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Machine or operator adjustment?
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zonk Offline

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Sex: Male
Location: Australia

Post: #21
RE: Machine or operator adjustment?
(02-01-2014 06:11 AM)comatose Wrote:  me50, I was led to believe that if I keep my leak levels below the red line in resscan, 24 L/min, and get a smiley face in the morning, then I should be getting an adequate flow and pressure of air.
Correct, from the manual: Mask-fit indicates ‘Good’ if the 70th percentile leak is less than 24 L/min.
Not all of us can have zero leak line all the time especially at high pressure, as far as I,m concerned, leak is only problem when disturb my sleep or come near my eyes. The machine increase pressure in response to snoring and flow limitation, can you also post snore and flow limitation graphs
02-01-2014 12:55 PM
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PaytonA Offline
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Post: #22
RE: Machine or operator adjustment?
(02-01-2014 05:48 AM)me50 Wrote:  
(02-01-2014 05:39 AM)comatose Wrote:  me50, I attached a screenshot on the previous page, post #6.
It appears to me that the pressure I am using is inadequate to stop recurring apneas.

Maybe you can go back and read the previous posts. Some of the data I looked at, you have clusters of leaks which means that you are not always getting treatment that you need. If you look, when you have high leaks/clusters of leaks, that is when you are having a lot of events and when your pressure is increased.

FFM are known to leak and the leaks are not easy to control. Rather than continue to raise your pressure, I would work on the leak issue and maybe change masks.

That is just my opinion.

I guess that I do not understand. ResMed indicates that leakage under 24 L/min still supplies therapeutic treatment. Most of this "higher" leakage is still within the 24 L/min range.

Next we come to the chicken or the egg discussion. Do the higher leakage clusters cause the events or do the events cause the higher leakage clusters?

Best Regards,

PayotnA
02-01-2014 01:21 PM
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zonk Offline

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Posts: 7,908
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Machine: A10 AutoSet
Mask Type: Nasal mask
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CPAP Pressure: 9/13
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Sex: Male
Location: Australia

Post: #23
RE: Machine or operator adjustment?
(02-01-2014 01:21 PM)PaytonA Wrote:  Next we come to the chicken or the egg discussion. Do the higher leakage clusters cause the events or do the events cause the higher leakage clusters?

Best Regards,

PayotnA
Maye bit of both, who knows, those machines got mind on their own
Any way the sleep study is only few days away and all will be revealed

Edit: If were me, I set the machine on fixed pressure and see what happens.
Definitely in the presence of on-goings leaks, the auto is not working as should
(This post was last modified: 02-01-2014 01:52 PM by zonk.)
02-01-2014 01:33 PM
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Peter_C Offline

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Post: #24
RE: Machine or operator adjustment?
Just throwing my hat in here too...

I've been chasing my leak rate for some time. My AHI is/was doing great if it was below '10'. Magically, now that my leak rate is really low, all of a sudden, my AHI numbers have dropped as well. We're talking an average of '2' - '4' most of the time now, and in the beginning, I was lucky to see a '10' once a week.

I've been tracking since NOV now, and it's only been the last 3 weeks or so that I've seen my numbers improve.

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
02-01-2014 02:48 PM
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comatose Offline

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Post: #25
RE: Machine or operator adjustment?
Zonk said, "can you also post snore and flow limitation graphs "

Here is a sreenshot of the 31st and one of the 1st, last night with the pressure adjusted to 14.2/17.2
Maybe it was a fluke AHI last night? 4.7 is the best for me, a few weeks ago I got a 5.
My lungs felt like I had run a marathon this morning but seemed to come good after my second smoke.
I did toss and turn quite a bit last night and at times found it difficult to breathe so I think that tonight I will change the EPR from 1 to 2.

Can snoring make the leak graph look worse than it actually is?
I was thinking the vibrations from snoring may have a jackhammer effect?

Zonk I had tried to find info on the flow limitation but nothing I found made any sense to me, could you please check out my pickies and enlighten me a bit about the FL please?


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(This post was last modified: 02-01-2014 07:31 PM by comatose.)
02-01-2014 07:29 PM
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vsheline Offline

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Post: #26
RE: Machine or operator adjustment?
(02-01-2014 12:35 AM)DeepBreathing Wrote:  
(02-01-2014 12:23 AM)c0reDump Wrote:  
(02-01-2014 12:16 AM)DeepBreathing Wrote:  Echoing what others have said - if you change pressures every day your body will never adapt and you won't get a true indication of what's working and what's not.

