Second night on a CPAP

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Uncle_Bob
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Re: Second night on a CPAP

Post by Uncle_Bob » Thu Jan 29, 2015 11:11 pm

I am not used to Respironics and sleepyhead software so i do apologize. Although i do enjoy a zero leak rate myself (ResScan flat line ) and recommend it highly

I'll bow out of recommendations for someone to try and self titrate on BiBap and leave it to the professionals here then

Good luck to the OP
~UB

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Pugsy
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Re: Second night on a CPAP

Post by Pugsy » Thu Jan 29, 2015 11:17 pm

OkyDoky wrote:That's close enough for me. I like the ballpark.
I like ballpark also. It's never exact anyway...if you look at the mask literature there's always a little Plus or minus number in tiny letters that we often miss.
It's rare that I even both to look up an actual pressure/vent rate graph for a specific mask. For leak evaluation exact numbers aren't really that critical now that SleepyHead reports time in large leak. When that happens I just eyeball how far into large leak territory things went (if there was much time in large leak territory).
For Respironics machines...Encore software has reported large leak flags for several years now and Respironics has a real general amount of leak it can compensate for before things go whacko.....now I have seen reports where leaks were over 110 L/min all night long on a Respironics machines...when that happens you can spot really quickly just how it messes up the machine. I once saw a bilevel in auto mode behave like a fixed cpap machine....the poor machine had no clue what to do with the pressure because it couldn't sense anything. The person who had that report thought his bipap was broken because the pressure never changed.
Once we addressed the massive all night leaks...surprise, surprise, the machine began auto adjusting the pressures like it was supposed to do.

In the OPs situation here...I didn't bother with the first night's report as others had already covered it and all I cared about was last night.

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palerider
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Re: Second night on a CPAP

Post by palerider » Thu Jan 29, 2015 11:22 pm

Uncle_Bob wrote:I am not used to Respironics and sleepyhead software so i do apologize. Although i do enjoy a zero leak rate myself (ResScan flat line ) and recommend it highly

I'll bow out of recommendations for someone to try and self titrate on BiBap and leave it to the professionals here then

Good luck to the OP
~UB
your equipment listing says you're using a respironics

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Pugsy
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Re: Second night on a CPAP

Post by Pugsy » Thu Jan 29, 2015 11:32 pm

I have used both brands and quite used to both brands name brand software as well as SleepyHead.
ResMed machines don't have near the leeway in terms of excess leak before things go whacko. From my own past experience having leaks from 24 to 30 to 35 and above (short lived for the most part)...I have found that with excess leaks ranging from the 25 to 30 L/min mark that the data seemed to hold true near as I could tell. From 30 to 35 I started seeing a lot of green unknown apneas which I take to mean the machine had trouble identifying some sort of event. It knew something was going on but couldn't tell me exactly what it might be so it called it an "unknown".
Above 35 L/min excess leak on a Resmed machine and the machine sort of went silent...no more green unknowns..no more anything...so I assumed the machine couldn't sense and thus report anything that might happen. This happened all in one night so it was a good base for judging what happened. It was fairly easy to spot the progression of the leak and the impact it had on the data reported.

Now Respironics machines...their large leak territory red line will vary depending on pressure and mask used so there is no hard fast number that we can look to because it can vary a lot but I have only seen one large leak flag at 75 L/min total leak and that was with nasal pillows at 5 cm pressure. Almost always large leak territory doesn't begin unless someone gets in the 80 to 90 L/min range and even then it depends on the pressure used. 85 L/min at 15 cm pressure probably won't cause a Large leak flag but 85 L/min at 7 cm pressure will likely cause one.

If I see a leak graph and the graph scale only goes to 70 and that number is never reached...I don't have to think much about actual vent rate at so and so pressure...I can eyeball it...if the pressure is over 10 then the large leak territory is going to be up around 90L/min and if I see 70 as being the maximum hit...I know that large leak territory was never hit so I don't go into much worry about the leak unless someone says it wakes them up.

Yes...those flat 0.0 excess leak lines are nice to see and I have had them myself but I have also had some ugly leak lines and to be honest...I feel the same with either report as long as I sleep decently and the leaks don't wake me up.

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Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
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Uncle_Bob
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Re: Second night on a CPAP

Post by Uncle_Bob » Thu Jan 29, 2015 11:34 pm

palerider wrote:
Uncle_Bob wrote:I am not used to Respironics and sleepyhead software so i do apologize. Although i do enjoy a zero leak rate myself (ResScan flat line ) and recommend it highly

I'll bow out of recommendations for someone to try and self titrate on BiBap and leave it to the professionals here then

Good luck to the OP
~UB
your equipment listing says you're using a respironics
I've a Philips Respironics PR ONE series 60 along with a Fisher and Paykel ICON and a Resemd S9, all APAPs. Resmed Rescan is the software i prefer.
Let me know if you know anyone who can use a Resmed Elite S8 auto, is gathering dust.

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Nathan C. Morales
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Re: Second night on a CPAP

Post by Nathan C. Morales » Fri Jan 30, 2015 10:43 pm

My previous night was so bad I was afraid to use the machine again. Last night was machine-less.

Also, my chest is sore presumably from exhaling in a mask?

Tonight I will try again with my min/max set to 9-20. We'll see how that goes.

