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mouth leaks graph.
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Galactus Offline

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Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
Mask Type: Nasal pillows
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Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #31
RE: mouth leaks graph.
The easiest way to get away from the Mrs is to send her shopping! Dielaughing and the added plus is to send her shopping for something for you Big Grin

Really though those results look good. I'm happy my graphs helped you. I also have updated my thread with the last 5 days which is during my ongoing cold that is annoying the crap out of me, so you can see the new stuff as well.

Congrads though you are definitely on the right track.

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Everyone knows something, together we could know everything.
09-27-2014 03:29 PM
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vsheline Offline

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Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
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Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

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Post: #32
RE: mouth leaks graph.
(09-24-2014 12:03 PM)Ghandi Wrote:  Dont you think increasing the pressure will lead to more leaks?

Your Leak is nearly always great, very low. If the pressure were to be increased a few cm H2O, this would probably have a small (and completely negligible) effect on your Leak.

(09-24-2014 12:03 PM)Ghandi Wrote:  Do you think i could play with the cflex+ and lower it to see the effect on the hypopneas before i ask the doc?

Sure. Flex is widely recognized as just a comfort setting, which users are generally free to vary, according to user preference, without affecting the machine's efficacy. Even ResMed EPR is (mistakenly, in my view) widely considered to be only a comfort setting which has no effect on therapeutic effectiveness.

I think decreasing the amount of Flex is highly unlikely to reduce the likelihood of having hypopneas. If anything, I would think raising the Flex setting may (very slightly) lower the likelihood of having hypopneas, since Flex makes it easier to breathe out.

Unlike ResMed EPR, which lowers the pressure during the entire time between inhalations, Flex is Flow based, meaning it only provides exhalation pressure relief while we are actively breathing out. If using Flex, by the time we are done exhaling and need to start inhaling, the pressure will have already returned to the higher therapeutic pressure, and our airway will already be fully pressurized and ready for our inhalation to begin.

The times we are most vulnerable for our airway to collapse is at the very end of exhalation when we are most relaxed, or at the very beginning of inhalation when inhaling tends to create a small amount of suction as we pull in air through our airway. If using EPR on a fixed-pressure CPAP machine, at these vulnerable times our pressure will be lower than the full prescribed therapeutic pressure. But using Flex does not cause the problem which EPR causes (that the pressure is lowest at the most vulnerable times).

ResMed EPR and Philips Respironics Flex are quite different from each other. Increasing the EPR setting on a fixed-pressure CPAP machine is likely to increase the likelihood of getting hypopneas (at least a little) unless the CPAP pressure is increased by a corresponding amount. Flex does not have this issue, but, personally, I find ResMed EPR provides a type of pressure relief which is far more comfortable than Flex.

ResMed EPR acts like a bi-level machine except limited to a difference of up to 3 cm H2O between EPAP and IPAP.

If using EPR on an auto-titrating APAP machine such as the AutoSet, however, I would not expect any loss of efficacy, since the machine will simply compensate for using EPR by raising the pressure whenever there are signs that airway collapse or obstruction is developing.

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: 09-28-2014 06:15 PM by vsheline.)
09-28-2014 04:01 AM
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Ghandi Offline

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Posts: 137
Joined: Aug 2014

Machine: RemStar Pro with C-Flex+Philips Respironics System One
Mask Type: Nasal pillows
Mask Make & Model: airfit p10(resmed)
Humidifier: systeme one humidifier with humidity set at 3 and heat set at 1
CPAP Pressure: 8
CPAP Software: SleepyHead

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Sex: Male
Location:

Post: #33
RE: mouth leaks graph.
(09-28-2014 04:01 AM)vsheline Wrote:  
(09-24-2014 12:03 PM)Ghandi Wrote:  Dont you think increasing the pressure will lead to more leaks?

Your Leak is nearly always great, very low. If the pressure were to be increased a few cm H2O, this would probably have a small (and completely negligible) effect on your Leak.