Yet Doctor's are writing prescriptions based on titration studies, where the techs are changing pressures every 10 minutes...

Yeah - I think it's crazy! The place I went to didn't do that. They provided an autoPAP machine on day 1 and reviewed the results after a week, then adjusted pressures, then reviewed after another week. This goes on for a month. Each week you go in and see the therapist who reviews your progress listens to what you tell them and makes adjustments for the following week. (Also changing the mask if you need to).

In my case I had a high percentage of centrals so the process went on somewhat longer, trying both the Philips and ResMed ASV machines.

The basic premise is that very frequent changes of pressure won't give you a valid result, which is why I much prefer my procedure to a one-night titration study.

Wow, what a great titration approach!

Would be good to have a diagnostic study (overnight sleep test without treatment) to see if there are any complicating issues, but a supervised at-home APAP titration sounds to me like a great way to do the titration.

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.
(This post was last modified: 02-01-2014 08:04 PM by vsheline.)
02-01-2014 08:03 PM
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me50 Offline

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Post: #27
RE: Machine or operator adjustment?
(02-01-2014 07:29 PM)comatose Wrote:  Zonk said, "can you also post snore and flow limitation graphs "

Here is a sreenshot of the 31st and one of the 1st, last night with the pressure adjusted to 14.2/17.2
Maybe it was a fluke AHI last night? 4.7 is the best for me, a few weeks ago I got a 5.
My lungs felt like I had run a marathon this morning but seemed to come good after my second smoke.
I did toss and turn quite a bit last night and at times found it difficult to breathe so I think that tonight I will change the EPR from 1 to 2.

Can snoring make the leak graph look worse than it actually is?
I was thinking the vibrations from snoring may have a jackhammer effect?

Zonk I had tried to find info on the flow limitation but nothing I found made any sense to me, could you please check out my pickies and enlighten me a bit about the FL please?

the flow limitation is under the snore data
02-01-2014 08:06 PM
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DeepBreathing Offline
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Post: #28
RE: Machine or operator adjustment?
(02-01-2014 08:03 PM)vsheline Wrote:  Wow, what a great titration approach!

Would be good to have a diagnostic study (overnight sleep test without treatment) to see if there are any complicating issues, but a supervised at-home APAP titration sounds to me like a great way to do the titration.

I should have mentioned that night 1 was a full polysomnograph with all the wires & tubes. I slept well (apart from about 4 toilet breaks), and was blown away when the guy came in to wake me up and told me I had an AHI of 62. I think that put me over the threshold where they give you a machine on the spot.

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02-01-2014 08:16 PM
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me50 Offline

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Post: #29
RE: Machine or operator adjustment?
(02-01-2014 07:29 PM)comatose Wrote:  Zonk said, "can you also post snore and flow limitation graphs "

Here is a sreenshot of the 31st and one of the 1st, last night with the pressure adjusted to 14.2/17.2
Maybe it was a fluke AHI last night? 4.7 is the best for me, a few weeks ago I got a 5.
My lungs felt like I had run a marathon this morning but seemed to come good after my second smoke.
I did toss and turn quite a bit last night and at times found it difficult to breathe so I think that tonight I will change the EPR from 1 to 2.

Can snoring make the leak graph look worse than it actually is?
I was thinking the vibrations from snoring may have a jackhammer effect?

Zonk I had tried to find info on the flow limitation but nothing I found made any sense to me, could you please check out my pickies and enlighten me a bit about the FL please?

[attachment=690]

this is a sample of my data when I was using the same machine you are using.
02-01-2014 08:23 PM
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zonk Offline

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Machine: A10 AutoSet
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Post: #30
RE: Machine or operator adjustment?
Hi comatose
First of all, may I suggest that you find a way to quit smoking, not going be easy after all those years but please try and see your doctor about lung function test. An oximeter is worth getting to monitor oxygen level, if you decide to take this route, post a separate thread so people who use oximeter (there,re number of them) can recommend which one to get and how read the oximetry data

The graphs you posted looks completely different but both are for 1st Feb ???

The machine increase pressure in response to snoring and flow limitation (FL) which are precursors to obstructive apnea. Apnea need to last 10 seconds or more to be scored, FL does not meet such criteria but nevertheless are partial obstructions. we want see more mountain shape near the bottom of the graph and less flat shape near the top end of the graph
02-01-2014 08:53 PM
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