Low Tidal Volume

[Gideon]

Close enough, it looks better at this scale.

I wouldn't touch anything unless you are having issues.  How do you feel?

I'm sure you see the same flow limitation I do.  Once again, the wrong machine (Dreamstation), but not medical "necessity" to change it.

Yep. But without symptoms and good numbers . . . .

[ajack]

If it was me, with the DS cpap. I'd raise the min pressure to 12 and then review

[michael9346]

If it was me, with the DS cpap. I'd raise the min pressure to 12 and then review

Ajack thanks for your response. I do not see any gain in increasing my minimum to 12 when hypopnia's and apnea's are not the issue. Can you explain your reasoning? In fact I was considering reducing to 9.5 as anything over 10 causes severe aerophagia, as well as mass leakage. I had a Resmed Airsense 10 autoset for a few weeks and it did nothing to help my TD. I'm leaning more on nasal obstructions as the primary cause and do a saline wash twice a day.

[ajack]

Raising the min pressure wasn't for AHI. It was to see how much effect it had on your tidal volume in total and the dips on the chart where you zoomed in.
12 is under your current used max and 1 above your 95% and would probably be about what some labs would put as fixed. It is a pressure I would try.

[ajack]

I had to do something and missed the edit within time.
Generally if you have a nasal restriction, The body chooses to breathe through the mouth. Do you have a full face mask to try, it may help with leaks?
You may find that the aerophagia settles over time. It did for me. I'd still try to get min 12 working for a couple of hours and see. You are currently within that pressure range now with max at 12.8 . So it may not be that bad. You may even want to set the alarm, so you don't get too much aerophagia. It's just to see if it helps and it's the right path.

[SnoringInOregon]

The thing that sticks out to me with the initial SleepyHead charts is the Leak Rate.

The machine is pretty sophisticated, but I bet it's hard for it to calculate an accurate Tidal Volume taking into account all the extra air it is blowing to compensate for the leaks.

What is the Tidal Volume with the P10 in the absence of leaks? In my P10, at a pressure of 10, I see almost no leaks.

Maybe you are opening your mouth? I think that's probably it, ajack mentioned this.

The only way I can use my P10 is supine, aka on my back. If I'm on my side I open my mouth and the air rushes out and I see a lot of leaks.

[michael9346]

Ajack / Snoring, I have used FFM since being diagnosed with OSA 2 years ago. I have switched to nasals and now switch between the Nuance Pro and the P10.  The first attachment is with the FFM Airfit and the second with the Nuance Pro. You can see a big difference in the tidal volume using the FFM to the pillow. I assume this may be a normal occurrence but it seems a little extreme. I was getting good readings with the Airfit & Airtouch and then out of the blue my AHI went out of whack. I originally was very bad about mouth breathing, but believe I have it under control as long as I sleep on my side.
Sleepyhead Welcomes tells me I had no leaks and then other times it says I had bad leaks, but it is not saying what the Dreamstation says. Turning up the pressure will create much more leaks and mouth breathing. I appreciate your help.

       

[Sleeprider]

That kind of obstructive cluster is often fixed with a soft cervical collar. It is more typical of what we refer to as positional apnea, than a therapy issue.

[michael9346]

That kind of obstructive cluster is often fixed with a soft cervical collar. It is more typical of what we refer to as positional apnea, than a therapy issue.

Sleeprider if you look down at the bottom graph (resp rate) you will notice I am on a potty break and so this was actually S/W/J and really doesn't count. I have two very lovely cervical collars which I haven't needed to use when using a pillow mask. I will say the aerophagia has subsided greatly since I switched to pillow masks, and that's why I am reluctant to increase my minimum pressure as suggested by Ajack. I'd rather deal with the low tv than getting aerophagia again.

[ajack]

It's OK, you are getting the sleepyhead to show and get opinions on. There's is probably not more I can add and wish you well.
You may note that with the ffm, it was tidal of 480 and the second with nasal was 380. I think you are still mouth breathing and need to go back to the FFM. Then work with that to decrease your AHI through pressure adjustment and possibly positional head adjustment. If you decide on a FFM, you may need to change masks until you find a FFM that suits you.