(09-24-2014 12:03 PM)Ghandi Wrote:  Do you think i could play with the cflex+ and lower it to see the effect on the hypopneas before i ask the doc?

Sure. Flex is widely recognized as just a comfort setting, which users are generally free to vary, according to user preference, without affecting the machine's efficacy. Even ResMed EPR is (mistakenly, in my view) widely considered to be only a comfort setting which has no effect on therapeutic effectiveness.

I think decreasing the amount of Flex is highly unlikely to reduce the likelihood of having hypopneas. If anything, I would think raising the Flex setting may (very slightly) lower the likelihood of having hypopneas, since Flex makes it easier to breathe out.

Unlike ResMed EPR, which lowers the pressure during the entire time between inhalations, Flex is Flow based, meaning it only provides exhalation pressure relief while we are actively breathing out. If using Flex, by the time we are done exhaling and need to start inhaling, the pressure will have already returned to the higher therapeutic pressure, and our airway will already be fully pressurized and ready for our inhalation to begin.

The times we are most vulnerable for our airway to collapse is at the very end of exhalation when we are most relaxed, or at the very beginning of inhalation when inhaling tends to create a small amount of suction as we pull in air through our airway. If using EPR on a fixed-pressure CPAP machine, at these vulnerable times our pressure will be lower than the full prescribed therapeutic pressure. But using Flex does not cause the problem which EPR causes (that the pressure is lowest at the most vulnerable times).

ResMed EPR and Philips Respironics Flex are quite different from each other. Increasing the EPR setting on a fixed-pressure CPAP machine is likely to increase the likelihood of getting hypopneas (at least a little) unless the CPAP pressure is increased by a corresponding amount. Flex does not have this issue, but, personally, I find ResMed EPR provides a type of pressure relief which is far more comfortable than Flex.

If using EPR on an auto-titrating APAP machine such as the AutoSet, however, I would not expect any loss of efficacy, since the machine will simply compensate for using EPR by raising the pressure whenever there are signs that airway collapse or obstruction is developing.

Wow, thanks for that complete explanation vsheline. I will try raising the flex to 3 again.

My AHi is still on track. I've had a couple of leaks peaking over the limit but really shortly. So i dont think it compromised the therapy.

I feel energized today.

screenshot
09-28-2014 06:57 AM
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Galactus Offline

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Posts: 1,388
Joined: Jan 2014

Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #34
RE: mouth leaks graph.
My Cflex was always at 3x and now my Biflex is set at 3x as well. I prefer it at that setting. (Cflex and Biflex are the same except one is what they call it in cpap mode while the other is what they call it in bipap mode)

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Everyone knows something, together we could know everything.
09-28-2014 04:40 PM
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Ghandi Offline

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Machine: RemStar Pro with C-Flex+Philips Respironics System One
Mask Type: Nasal pillows
Mask Make & Model: airfit p10(resmed)
Humidifier: systeme one humidifier with humidity set at 3 and heat set at 1
CPAP Pressure: 8
CPAP Software: SleepyHead

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Sex: Male
Location:

Post: #35
RE: mouth leaks graph.
I raised the cflex+ to 3.

I dont think it's in anyway related but my leaks are higher. There is more of them a little over the limit.
Is it still under control?

screenshot

I'm feeling better overall so it looks like the previous problems were related to the cold.

Still have lots of hi but they are very mild flow decrase and inscrease. Like periodic breathing but to a way smaller scale. It makes my ahi looks ugly but i dont think it changes anything to my sleep quality. IT doest seem to disrupt anything
09-29-2014 06:46 AM
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Galactus Offline

Advisory Members

Posts: 1,388
Joined: Jan 2014

Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #36
RE: mouth leaks graph.
CFlex is only related to exhaling, it allows for a more comfortable exhale, I do not believe it will have any effect on leaks whatsoever, and has never had any for me. Looks like we both had an "eh" night regarding leaks. I don't know what happened, my hose got tangled or what, was just one of those nights, and even with these leaks I have been told it's not a cause for concern so I'd say you're still good. But this was me last night,

[Image: 14viky1.jpg]

By the way, I have no idea what %^$# genius thought it was a good idea to have the hoses shipped with those 90 degree bends in them rather than as a coil but I'd like to meet that guy so I could smack him upside his head. It is so annoying to have to try and get those bends out, and add to that the P10 lacks the swivel to allow for the hose to untangle and it just gets on my last nerve. I ordered a swivel thing to see if that will help, but truly it is my only complaint about that mask so far.

