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Sudden increase in AHI
#31
RE: Sudden increase in AHI
Thanks, Dave.  The leak line was placed based on the Quattro Pro mask I was using.  I don't know what it should be for the F20.  That's what I was asking.

I know that I have to better control the leaks - I just don't know how.  Remember, this all started at once.  My AHI used to be consistently below 5, sometimes 0.
--

Larry
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#32
RE: Sudden increase in AHI
Hi Larry,

Find the F20 Leak Rate chart at the top of page 14.  

https://www.thecpapclinic.com.au/persist...er_eng.pdf 

WillSleep

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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#33
RE: Sudden increase in AHI
Thanks WillSleep,

The chart is interesting and understandable, but I don't think it tells me what number I need to put in the leak rate chart.  The number that's in there now was one given to me by Sleeprider for a Mirage Quattro mask severak months (or maybe more) ago.
--

Larry
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#34
RE: Sudden increase in AHI
(10-06-2019, 12:43 PM)LarryRapp Wrote: Thanks WillSleep,

The chart is interesting and understandable, but I don't think it tells me what number I need to put in the leak rate chart. 

Hi Larry, 

I am guessing that you are referring to "Flag Leaks over Threshold" setting in OSCAR's  File>Preferences>CPAP menu.  

The Principle (my view):   We want to enter the number of L/min that is just low enough to highlight gray zones on our chart where we think the Leak has become high enough to negatively impact our therapy / other data we see on OSCAR charts and reports.  

Ok, but what is the number?

It seems like my Aircurve ASV only sends leak data to OSCAR that has already exceeded the curve line in that chart    

Assumption:  All leaks OSCAR reports are bad, above the mask's design limit.  
Therefore:  So while I use that chart on page 14 to help configure preferences settings for my PR machine profile I do not use the chart at all for the ASV, the numbers on that chart no role in how I use OSCAR for the ASV.   

Ok, but what is the number I should type in?
 
To find the number to type in for the "Flag Leaks over Threshold"  I zoom in and study 2 min segments in the Flow Rate chart to identify the largest Leak rate that does not seem to impact my therapy, add 2 L/M and type in that number.

So if a 8 L/M leak is just not relevant to the issues I am trying to clear out but a 9 L/M leak is I enter 10 L/M as the "Flag Leaks over Threshold" setting  I have used 8, 10, 12, 15, the default 20 and 25 L/M. 

Therapy on the ASV goes haywire when there are a lot of leaks. When tuning therapy on the ASV and I have a lot of leaks I want to filter to the few portions of the chart I that are actually useful so I have used 10, 12, or 15 L/M for the "Flag Leaks over Threshold" setting. The number seems to change from time to time.

If I only have a few short large leaks and Leaks are not worth looking at I want the noise of the gray to disappear from my charts and use 25 L/M or more as the setting.

The good news is this is a very easy setting to test. Try a few numbers and just take a look and see if the Leak Limit setting is helping you answer the questions you are trying to answer at the moment.
If not just change it up or down and look again. One of the only settings that does not require us to wait a night to see how it worked out.

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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#35
RE: Sudden increase in AHI
Willsleep,

That was a wonderful post.  Unfortunately it didn't help me simoly because I have no idea of what I am trying to do!  I put in 54 only because Sleeprider told me to (for the Mirage Quattro).

In other words look at my situation.  Everything got screwed up at once.  SOMETHING happened but I don't know what
--

Larry
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#36
RE: Sudden increase in AHI
Larry, most people do well with default leak rates in OSCAR.  You can find the design leak rate by searching for the user guide for any mask.  For the F20, here is the design leak rate. For your maximum pressure a leak rate of 60 L/min would be the maximum expected leak. The machine zeros out the nominal leak, and we really don't know the details of how it does this. With Respironics, the total leak is always reported.  

[Image: attachment.php?aid=15973]


Attached Files Thumbnail(s)
   
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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#37
RE: Sudden increase in AHI
Sleeprider,

Thank you.  Attached is a chart with the leak thing set at 60.  It's pretty awful with AHI at 22.  I am setting up for another sleep study this week.  I think my problem is not related to leaks - it is something substantial.

Bonjour,

Have you ever done a mask test and got it to pass?  Last night I tested many of my masks and could not get one to pass!  That was at all kinds of tightness.  It turns out I have an Amara View and it was awful!  Looks like I can do pretty well with the F20 or Quattro Pro although neither one passed the test at maximum pressure.  I think it's the beard although I really don't know.


Attached Files Thumbnail(s)
   
--

Larry
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#38
RE: Sudden increase in AHI
Your leak rate remains above that "redline" during all the periods of apnea and hypopnea. It is very difficult to know if the events are real, or a function of the loss of feedback due to leaks. When your maks or other component leaks, it makes it very difficult for the machine to detect the flow rate of your respiration. It appears low to the machine, so it flags hypopnea. It's like fishing with too much slack in the line; you'll never feel a bite.

You have had this problem for a long time. You may need professional assistance to resolve it. If your current DME is unwilling or unable to help you, consider calling around and moving your business elsewhere.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#39
RE: Sudden increase in AHI
I'm guessing mask test equals the machine Mask Fit. For myself, I have only used Mask Fit early on when doing adjustments during the first few days on the ASV. It can only give a Smiley face or a Frowny face. Realistically, that's not enough accurate info due in part to you're not sleeping nor probably not lying down while doing Mask Fit.

The most recent OSCAR graph shows 93.4% leak rate. This is so close to the mask leaked all night that my guess is that the chart for this night is too inaccurate to gauge anything. Further, the probability is your ASV had little chance to address any event.

How to fix it? I'm afraid I don't have an answer. I don't have a heavy beard as I try to remain relatively clean shaved. Yet I have some leaks with the F20 with the AirFit silicone cushion. I still have the Amara View, but it's staying on the shelf. For me, it leaks far worse than the F20. Having said that, if I get adjustments right, I'll have almost zero leaks for weeks at a time. Then I've got to adjust again for strap stretch I'm guessing.

This sounds somewhat like your situation but leaks are drastically worse. So again, how to fix that? Unfortunately, I don't have the solution. But it sounds like you're relying on Mask Fit and the green smiley face too much. I suggest you go by hearing and feeling leaks and then acting on it.

PS I'm in agreement with Sleeprider's assessment. You need a DME person to help get you a mask that fits and doesn't leak.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#40
RE: Sudden increase in AHI
Sleeprider,

I completely agree, but instead of the DME, I am talking to the sleep doc.  He is excellent!  For some unknown reason, he can't get my history, so today we're going to try to get him a copy of my memory card or something else.  Maybe I can get him to get Oscar and I can send him all kinds of history.  I'm wondering if maybe there is something wrong with the unit.  I moved last December but the place I moved has WAY better cell service.  In fact the only way I could get cell service at my last house was to use an "extender".  This house doesn't need anything - I normally get 3 - 4 bars.
--

Larry
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