How to identify central or complex apneas using software

[biz1219]

That bit at 4:30 was a winner. Very little leak and the pressure rose to the treatment pressure for a few minutes. All you need to do is get the rest of the chart to look like it. It's back to the DME for them to fit it or try another mask. I'd ask for the manager, who is normally the one who has a better idea and will do something to stop you bothering him. I would guess like here, half the front staff are clueless.
There are also suppliers online that will allow a mask return.

Do you have the tube running back behind your head? arms and bedding can cause issues.

When you do the mask fit function blowing high pressure air, laying down. Have a good pull and twist of the mask, to see where it is leaking. What model of FFM are you using. It's very individual. I tried several, the f20 was the one that worked for me best.

Attached is report for 8 May.  Improved - much improved from 6 May.   I am working with the DME and also the Rx physician - slow as molasses to resolve anything.   I am using Respironics DeamWare full face mask.   I also have ResMed nasal pillows but results are far worse.  I am eligible for a new mask so it is an opportune time to try various masks.   The tubing runs behind my head.  It connects at the top of the head.

Have there been any reports of performance of ResMed's latest full face mask.

Last night except for 0400-0500h period the night went quite well IMO.   After 0230h the mask pressure started to drop and apneas crept in when they formed a tight cluster from 0400-0500h.  

Thanks to you for advise and help,  clif

[biz1219]

Attention please:  aJack

Attached are Oscar screen shots for period of 10 May through 13 May plus a .PDF with ResScan graph for the same period.   It seems like two good nights followed by a poor one.   On the night of 13 May there were 7 apnea events of 50 seconds or longer:   53-78-55-57-82-50-50.   For period involved the mask fitting remained unchanged.  That seems significant to me when comparing good nights with poor night(s).   TIA for your review and comments.

[jaswilliams]

You need to fix your leaks, the machine cannot decide what is going on and you are loosing therapeutic pressure. It my be miss flagging apnoea due to the leaks or it may be accurate. Do you really need such high pressure support


What medical conditions are being treated

None of these graphs look good to me


I think your pressures are causing your issues and over ventilating you. Do you have the detailed data from when you first got your machine ? I wonder if someone has changed the settings on your ST

[ajack]

Sorry, the software forum doesn't notify, if someone tags you. You are welcome to PM me.
The leaks, although still shocking, are actually a bit better, you are holding the 14cm most of the night. You still can't get the 23 to hold.

Did you try the mask fit function that blows the high pressure?
I would use the FFM, it may show higher AHI, but we can sort that after the leaks are fixed. I found the f20 was best for me, but I think it is still largely a mask fit issue.

@Jas I agree the main issue is leaks. PS 9 isn't that unusual with someone with issues The 23 is high and hopefully that can come down when the leaks are fixed and any positional stuff corrected. The DME would have went off a script and the doctor would have a lab titration to support it. I would guess on the night, they would have needed 14 for OA or o2 and ps9 for H and tidal volume.

[biz1219]

Yes, I have used the mask fit utility and have spent this afternoon making adjustments and testing.   I am using the Respironics Dreamwear FFM.
Loosening, as suggested in a different thread, did not help.  It increased leaks.

After much testing, I have returned the upper head band to the position it was in at the start of the day.   Nothing was accomplished by either
loosening or tightening the upper head band.  I make adjustments based on recorded measurements so that I have a point of reference.


Loosening the lower head band did not help, quite the contrary.   In the end, the lower headband was tightened 1/4 inch overall.   It is in that setting for tonight's usage. 

If I tighten the lower headband any further I'll need "bailing wire" and a turnbuckle <grin - although is isn't funny!>.

JasWilliams wrote:  ...and ps9 for H and tidal volume.   Please clarify the "ps9."   Are you referring to a pressure setting of 9....?  please enlighten me.   [....is the ps9 the setting above the 14cmH2O to arrive at the 23cmH2O top pressure?]

I will report back tomorrow after trying yet another mask setting.    TIA for all of your help.

At the moment the DME is being unresponsive to my inquiries.

c!

[Gideon]

If you haven't please view the manufacturer vide for fitting the mask.

Getting the mask to fit is one of the harder tasks we face. There is a lot of info on fitting in the Mask Primer.

[biz1219]

I have used the Mask Primer as a guide and I will seek out the manufacturer's literature too.

I understand the logic of not over-tightening; but in my trials it hasn't worked for me so far.

Off topic a bit - - - what troubles me is the fact I was doing reasonably well as for AI with nasal pillows until July 2018 surgery - - - and after that I've never been able to regain any semblance of normal (for me) AI  with either the nasal pillows or a FFM.

[biz1219]

aJack you wrote:  "I found the f20 was best for me, but I think it is still largely a mask fit issue."

The F20 now comes in an AirTouch and an AirFit model - one with memory foam and one with silicone.   Do you have a recommendation on which one I should test first?   I am eligible for a new mask and they come with a 30 day trial, and my intent is to test test test to resolve the issues I'm dealing with .   TIA

"

[Gideon]

The memory foam supposedly seals better but has a shorter life.

[biz1219]

Thanks, that is what I gathered.   I have not seen the foam they use but foam can dry out and become flaky.