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help, way too many leaks last night
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PaytonA Online
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Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Orange County,California

Post: #61
RE: help, way too many leaks last night
This brings up a question that I think is interesting. For example, if you set the min EPAP to 12, the max IPAP to 15, and the pressure support to 4, how will the machine handle it? Spit in your eye?

Best regards,

PaytonA
09-12-2014 05:09 PM
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Clementine Offline

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Posts: 208
Joined: Sep 2013

Machine: ResMed VPap Auto
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: ResMed H5i--not using currently
CPAP Pressure: Auto -- 8/13.2 PS 3.2
CPAP Software: SleepyHead

Other Comments: Began with machine on 7/7/14.

Sex: Female
Location: eastern Iowa

Post: #62
RE: help, way too many leaks last night
lol.
Now I'm confused.
09-13-2014 09:38 AM
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PaytonA Online
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Monitors

Posts: 3,005
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #63
RE: help, way too many leaks last night
Sorry Clementine, the question was just my curiosity and does not really have anything to do with your situation.
Sleep-well

Best Regards,

PaytonA
09-13-2014 12:24 PM
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PhyllisBalboa Offline

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Posts: 155
Joined: May 2014

Machine: ResMed VPAP Adapt S9 (36067), ASV mode
Mask Type: Nasal pillows
Mask Make & Model: Swift FX for Her
Humidifier: H5i
CPAP Pressure: EPAP: 4.4; PS: 1-6
CPAP Software: SleepyHead

Other Comments: diabetes type 1, fibromyalgia, MTHFR double genetic mutation

Sex: Female
Location: American in Montreal, Qc

Post: #64
RE: help, way too many leaks last night
Clementine, my only thought was about the size of your nasal pillows. I use the extra small pillows (FX for her), and tried the small (larger) to see if they were better, but they raised my AHI and gave me lots of leaks. I returned to extra small and am back to fine, except the persistent swallowing of air. My AHI is almost always under 1, usually .3.

I've read that the pillows should rest nicely at the entrance to the nostrils, but that doesn't seem to work for me. The extra small goes in a bit, and stays put. I'm 5'5", slender, with small features, so that could be why, but even my husband does the best with small pillows. Are you sure you need large? Maybe a possible, easy fix.

On another note, with my air swallowing, I'm struggling with pressure ranges with the vpap, and pressure support, like you. It takes small changes. I usually get three great/pretty good nights, then an uncomfortable one, yet my AHI's are still great. Maybe just the nature of the beast.
09-13-2014 12:39 PM
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Clementine Offline

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Posts: 208
Joined: Sep 2013

Machine: ResMed VPap Auto
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: ResMed H5i--not using currently
CPAP Pressure: Auto -- 8/13.2 PS 3.2
CPAP Software: SleepyHead

Other Comments: Began with machine on 7/7/14.

Sex: Female
Location: eastern Iowa

Post: #65
RE: help, way too many leaks last night
I have had 3 not-too-bad nights now, with at least 7 hours of sleep. Smile Smile Smile

Feeling halfway human.

Hope I don't jinx things.

However, AHI is still a bit high at 6.8 last night. And the leaks still look not so great, to me, anyway. But ..... I'm just gonna keep on keepin' on. Making teeny adjustments to the PS. Back to using the medium mask. Large is comfy but really just too large for me, thank goodness. I agree, Phyllis, that the mask seems to need to fit inside the nostrils just a tad in order to stay put. However, at some point during the night it's not staying put.

here's last night:
[Image: screenshot-20140914-134107_zps5d8c5716.png]
09-14-2014 01:43 PM
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surferdude2 Online

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Joined: Jul 2014

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro & Optilife
Humidifier: ResMed H5i @ #3 if nose breathing & #5 if mouth breathing
CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
CPAP Software: ResScan SleepyHead

Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #66
RE: help, way too many leaks last night
It looks like you need more pressure on the top end to combat the apnea events. I know you have that leakage problem but it looks like it may be more due to your movements than to the pressure you are running. A full face mask may be something you should consider, at least as an alternate to help you get a handle on things.
09-14-2014 02:10 PM
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Clementine Offline

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Posts: 208
Joined: Sep 2013

Machine: ResMed VPap Auto
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: ResMed H5i--not using currently
CPAP Pressure: Auto -- 8/13.2 PS 3.2
CPAP Software: SleepyHead

Other Comments: Began with machine on 7/7/14.

Sex: Female
Location: eastern Iowa

Post: #67
RE: help, way too many leaks last night
Thanks for your reply, SD. I truly cannot use a FFM, and I even have a very difficult time with a nasal mask, due to claustrophobia. I agree, I'm moving a lot and that's probably what is moving the mask around.
I will try the higher pressure.
09-14-2014 02:25 PM
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surferdude2 Online

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Posts: 1,077
Joined: Jul 2014

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro & Optilife
Humidifier: ResMed H5i @ #3 if nose breathing & #5 if mouth breathing
CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
CPAP Software: ResScan SleepyHead

Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #68
RE: help, way too many leaks last night
I'm sorry to hear that the FFM doesn't suit you. It's just so obvious from your usage graph that once you settled down and fell asleep, the leaks stopped and then the apnea events started scoring. Then when you awakened, the leaks sprang back up. It looks like you had a good run of over 4 hours of sleep albeit full of apnea events that could possibly have been prevented if the pressure was available. During that same period, leaks were minimal.

Okay Good luck with the new pressure setting. Maybe 14 cm ?
09-14-2014 02:35 PM
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APAAW Offline

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Posts: 54
Joined: Nov 2013

Machine: Respironics 660 BiPAP Series One
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: Respironics Series One
CPAP Pressure: 9.5 - 13.5 BiPAP
CPAP Software: SleepyHead

Other Comments: My second time on CPAP, finally successfully

Sex: Male
Location: Kansas USA

Post: #69
RE: help, way too many leaks last night
It really looks like things are improving for you!

Looking at your S9 settings from last night: it looks like the 12.4 cm IPAP maximum was inhibiting the S9 from more fully controlling obstructive apneas.

I agree with surferdude2 that in the long term, 13 will not prove to be high enough a max IPAP setting for you. But if you feel things are better already, you can take your time getting to your long-term optimum settings.

So if I were in your situation, I'd nudge my max IPAP to 13.0, min EPAP to 8.0, PS to 3.4, and let things settle down over several days without further changes. Ideally these settings would reduce both leaks and AHI a bit over the long term. Realistically I wouldn't expect much change either way, but things should stay steady, and quite possibly improve.

I'm not much of a believer in the Holy Grail of a xPAP machine-scored 0.0 AHI - yes, I've had a couple such nights, but no, I didn't feel any better the following days. It's remarkable what the machines can do and even more what they can record, but I can also see mine _not_ scoring breathing disturbances when there really wasn't significant airflow. Getting AHIs down to low single-digit averages over the long term will do us the most good, and I believe that's where you're headed.

Good luck and keep hanging in there!
09-14-2014 04:34 PM
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PaytonA Online
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Posts: 3,005
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #70
RE: help, way too many leaks last night
Do you have some indication that the masks is getting moved around and that is what is causing the leaks? Do the leaks wake you up and do you find the mask has moved out of position?

If the answer to these questions is no, then I would suspect (once again) that you may be mouth leaking especially if you did not wake up and readjust your mask to end those leaks.

Best Regards,

PaytonA
09-14-2014 06:01 PM
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