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Mask Pressure
#1
Question 
My husband finally got Sleepy Head to work after about 4 hours. But now I have another question. I have an ASV machine.

What is mask pressure? It seems to be different from the pressures that I have set (4/8). It varies between 8 and what I believe is I believe 17.

The site will not let me post from my document library where my read outs are. It makes no sense because I have seen other people do it. So I will describe it. The graph looks like an almost solid blue line between 8 and 15 with spikes to 17. It does not look like anything I've seen from other people.

What is making this happen? The mask almost lifts off my face when I have the machine going.

Thanks Kate
:Using cpap then vpap since Feb.2013,
Kate
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#2
Mask pressure basically is reflecting the inhale pressure and the exhale pressure which would be different if you have EPR on. If you do not have EPR on, then it would be a solid line vs a thicker one.

As for why you could not post a link, I am not sure why that would happen.

You can post an attachment of an image once you upload it
http://www.apneaboard.com/forums/Thread-...ttachments

You can post a link to an image uploaded to a photo or site such as photobucket
http://www.apneaboard.com/forums/Thread-...13#pid3213
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.




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#3
How do I set the EPR?
:Using cpap then vpap since Feb.2013,
Kate
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#4
(02-20-2014, 10:59 PM)Kate Wrote: How do I set the EPR?

Hi Kate,

I'm not sure your machine actually has EPR.... but assuming your machine has EPR, the first thing you'll have to do is get into the Clinician Menu and make sure EPR is turned on. Then back out of the Clinician Menu and go into the Patient menu to see the level of EPR you want (1 for lowest pressure relief, 3 for the highest).

This page has instructions with pictures and videos on how to make get into the Clinician Setup and other adjustments on the S9 machines:

http://www.apneaboard.com/resmed-s9-cpap-setup

But I think on Bi-levels, you can set the upper and lower limit of pressure and that's kind of the same as EPR, except with more of an available range for pressure relief.

Hope this helps!

Coffee
SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


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.



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#5
If it has it, those letters would be near the on/off buttons, usually below it to the side. Or I would assume it would. ResMed is rather proud and likes to show off their stuff.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.




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#6
(02-20-2014, 02:43 PM)Kate Wrote: The graph looks like an almost solid blue line between 8 and 15 with spikes to 17. It does not look like anything I've seen from other people.

That sounds like what the graph would look like when zoomed out. Try zooming in on the graph to see the detail over a 5 minute timeframe.

A screenshot would help if you can get one posted (new members can't post links per forum guidelines).

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#7
(02-20-2014, 10:59 PM)Kate Wrote: How do I set the EPR?

Hi Kate,

Your machine doesn't have (or need) a separate "EPR" setting when operating in AutoASV mode, because your S9 VPAP Adapt machine has other settings which provide the same (and more) adjustability.

When using ResScan, I suggest you look at the "Pressure (High Rate)" waveform (rather than the normal "Pressure" waveform, which I think might not display correctly for bilevel machines like yours unless operating in CPAP mode).

Before I can comment on how your machine is behaving, can you list for us what are your present settings?

Min EPAP?
Max EPAP?
Min Pressure Support?
Max Pressure Support?
Max IPAP?

--- Vaughn

Added:
Or, if like me you are using the older S9 VPAP Adapt (USA models 36007 36017 or 36027 made before November 2012), EPAP does not auto-adjust, so there is only one setting for EPAP. On older machine the Ramp function works only if in straight CPAP mode, so the only available pressure settings would be:

EPAP
Min PS
Max PS
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.
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#8
(02-20-2014, 02:43 PM)Kate Wrote: I have an ASV machine.

What is mask pressure? It seems to be different from the pressures that I have set (4/8). It varies between 8 and what I believe is I believe 17.
and
Quote:The graph looks like an almost solid blue line between 8 and 15 with spikes to 17. It does not look like anything I've seen from other people.

Mask pressure is the pressure delivered at the mask by the machine. The pressure curve shows just the current set pressure for the EPAP pressure on your machine, if I recall correctly.

It sounds like your EPAP pressure is allowed to range from 4cm to 8cm as the machine responds to OAs, Hs, Flow limitations, and snoring. Or perhaps you are using the ramp and the initial ramp EPAP is 4 cm.

But an ASV machine is only prescribed when a person has real problems with central apneas. And an ASV machine has a couple of other important setting for explaining why your mask pressure graph looks the way it does. Those setting are the min PS and max PS settings.

The IPAP pressure will always be between EPAP + min PS and EPAP + max PS. And the variation in the mask curve (if you zoom in far enough) will show how the pressure is increased from EPAP to IPAP and then decreased back to EPAP as you cycle through inhalations and exhalations.

It's also worth pointing out how the ASV machine treats central apneas by monitoring the frequency and depth of the inhalations. When the machine's ASV algorithm is not happy with your overall breathing effort, it will then step in and start "triggering" breaths: In other words, the ASV algorithm will start increasing the IPAP pressure drastically in an effort to force you to inhale. In ASV mode, it is possible for the IPAP to suddenly increase over a few breaths up to where it is 10cm (or more) higher than the EPAP pressure.

The docs who treat us and the engineers who design our equipment also seem to believe that a pretty significant difference in IPAP and EPAP pressure may help the CO2 overshoot/undershoot cycle that is at the root of central sleep apnea from developing in the first place.

So if I had to make a guess, I'd guess than your EPAP is hovering around 8cm most of the night and that your max PS setting is at least 9cm. It sounds as though you are spending much of night with

IPAP = 15 (and spikes to 17 when the machine is triggering inhalations)

EPAP = 8 (so the machine is running at or near max EPAP most of the night OR your machine actually has a fixed EPAP = 8 and you are starting the night off with a ramp period where the starting ramp EPAP pressure is 4cm)

Quote:What is making this happen? The mask almost lifts off my face when I have the machine going.
What's causing the mask to almost lift off your face is that rather large difference between and EPAP = 8cm and an IPAP in the 15-17 cm range. It is, alas, part of what's expected when using an ASV to treat central apneas. And learning to deal with it is, an unfortunate part of needed an ASV machine to treat problems with central apneas. Mask liners might help.


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#9
Just as long as mask take-off is normal, that's fine.
:Using cpap then vpap since Feb.2013,
Kate
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