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New user with questions and frustrations
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Sleeprider Online
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Advisory Members

Posts: 3,395
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #11
RE: New user with questions and frustrations
(05-17-2015 02:25 PM)Suzannekty Wrote:  My prescription is for 2 weeks of auto pressure between 4 and 20 and then it is to be set at a constant rate at the 95th percentile. The DME guy said that would be 15 and according to the prescription they would set it for that on this coming Tuesday, the end of my 2 weeks. I have written my physician and asked to change the prescription. I feel suffocated at the level 4 and whenever the machine gets anywhere close to 15, I wake up and stare at the clock until my 4 hours are up, for compliance reasons, then take the darned thing off. I can't sleep at that high pressure. Most of the time, it doesn't need to be that high, so I asked the doctor to change the prescription to start the ramp at 6 then go to an automatic variable between 9 and 16. I have not heard back from her, yet, but it is the weekend. I would also like to have some exhalation relief, but the technician said that the doctor would have to prescribe that, too.

Setting your pressure at the 95th percentile is a bit much. The best bet is to stay in auto mode and set the minimum pressure to the median pressure. This takes a lot of the pressure swing out. For CPAP mode, the 90% value is usually used.

Resistance may be futile, but the settings are very easy for YOU to change. Passive resistance would dictate letting the DME and doctor be happy setting up your machine. Then bring it home and reset it where you know it should be.

Get Sleepyhead, do it now. Do the setting changes yourself before your appointment. I suspect that you will avoid the sense of air starvation, and the machine won't adjust up as high when the minimum pressure avoids many of the precursor events. You can get the setup manual from the forum here: http://www.apneaboard.com/adjust-cpap-pr...tup-manual

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05-22-2015 03:54 PM
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CHanlon Offline

Advisory Members

Posts: 292
Joined: Mar 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: ResMed Activa LT
Humidifier: ResMed Hi5
CPAP Pressure: 12 -20
CPAP Software: ResScan SleepyHead

Other Comments: Mirage Activa LT nasal mask

Sex: Male
Location: Ontario, Canada

Post: #12
RE: New user with questions and frustrations
And as to your leak numbers... the 95th percentile number is the one to look at. 95% of the time, you're under 2. You had a spike to 140... or you took the mask off and let the auto shut off turn it off. Smile
05-22-2015 04:48 PM
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franswahili Offline

New Members

Posts: 2
Joined: May 2015

Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: Mirage FX
Humidifier: ResMed H5i + Climateline
CPAP Pressure: 7
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Female
Location: Eastern Carolina

Post: #13
RE: New user with questions and frustrations
(05-22-2015 02:42 PM)sgearhart Wrote:  
(05-22-2015 01:55 PM)franswahili Wrote:  I just downloaded the ResScan software and I am trying to make heads and tails about the Leak rate portion of it. Are these good readings:

Leak - L/min
Median: 0.0
95th Percentile: 1.2
Maximum: 141.6

When I check the reading on the display of the machine it gives me a green smiley face that all is okay SHa_biggrin5

Am I reading this incorrectly?
Any leak over 24L/min is considered a major leak. Also, please provide the median, 95%, and max pressure listed in the statistical report of ResScan for all nights that are available. Most people have a suffocating feeling with the pressure set to 4 and usually set it to 6 or 8 for a starter.

I've been playing with pressure ranges on the Resmed and, in my experience, find their algorithm somewhat aggressive toward the upper pressure limit. I wake-up when the unit goes to the upper end of the pressure setting. I've since reduced the top pressure setting to the 95% value and my AHI's and sleep quality have improved significantly.

Hang in there; Getting this therapy fine tuned can be a real biddy!

I thought I was doing good. Been using this since August with no problem, I thought. Except for the first week, I never had a suffocating feeling. When I went to doctor in October, he did not mention anything wrong. Am I possibly sleeping with my mouth open?Huh

Here are the reading from the last 21 days. The ones I posted before were from when I first started therapy.

Leak/min

Median: 0.0
95th Percentile: 0.0
Maximum: 111.6

On the graph there are three colors. Dark green at bottom for median. Lighter green in middle for 95th percentile, and a lighter green at top for maximum. My longest line is the maximum.

