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Very High Leak Rate
#41
Well this is terrible, after like 6 nights not registering any AHI, this was last night:
http://imgur.com/sE03gCU
I don't think I did anything different; the last couple nights I did "mask check" when I first laid down.
I haven't been able to get ahold of my equipment provider yet.
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#42
You have Ramp enabled. What is the time of ramp in your settings...reduce it to 10 minutes tops. It currently appears to be at 20 minutes. The vast majority of events are occurring in the first half of pressure ramp, so that tells us something useful.

Let's get a close up of the events and see what's going on with the breathing wave form. Were you using a cervical collar or other support last night?
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#43
I just checked the ramp was 45 minutes; I just now changed it to 10; I wonder if I need it at all - I might just turn ramp off;
I was using the collar last night. I think everything was the same as the night before.
How do I do a close up of events and whatever else you want?
Thanks!
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#44
Just place your mouse cursor slightly to the left of the event of interest and, while holding down the left button, drag it to the right, past the event to highlight the time period you want. Release the button, and all the graphs will adjust and expand to show just that time period in greater detail.

You can adjust it by using the mouse the same way to expand or contract the selected period. There are a couple of ways to get the graphs to show the whole night again. I find the easiest is to repeatedly right click the highlighted area and it will incrementally expand.

I hope this is clear. You will need to experiment a little to get exactly what you want.

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#45
Thanks for the detailed instructions!
Okay, I picked a time period with what seems like alot of events.
http://imgur.com/NAZ3sSD
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#46
Need it a little closer. No more than a 2-minute segment so the wave form becomes defined. Also, minimize the monthly calendar by using the triangle in the date line above it.
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#47
You got it! I'm glad my instructions were good enough. I'm sure Sleeprider will get back to you soon to tell you what events to zoom in on and to what degree.

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#48
Wow, I'm learning lots about this software!
How's this:
http://imgur.com/tWEy0Z2
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#49
Really interesting graph there.  This is a snapshot at 13.8/9.8 pressure. The breathing shows a periodic interval and lack of recovery breathing which suggests this is more central in nature, but the inspiratory breath shapes show considerable flow limitation with flattened sloping peaks.  Increasing the height of the flow line would be helpful to better define the wave form and breath size, also, the flow is masked by the moderately high leak rate of 52-60 L/min.

Here we see that in VPAP S mode, there is not any attempt by the machine to provide backup breathing during the apnea, and the mask pressure stays low until a spontaneous inspiration occurs.  I think what we are seeing here is a mixed apnea with both central and obstructive elements.  It may be because the pressure is too low to support the airway (obstructive component), and yet there appears to be an open airway (central). All of these apnea are of minimal 10 second duration.  You should compare this to periods where you are event-free later in the night at higher pressure.  I think your ramp is far too long, and you need to drastically shorten the ramp to no more than 10 minutes.

I don't recall if you ever replied to why you have a VPAP ST machine.  You're not using the feature that sets this machine apart.

[Image: tWEy0Z2.png]
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#50
here is a 2 minute segment later in the night, with no events;
but i noticed - why is the AHI not 0?
http://imgur.com/2VipHa6
also, I have the vpap st machine, with the S setting, because thats the only machine she had on hand; when I questioned her, she checked and realized I just need an S and I will talk to her about ordering a different machine for me.
Thanks for your analysis.
So I had reduced the pressure to 20-16; was that the wrong thing to do?
I have an appt in the a.m. to try to find a better mask and a solution to this.
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