New to APAP Dreamstaion - Resmed F20 Mask

[MitchS]

I'm going to confuse you and tell you how I got SleepyHead to flag large leaks more closely to what my DreamStation reports.

First, I went to the CPAP tab of the SleepyHead preferences and checked the box next to Calculate Unintentional Leaks When Not Present. I changed the pressure slides to match my mask's intentional leak rates at 4cm and 20cm as listed in the mask's user manual. In your case, using a AirFit F10, that would be 21.6 L/Min for 4cm and 60 L/Min for 20cm. The 20cm slide will only go to 55 L/Min so I would set it at that.

Next, I set the Flag leaks over threshold setting at 29cm, which is when SleepyHead seems to start flagging DreamStation leaks.

If you use this approach you will need to change the slider setting whenever you to a mask other than the one they are have been set for.

[Ron AKA]

So back home from work, I have changed the leak setting in SleepyHead and I went from major leaks to no leaks reported. I was also playing with the ramp setting. It seems I must hit the ramp button in order to start the ramp on the machine. This is because the machine is set to "auto" if the machine is set as "CPAP" then I can set ramp to start on it own. At least that is how I understood the manual, and how the machine is acting with the settings. I dont mind hitting the ramp button for now. If the machine is set as CPAP instead of AUTO would it function the same?


edit...I do like the ramp feature myself.

I'm handicapped somewhat in that I have not used a Dreamstation, and the manual covers all machines, so it is hard at times to figure out what they are saying. Options turn on and off based on your specific machine, and how you have configured it as well. But it says:

"When you set the Ramp time, the device increases the therapy pressure from the value set on the Ramp start screen to the therapy pressure setting over the length of time specified here. If the therapy pressure is set to 4 cm H2O (the minimum setting), this screen will not display. Note: Depending on the therapy mode, the therapy pressure setting could be CPAP pressure, CPAP-Check pressure, Auto min pressure, EPAP pressure, or EPAP min pressure. Note: If the Ramp time is set to 0, Ramp start will not display"

I read that as it will let you use a Ramp regardless of whether CPAP is selected, or Auto-CPap, as long as the therapy pressure is more than 4 cm. And you have it more than 4 now. So you should just have to set the ramp time first, and then the Ramp Start option should be there and you can set it to 6 cm, or what you prefer.

[Walla Walla]

I'm going to confuse you and tell you how I got SleepyHead to flag large leaks more closely to what my DreamStation reports.

First, I went to the CPAP tab of the SleepyHead preferences and checked the box next to Calculate Unintentional Leaks When Not Present. I changed the pressure slides to match my mask's intentional leak rates at 4cm and 20cm as listed in the mask's user manual. In your case, using a AirFit F10, that would be 21.6 L/Min for 4cm and 60 L/Min for 20cm. The 20cm slide will only go to 55 L/Min so I would set it at that.

Next, I set the Flag leaks over threshold setting at 29cm, which is when SleepyHead seems to start flagging DreamStation leaks.

If you use this approach you will need to change the slider setting whenever you to a mask other than the one they are have been set for.

For the F20 it would be 22 l/min at 4cm and 54 l/min for 20cm as per the F20 manual. I was going by the example used in the beginners guide for sleepyhead on figuring the cutoff for a Respironics Large leak which is 70 l/min. So I don't know who's right as far as amount over threshold for a large leak. If your machine shows a large leak than you'll know for sure.

[SarcasticDave94]

Better yet don't use the ramp.

We all have our opinion, and mine is that it is much more comfortable with the ramp. Can't think of a reason not to use it, if it is well set up.

FWIW and educationally speaking, any ramp use made my therapy session much less effective for the Ramp duration. For me, it's likely due to needing ASV Auto's ability to detect different events and act on them. As I recall, ramp blocks the algorithm from acting. For me, ramp is a bad choice.

We've seen some others that react badly to the extra pressure changes ramp causes. I'm thinking central apnea patients can have a reaction to ramp. Ramp is good for some and others it's not.

[jaswilliams]

Ramp is a comfort feature that delays the required treatment for me I don't bother with ramp and just get on with it. If you need ramp to get to sleep then use it. Over time as you get used to the pressure you may not need or want it

[sickntired]

Had a decent sleep again last night. I didnt mess with the ramp setting any more, just pushed the button to make it work. I have no idea why I can not get the ramp to start on its own, will have to read and try again I guess. After making the adjustments for leaks SleepyHead recalculated everything and says I am still having leaks. On the positive side there are no events during the leaks and I didnt rip the mask off in my sleep again. 

Will fixing my apnea help fix my sleep patterns? We go to bed around 8:30 pm, but I have a hard time staying asleep after 2 am or so. I usually wake around 3:30-4:00 am getting anywhere from 5 to 6 hours sleep a night. I am currently taking 3mg time release melatonin to try and combat the troubles staying asleep and it has helped some, but I feel like it's not enough.

I have attached 2 images to include all the graphs, and a c/p of the Welcome message.

The last time you used your Philips Respironics Auto CPAP...
was last night (on Wednesday, April 4, 2018)
You had an AHI of 1.99, which is considered reasonably good
You machine was on for 6 hours, 32 minutes and 14 seconds.
Your mask is leaking way too much.. Talk to your CPAP advisor.
Your pressure was under 10.7cmH2O for 95% of the time.


Thanks

[Walla Walla]

When you looked at the machine itself did it show any large leaks?

[sickntired]

On most nights/mornings no, but it did show a percentage this morning. I've left for work already and don't recall what the percentage was though. Most of the time when I do see leak percentage it is in the lower 20's, maybe 2 or 3 out of 7 nights.

[Walla Walla]

When you get a chance go back and look at your leak percentage on your machine than look at your chart and try to figure where the leak rate is that allowed that percentage. That is the number you want to set your red threshold line at. As far as fixing the leaks I'd review the mask primer in the link below.

[sickntired]

I have Large Leak of 26.1% for last night on the machine and SleepyHead reports 24.82%. Pretty close, sure I can play with the numbers and get it to a exact match.

Interesting...moving the sliders does not change the reported percentage by SleepyHead.