Just need a explanation in simple layman terms. Is it possible the the maximums are the times that I may have gotten up to use the restroom (which is not every night) and took the mask off without cutting the machine off? Mine does not cut off automatically if I take it off.
05-23-2015 07:37 AM
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MobileBasset Offline

Advisory Members

Posts: 198
Joined: May 2015

Machine: ResMed AIRCURVE 10 V Auto
Mask Type: Nasal mask
Mask Make & Model: Fisher Paykel Zest
Humidifier: Integrated
CPAP Pressure: 10 (minE 6,maxI 12, PS 3)
CPAP Software: ResScan SleepyHead Other Software

Other Comments:

Sex: Female
Location: Florida

Post: #14
RE: New user with questions and frustrations
(05-22-2015 12:13 PM)Adoniscmj Wrote:  Hi, I feel your pain. I am new to this as well and like you I don't feel tired during the day, however I do have severe sleep apnea and I have been told that it will help with my quality of life. Consider this, if your blood oxygen level falls below 90% several times each night for say 10 seconds or more, how much damage can that cause in terms of cell death around the body. This type of thing can lead to decreased mental function as well as heart damage. This is why I choose to stick it out. I have the same machine as you and it is a really good machine. It is capable of tracking all kinds of sleep parameters so that you can review them and see if it is reducing your AHI number. Get into the set up menu by pushing the knob and the home button at the same time for 5 seconds. In the set up menu you can turn on EPR relief. Set the EPR to full time and set the level to 3. This will help with exhale so you don't feel like you are fighting the machine. In the set up menu you can adjust your max and min pressure to feel more comfortable with it. I had to adjust mine as well because mine was set 4-20 and at 4 I felt like I couldn't breathe so I increased this to 5.6 which helped. I also set the max to 9.0 and for me this worked as my AHI is 0.0 at this setting. Make it comfortable for you so you can use it and if you notice your AHI is more than 5 you can slowly increase the pressure until your number gets better. I hope this helps. I would make sure your doctor is in the loop as well.

I agree strongly with this advice. No one cares about your therapy success as much as you do. Every one else is just trying to meet some criteria for getting some average ability to improve their clients situation with out spending too much time on any one client. Whereas we can get the best improvement possible for ourselves by analyzing our data and working the adjustments our devices provide. I am so happy with the improvements I have been able to achieve by tuning up my settings and mask accessories. When we put in the effort we can be smarter than our doctors and respiratory therapists about our own therapy.
Make sure to tune up your leakage values. This is something you don't necessarily know is happening unless you study the data and it will make your machine drive higher pressures and be less effective even though you might see a decrease in your AHI. I added a chin strap when the data showed a leakage problem and it made a big difference. My leakage went to nothing and my pressure totally stabilized.
05-23-2015 09:36 AM
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retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #15
RE: New user with questions and frustrations
(05-23-2015 07:37 AM)franswahili Wrote:  I thought I was doing good. Been using this since August with no problem, I thought. Except for the first week, I never had a suffocating feeling. When I went to doctor in October, he did not mention anything wrong. Am I possibly sleeping with my mouth open?Huh

Here are the reading from the last 21 days. The ones I posted before were from when I first started therapy.

Leak/min

Median: 0.0
95th Percentile: 0.0
Maximum: 111.6

On the graph there are three colors. Dark green at bottom for median. Lighter green in middle for 95th percentile, and a lighter green at top for maximum. My longest line is the maximum.

Just need a explanation in simple layman terms. Is it possible the the maximums are the times that I may have gotten up to use the restroom (which is not every night) and took the mask off without cutting the machine off? Mine does not cut off automatically if I take it off.

95% of the time you have zero % leak. It doesn't get any better than that. If your mask is comfortable, i.e. not too tight, then you're good to go. The max number is probably something that occurred when you first put on your mask, or when you took it off. Do you take it off before you turn off your machine? That would create a rather sizable leak, which would be totally unimportant as to your therapy.
05-23-2015 12:11 PM
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Suzannekty Offline

Members

Posts: 7
Joined: May 2015

Machine: ResMed Airsense 10 Autoset
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10
Humidifier: yes, on 1, plus heated tube
CPAP Pressure: 8.5-12 with EPR on 3
CPAP Software: Not using software

Other Comments: frustrated and tired

Sex: Female
Location: North Carolina

Post: #16
RE: New user with questions and frustrations
Thank you all for your input.
05-23-2015 01:36 PM
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vsheline Online

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #17
RE: New user with questions and frustrations
(05-23-2015 07:37 AM)franswahili Wrote:  
(05-22-2015 01:55 PM)franswahili Wrote:  I just downloaded the ResScan software and I am trying to make heads and tails about the Leak rate portion of it. Are these good readings:

Leak - L/min
Median: 0.0
95th Percentile: 1.2
Maximum: 141.6

When I check the reading on the display of the machine it gLeak/min

Median: 0.0
95th Percentile: 0.0
Maximum: 111.6

... Just need a explanation in simple layman terms. Is it possible the the maximums are the times that I may have gotten up to use the restroom (which is not every night) and took the mask off without cutting the machine off? Mine does not cut off automatically if I take it off.

Your Leak statistics look great to me.

The Max Leak number is often invalid. If we remove the mask and create a Large Leak for longer than (I think) 10 seconds then the Max Leak number reflects something which happened when we were not asleep, and therefore is invalid.

You can look at the Detailed Data (waveforms showing when things happened) to see when the large leaks are occurring.

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: 05-23-2015 01:49 PM by vsheline.)
05-23-2015 01:42 PM
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