 14
CPAP Software: ResScan SleepyHead

Other Comments: Beard

Sex: Male
Location: Alabama

Post: #6
RE: Help with my stats please!
(04-12-2014 10:57 AM)jpchartrand Wrote:  Thanks a lot for the feedback. So it looks like leaks are the problem here. I don't understand how I'm getting so much leakage. I'm at my second mask and I'm using a cpap pillow and a chinstrap. I've tested my mask at a pressure of 17 and I had no leakage... I guess it moves when I sleep?

Any tips to reduce leakage?

edit: my machine says my mask fit is good... Confused

I personally had issues with the mirage air leaking into my eyes, and have moved to the mirage quattro. Most people see this as a step back. They are quite similar to me, the main difference was the mirage fit better around my nose. It is heavier, but I also like the vents not being around my mouth. The way I sleep, the mirage is more quiet.

Sometimes you have to play with different settings on the headgear. Tighter is not always better. Some masks operate better with the cushion "inflated" by air, so if you tighten so much that it's crushed you end up leaking more.

I personally use a mask liner, but I wasn't having leak issues as bad as you are. I was trying to hit that sweet spot of a little leak, but not too much and my mask liner kept burping on me.


Also, are you sure you need a chinstrap? Traditionally you go for a chin strap if you're not using a FFM to prevent loss of pressure through the mouth. With a FFM, you're not going to lose pressure that way, but you can dry your throat/mouth out.
04-12-2014 11:16 AM
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PaytonA Offline
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Monitors

Posts: 3,005
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #7
RE: Help with my stats please!
Welcome to the forum.

There some things that I find a little unclear. Your profile says that your max pressure is 16 but the screenshot says that your max pressure was 17. What is the actual max IPAP pressure setting? For most of the night your leaks were reasonable (maybe not great but reasonable). You shut your machine off for a short period. What woke you up? Did you take your mask off?

It looks like maybe you did not get your mask back on well after shutting the machine down. I would not worry about the leaks at this time.

More to come.
04-12-2014 11:22 AM
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mjbearit Offline

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Posts: 605
Joined: May 2012

Machine: REMstar Auto AFlex DS550
Mask Type: Nasal pillows
Mask Make & Model: RESMed Swift FX
Humidifier: Heated humidifier - 2
CPAP Pressure: 12.5-20
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: So Cal

Post: #8
RE: Help with my stats please!
(04-12-2014 09:55 AM)jpchartrand Wrote:  Hi! I really don't understand my stats. I've just had a really good night sleep or so it seems. I don't remember waking up because of any leaks...yet my stats are off the chart. My pressure seems to always be as high as it can get...

I've taken a screenshot to show you exactly what I mean.

Can someone please help me understand this?

It looks to me like you were doing okay-ish until just before 3:00 AM. Just before 3 you started leaking like crazy and turned off your machine. Around or just after 3 you started the machine back up but you never got the mask seated properly and the rest of the night was a complete loss of data. As harsh as it may sound the way to get this therapy to help you is to use it... It appears you have not been using your machine every night so you can't get used to it if you don't use it. If you don't get used to it, you will not learn the best way to set your mask on your face to avoid leaks and such. I wake up instantly when I have a leak and I don't really wake up enough to be aware of anything other than knowing which way to move the mask to get rid of that annoying leak and then I am back asleep within seconds! The only way to get to that point is to use the machine every night. Fix your compliance and it will help you fix you leaks which will help you with your overall sleep which in turn will help you with your numbers! It is really about the quality of sleep, not the numbers. But once you get the quality of sleep, the numbers will follow! Smile Good luck!

As always, YMMV! You do not have to agree or disagree, I am not a professional so my mental meanderings are simply recollections of things from my own life.

PRS1 - Auto - A-Flex x2 - 12.50 - 20 - Humid x2 - Swift FX
04-12-2014 11:45 AM
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robysue Offline
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Posts: 1,226
Joined: Oct 2013

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: #9
RE: Help with my stats please!
My take:

Yes, the leaks are a huge issue, but that is NOT why your pressure is maxing out at 17 and staying there all night.

The machine is reporting an AHI = 25.84 and almost all of it is obstructive (either OA or H). So the machine has rapidly increased the pressure to 17 during the first cluster of events and it can't lower the pressure back down because the events keep occurring. You're also snoring pretty significantly all night.

What to do?

1) Fix the leaks (more on this in a bit)

2) Increase the min pressure setting so that is is much closer to 17. I'd suggest increasing the min pressure to about 15. Consider increasing the max pressure to 20.

Now: How to fix those leaks?

Your profile shows that you are already using a full face mask. You need to reread the fitting process carefully. Make sure the straps are snug, but not tight. If the mask uses an air cushion (like all the Quattro masks), you need to fit the mask while you are laying down in your sleep position and with full pressure --- as in 15-17 cm NOT 8cm. The cushion must be able to fully inflate in order to seal well, and overtightening the straps will prevent that. If you are using an air cushion mask, check out JanKnitz's fitting tips in her blog entry Taming the Mirage Quattor

Also make sure your face is both clean and dry before you put the mask on for the night. This may mean that you need to wash your face well before bedtime. If you have a heavy five o'clock shadow of beard stubble, you may also need to shave in the evening too.

Mask liners might also help. Depending on which full face mask you are using, you might also find Padacheek's Anti-leak strap helpful.

And given the size of the leaks, it's also worth checking the hose for leaks and tears, making sure the mask is assembled correctly, and making sure the humidifier and blower unit are firmly attached and that the humidifier lid is firmly closed.
04-12-2014 12:09 PM
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vsheline Offline

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Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #10
RE: Help with my stats please!
Hi jpchartrand, welcome to the forum!

OSA is usually highly positional, with the supine position (flat on the back) usually being the worst.

During sleep studies the technician is supposed to make sure we sleep at least part of the time on our back, because they want to witness the worst case.

I wear a teeshirt with a tennis ball in a pocket sewn high in the back, right between the shoulder blades, to make sure that if I roll onto my back while asleep, I keep rolling until I'm not on my back.

If you are able to stay off your back while asleep you may find your pressure needs are greatly reduced, leaks are less, comfort is greater, AHI is lowered, sleep quality is increased, and the whole world seems much better.

Take care,
--- Vaughn

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.
04-12-2014 11:44 PM
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