I managed to find a strap and an Airfit P10 Nasal pillow, but I cannot discern what type of tubing to buy. Doing a search for 'airfit P10 Nasal Pillow' does not give good results.

Is there a name for that specific type of tubing?

--Nathan

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sleep_quest
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Re: Second night on a CPAP

Post by sleep_quest » Fri Jan 30, 2015 10:55 pm

No, your P10 should insert right into your existing hose that leads from your machine. You did get a full P10 mask, right? It has it's own flexible hose...

https://www.cpap.com/productpage/resmed ... dgear.html

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Nathan C. Morales
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Re: Second night on a CPAP

Post by Nathan C. Morales » Fri Jan 30, 2015 11:06 pm

sleep_quest wrote:No, your P10 should insert right into your existing hose that leads from your machine. You did get a full P10 mask, right? It has it's own flexible hose...

https://www.cpap.com/productpage/resmed ... dgear.html

Indeed. It's that it's so much cheaper on Amazon to buy the pieces separately.

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grayghost4
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Re: Second night on a CPAP

Post by grayghost4 » Fri Jan 30, 2015 11:07 pm

If you're not part of the solution you're just scumming up the bottom of the beaker!

Get the Clinicians manual here : http://apneaboard.com/adjust-cpap-press ... tup-manual

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grayghost4
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Re: Second night on a CPAP

Post by grayghost4 » Fri Jan 30, 2015 11:17 pm

Also, my chest is sore presumably from exhaling in a mask?

Many people (including my) have had this problem.
It will pass given a little time
If you're not part of the solution you're just scumming up the bottom of the beaker!

Get the Clinicians manual here : http://apneaboard.com/adjust-cpap-press ... tup-manual

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Nathan C. Morales
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Re: Second night on a CPAP

Post by Nathan C. Morales » Fri Jan 30, 2015 11:21 pm

grayghost4 wrote:this is what you need :

http://www.ebay.com/itm/New-Opened-Resm ... 339cfa163d
Yes! I am ordering it now. Thank you!

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Nathan C. Morales
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Re: Second night on a CPAP

Post by Nathan C. Morales » Sat Jan 31, 2015 9:56 am

Here was my fourth night. I took my mask off sometime in the early morning hours, so this only reflects 4 hours of CPAP time.

Image

I wish I felt better.

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OkyDoky
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Re: Second night on a CPAP

Post by OkyDoky » Sat Jan 31, 2015 10:23 am

Nathan C. Morales wrote:
sleep_quest wrote:No, your P10 should insert right into your existing hose that leads from your machine. You did get a full P10 mask, right? It has it's own flexible hose...

https://www.cpap.com/productpage/resmed ... dgear.html

Indeed. It's that it's so much cheaper on Amazon to buy the pieces separately.
You can find the whole mask on Amazon. http://www.amazon.com/ResMed-AirFit-P10 ... Airfit+P10
ResMed Aircurve 10 VAUTO EPAP 11 IPAP 15 / P10 pillows mask / Sleepyhead Software / Back up & travel machine Respironics 760

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Pugsy
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Re: Second night on a CPAP

Post by Pugsy » Sat Jan 31, 2015 10:43 am

It's hard enough to feel better even with optimal therapy and 8 hours of sleep....impossible with 4 hours of sleep and sub optimal therapy. I think you are going to want to use 10 cm minimum and not 9. But if you notice this 4 hour report is still cleaner than your past reports.
Finding the right mask is critical to a lot of things...therapy, comfort, ease in adjusting to and accepting the machine....along with a host of other reasons.

I wish we all had the good luck to experience the miracle overnight but you what....those people are just a very lucky small minority...most of us it took a LOT of time and work and improvements were very slow and gradual...myself included.
I was lucky enough to start out with a great mask and a great attitude towards therapy and it took me 2 weeks to just get my therapy dialed in but it took months to work up to 6 hours of sleep a night. I can count on one hand the number of "miracle nights/days" that I have had in 5 1/2 years of therapy.

Be patient...but be persistent and you will master this therapy but you didn't get the lucky straw to take to it like a duck to water.
You are going to have to fight for every improvement but if you will stick with this and not yield to the temptations of going without the machine or taking the mask off in the middle of the night...there's a real good chance that in 6 months you will be able to see some improvement. You may not feel like running a marathon but at least you won't wake up feeling like you just ran a marathon.

You need at least 6 and preferably 7 to 8 hours of good sleep with optimal therapy for prolonged period of time (and it varies with each person) to expect to see much improvement.

The P10 is a great mask but like any mask out there not everyone loves it but if playing the odds....there's a good chance you will do well with it. If you end up hating it I bet we can find a home for it so you get most of the money you spent on it back.

Oh...your leak graph for the short 4 hours...looking really good. Better than mine I am sure..mine almost always has at least one short lived ugly spot.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
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I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

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grayghost4
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Re: Second night on a CPAP

Post by grayghost4 » Sat Jan 31, 2015 10:48 am

You need to change you equipment .... you don't have a Bipap.

+ 1 to what Pugsy said. She has a way of saying it so well.
If you're not part of the solution you're just scumming up the bottom of the beaker!

Get the Clinicians manual here : http://apneaboard.com/adjust-cpap-press ... tup-manual