Just got new BiPAP machine, need help with treatment/optimization

[blancobonzo]

Thanks for the response. What about large amount of leaks throughout the night? The cervical collar was on and the medical tape didn't fall off.

[cathyf]

Turn "SmartStart" off. ResMed are idiots -- SmartStart is clever, but for some reason some total moron thought that it was necessary to force you to allow the machine the power to turn itself off when you give it the power to turn itself on. (This is apparently fixed in the 11.)

What happened at 4:30 is that the machine decided you were dead and so you didn't need it anymore and so it turned itself off. It very briefly detected life and turned itself back on, but then decided you were dead again for awhile...

In other words, just when you need the machine the most -- because you've stopped breathing -- the machine decides that it can turn itself off.

ResMed is like an idiot savant. Brilliant engineering, powerful, subtle science, combined with such amazingly stupid little details that you wonder if the brilliant engineers were off drinking and left some idiot in charge for awhile...

[SarcasticDave94]

Hmm then smart start isn't as smart as it's named at times.

[blancobonzo]

Hello, here is OSCAR data from last nice. The high trigger sensitivity seemed to reduce most of the central apneas. However, I still seem to be having a relatively large amount of leaks when compared to the full face mask. I use mouth tape and a soft cervical collar. The tape stayed on the whole night. I was wondering where the leaks could be coming from. With the nasal pillows it couldn't slip and then fall back into place right? Also, last night I turned up the PS to 6. Should I turn it back down to 5 to try and remove the current centrals? Throughout the night I seem to minimal leaks most of the time. The ones that are very low are of little consequence most of the time but I'm just curious as to what might be causing them. Thanks for the help.

[SarcasticDave94]

IMO it looks like a mouth leak pattern. Could be the tape isn't staying sealed or some tape is more porous than others.

[Sleeprider]

The trigger sensitivity had the expected benefit of fixing the CA, so this therapy looks great. Your leaks are not that bad, more of a nuisance. How are you feeling? Are you waking from dry mouth or disruption from the leaks? It looks like all you need is a gentle nudge to keep your jaw closed. I often tuck a piece of my down pillow up between may shoulder and jaw along the side of my neck.

[blancobonzo]

I woke up around 5 hours in and the leak rate spiked up to 90 beforehand. I already use a soft cervical collar for chin tucking. Should I get a slightly larger one? The one I’m currently using seems to have a little space where my chin could possibly drop. Also I use some kind of 3m nexcare medical tape (brown one). If this is porous, is there any tape you would recommend that works for this more often?

[Sleeprider]

I don't tape, and have some leaks. I think your answer will be something that just comfortably encourages the jaw to stay closed. I have not seen the kind of events that suggest chin-tucking. Just think of how your collar supports the back of the jaw, and that is how I use my pillow.

[blancobonzo]

Hello. I have OSCAR data from last night and OSCAR statistics from 2 nights ago (forgot to put sd card in). Two nights ago I managed to secure the tape on my face by multi-layering it and wrapping my jaw with grip tape, and had an AHI of 0.2 with Min EPAP=8 and PS=6. I slept well but woke up too early due to either an arousal or bloating caused by aerophagia, likely because I was somehow lying on my back while normally being a side sleeper (MedCline). The next night I decided to set min EPAP to 7 and PS to 7 to try and avoid the aerophagia and see if centrals would somehow increase. The night went well with 0 events until I had an obstructive apnea followed by a very high leak and a central apnea (attachment below event), and the AHI for the rest of the night was significantly worse than last night. I was wondering what might have caused this massive leak and how it could have led to a higher AHI for the rest of the night despite seemingly being resolved (the leak). Also, are there any modifications I should make to the settings to further optimize therapy? Thanks for your help.

[blancobonzo]

Hello, I finally managed to find a tape that stays on the whole night. Despite this my breathing seems to be erratic at times and the AHI seems to have gone up a bit since last time. Perhaps it's the PS=7. Here is the oscar data from last night. Are there any further optimizations to be made? Also, there is an attachment of what is an example of the "erratic breathing" and also and what my normal breathing looks like. The normal breathing seems to be done in 2 parts. Is this normal? Thanks for any suggestions.