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
09-29-2014 12:46 PM
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Ghandi Offline

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Machine: RemStar Pro with C-Flex+Philips Respironics System One
Mask Type: Nasal pillows
Mask Make & Model: airfit p10(resmed)
Humidifier: systeme one humidifier with humidity set at 3 and heat set at 1
CPAP Pressure: 8
CPAP Software: SleepyHead

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Sex: Male
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Post: #37
RE: mouth leaks graph.
(09-29-2014 12:46 PM)Galactus Wrote:  CFlex is only related to exhaling, it allows for a more comfortable exhale, I do not believe it will have any effect on leaks whatsoever, and has never had any for me. Looks like we both had an "eh" night regarding leaks. I don't know what happened, my hose got tangled or what, was just one of those nights, and even with these leaks I have been told it's not a cause for concern so I'd say you're still good. But this was me last night,

[Image: 14viky1.jpg]

By the way, I have no idea what %^$# genius thought it was a good idea to have the hoses shipped with those 90 degree bends in them rather than as a coil but I'd like to meet that guy so I could smack him upside his head. It is so annoying to have to try and get those bends out, and add to that the P10 lacks the swivel to allow for the hose to untangle and it just gets on my last nerve. I ordered a swivel thing to see if that will help, but truly it is my only complaint about that mask so far.

Yeah our leaks are pretty similar. Just wanted to make sure it was still alright.

We pretty much have the same equipment too. For the hose i think you should get another and maybe ask for a refund if it's not too late.

Because of the swivel less mask, i had only one or 2 night were i would ear the hose force to stay in position. Putting it in place before bedtime makes it ok for me. I heard that some ppl move more than others Smile
09-29-2014 06:23 PM
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Galactus Offline

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Posts: 1,388
Joined: Jan 2014

Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #38
RE: mouth leaks graph.
Oh yah they'll give me another hose, but it will still be folded, you know how they come.... so damned annoying. So when I go to bed I get the hose in place, but then yah I move around some nights and it takes like 2 months after I change the hose to get the kinks out of it. So it folds back and forth and then again in half. At least with the swivel it would untie itself, but with this mask it just gets tangled on me. I get tired of caring about it but it just annoys me that they can't ship the hoses coiled vs bent like that every 12 or 20 inches. I want to just find that guy who said let's do it this way, and smack the ever loving crap out of him. Ok rant ended.

Last night the wife said I was leaking away, lol.

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
(This post was last modified: 09-29-2014 07:44 PM by Galactus.)
09-29-2014 07:44 PM
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retired_guy Offline

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Post: #39
RE: mouth leaks graph.
(09-29-2014 07:44 PM)Galactus Wrote:  Last night the wife said I was leaking away, lol.

Yeah, ok..... But how about your mask. Was it leaking too?
09-30-2014 01:40 AM
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Ghandi Offline

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Posts: 137
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Machine: RemStar Pro with C-Flex+Philips Respironics System One
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Humidifier: systeme one humidifier with humidity set at 3 and heat set at 1
CPAP Pressure: 8
CPAP Software: SleepyHead

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Sex: Male
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Post: #40
RE: mouth leaks graph.
The leaks were under contril last night but i had a lot of CA episodes.
I wonder if that's in any way related to my cflex+ increase but i doubt it.

I have the feeling it's just another bad night without explanation. I was visited by the aliens Loco

screen shot

However i feel well rested and energized.
09-30-2014 06:53 AM
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