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Starting pressure setting
#1
Question 
Starting pressure setting
I have good result. AHI = 0,25. Large leaks are 16,52 %. And I have slept 8 hours 4 minutes without waking up. I have upgraded starting pressure to 9,6 step by step. This feels quite good when I put the mask to face. And I fall to sleep after quite short time (varies every night). But I have thought if the lower starting pressure might be better. If I reduce pressure for example to 8,0 I think that I feel I get not enough air. Is there some other setting which can be adjusted and so I coud use lower starting pressure. Mode is APAP 9,6 - 20,0 cmH2O. The lower pressure could reduce leaks? However, everything is fine already. No particular problem.

Tapahtumat = Events, Vuototaso = Leak rate, Paine = Pressure.

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#2
RE: Starting pressure setting
Before playing with the pressures I really think you should get the leaks under control. You are over the red line for 16% of the night, but on or just below it for at least that much again. As an experiment, go into the preferences in Oscar and set the large leak threshold to 23 instead of 24 - I think you'll find the extent of leaks is much greater than you are assuming.
DeepBreathing
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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
RE: Starting pressure setting
I think you are using a Resmed Airfit P10 nasal pillows mask (prongs are something else). The answer to getting more air is to use the next size larger nasal pillow. If you're using small, go to medium; if medium go to large. You have a lot of leaks through your mouth, and need to learn to manage the air pressure, or use an aid like a soft cervical collar or chin strap to keep your mouth shut. Air management is accomplished with the back of the tongue against the roof of the mouth and soft palate. You can think of sucking it into position to prevent air leaks. You should eventually be able to control the pressure with this technique enough to actually talk with the CPAP pressure on.
Sleeprider
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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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#4
RE: Starting pressure setting
Yes, I am using ResMed AirFit P10 mask with Medium pillow. When I tried Large the breathing were easier but large leaks increased. And the sleep apnea clinic recommended me to use so small pillows as possible to use. I looked Overwiev graphs that the large size didn't increase radically leaks. In daily graphs the size medium seems to effect smaller leaks. I can try the large size again.
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#5
RE: Starting pressure setting
I corrected the mask type to my profile. Thanks.
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#6
RE: Starting pressure setting
(09-26-2019, 07:48 AM)DeepBreathing Wrote: Before playing with the pressures I really think you should get the leaks under control. You are over the red line for 16% of the night, but on or just below it for at least that much again. As an experiment, go into the preferences in Oscar and set the large leak threshold to 23 instead of 24 - I think you'll find the extent of leaks is much greater than you are assuming.

The amount of leaks varies every night quite much. I can try the 23 setting.
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#7
RE: Starting pressure setting
I went up from small to medium then medium to large. For me, the trick with large is to slightly angle the pillows to line up with my nostrils before I settle them into place. They then usually stay put all night.
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#8
RE: Starting pressure setting
I originally had trouble with leaks on the P30i, which has a pillows design that is, I think, very similar to the P10 (though the frame and headgear is quite different). The RT also had me try a P10 at the mask fitting, with the same result.

However, in the search for more air, I recently tried the P30i again. I was able to stop the leaks by loosening the straps a little. The pillows actually has two cones in each nostril. The inner one is stiff, but the outer cone is soft and intended to inflate against your nose with CPAP pressure to form the seal. This does not work if the outer cone is mashed against the inner cone by your nose before you turn the air on. I also found it helped to pull the cushion outward slightly (toward the tip of my nose) before turning on the air. The cone should be roughly centered in your nostril. Once the seal is formed, it should stay in place.

I know it may seem counter-intuitive to loosen the straps to stop a leak, but it worked for me. I use a large, btw.

The expanding seal also helps hold your nostrils open. That and the air pressure work together to expand your nasal passages to flow more air.
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#9
RE: Starting pressure setting
The two most common issues with a mask are
1. the mask does not fit you/is the wrong mask for you and
2. the mask is too tight
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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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