new user needing help

[AlanT]

I've rechecked the readings on the machine and the AHI is 8 for the full night and also high leakage reads 0%.

ta

Alan

[chill]

SleepyHead is reporting a lot of large leaks. And the leaks correspond to "About 2.40 I woke and pressure was continuous on max setting 15 I was breathing normally and then sat on side of bed for 10 mins before I switched machine off" and "woke again about 3.45 and it was the same again continuous pressure of 15 mask not leaking"

I can't explain the difference between what SH is reporting and what you and your machine are reporting. It could be that there is a bug in SH related to the data from your machine. But... in both cases the large leaks started when your pressure hit 10. It looks to me, based on the SH graphs, that your mask is not tight enough or improperly adjusted and when the pressure increases it leaks and the leaks or pressure increase wake you up.

Does your machine have a feature that lets you adjust the mask at the top pressure before starting a session?

Chuck

[justMongo]

All of the grayed out area in the leak graph is "Large Leak." 50% of the time, you were in Large Leak.
Meaning therapy is compromised by leaks. You must fix the leaks.

The ResMed Mirage Liberty may not be the right mask for you.

[AlanT]

Thanks for the replies but I'm a bit confused here. When I woke up the pressure felt high I sat up looked at the reading and it was 15 I was breathing normally and deeply for about 10 mins and the pressure didn't drop. This is an autoadjust machine so why didn't the pressure drop down.
While sat I checked the mask and there were no leaks only air blowing out of the small breathing holes on the front. I turned the machine off and on and it went down to 8, I was still sat on bed hadn't moved the mask and there were no leaks.

I'm going to try a night with my nasal mask.

ta

Alan

[justMongo]

The pressure retreat time is of the order of many minutes. It rises quickly, then retreats slowly.

[AlanT]

The pressure retreat time is of the order of many minutes. It rises quickly, then retreats slowly.

But mine isn't retreating at all.

ta

Alan

[vsheline]

Hi AlanT,

The first thing to focus on is to reduce the leaking, because the data during Large Leak is often not reliable.

The second thing would be to either:

1. Increase Min Pressure gradually until it is not less than 2 or 3 lower than your average 95% pressure.

2. Or, usually better yet, if you can manage it, would be to make sure you are never sleeping flat on your back, which is usually the worst position, usually requiring higher treatment pressures.

The 95% pressure is the pressure your mask was at or lower than for at least 95% of the night. It is also the pressure your mask was at or higher than for at least 5% of the night.

Take care,
--- Vaughn

[chill]

It was having a large leak at the time you were observing it, and that impacts the machine's ability to tell what is going on and if it should or should not try lowering the pressure. And 10 minutes is too small of a window to watch for pressure decreases.

One thing that may be confusing you: these machine to no react to what is happening now, they react to what has happened before. That is, they don't try to treat an event as it occurs, they observe what is happening and make changes to try and prevent future occurrences. When you are sitting there breathing normally, that enters into the statistical calculation of what the pressure will need to be, but the pressure is higher due to what happened before you woke up.

[artfro]

Hi AlanT
As colleagues have suggested above, also I suggest you sleep on your side. Put yourself an obstacle on the back, which does not allow you to lie on your back while sleeping. I use a full face masks and noticed that when sleeping on your back and the pressure above 13 often appear leaks that were not there when checking the tightness of the mask before bedtime. I basically almost every night I sleep on the side and in the statistics and graphs have mostly zero leaks

[vsheline]

these machine do not react to what is happening now, they react to what has happened before. That is, they don't try to treat an event as it occurs, they observe what is happening and make changes to try and prevent future occurrences.

Yes, regarding the response to apnea of a ResMed APAP machine, that is my understanding, too, that the pressure is not automatically adjusted while an apnea is still occurring but afterwards, after it is known how long the apnea lasted.

Here is a table giving a brief comparison between the APAP algorithms for different APAP manufacturers:
http://www.ncbi.nlm.nih.gov/pmc/articles...der-8-425/

And here is the article the table is part of:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4629962/

It is not clear to me from table and its article exactly when the adjustments are made, how much pressure adjustment is done (if any) during an apnea or during an hypopnea. But the table and article seem to indicate that at least Flow Limitation and Snore are responded to when they occur, perhaps including during hypopneas.

Take care,
--- Vaughn