help heart pounding
help heart pounding
so both my resmed s9 autoset last night info shows no major mask leaks and sleepyhead an ahi of 0.00 but I don't understand how to read sleepyhead's average leak rate and all that. everywhere I read said some number then an L something but sleepyhead just says
average leak rate: 0.77
90% leak rate: 1.20
% of time above leak rate threshold: 0.40%
so what does that mean? I have cognitive problems which is why I'm having a hard time figuring this out. i have my s9 on all the right settings and if my mask isn't leaking more then normal for the airfit f10 why am I waking up about every half hour all night with my heart pounding? I've never experienced this until the last 3 nights. it scares me. and the sleep center I'm with works with a totally different company than where I got my s9 in 2016 and they said they can't give me a new machine until 5 years so the brand new respironics dreamstation has to be returned and only until after they receive everything can they try to help me. but that won't be for like another week or so. I'm finally getting some cbd oil today to help with my pain and anxiety and it might help with my sleep (i take both 10mg Ambien and 300mg seroquel to sleep but with all this apnea business it's not helping). any help and insight is greatly appreciated. to add I'm also on lamotrogine 400mg which gives me horrible dry mouth so my humidifier and heated hose are both on max but it's not enough because of the meds. I see my psych next week to start tapering off of it so I won't see improvement in dry mouth for maybe a month. oh and my recommended cpap pressure is 7 also tried 8 then auto and sleepyhead shows it going from a min 7.20 to max 9.72 and 90% pressure 8.92 average epap 7.76 min epap 7.20 max epap 9.72
average leak rate: 0.77
90% leak rate: 1.20
% of time above leak rate threshold: 0.40%
so what does that mean? I have cognitive problems which is why I'm having a hard time figuring this out. i have my s9 on all the right settings and if my mask isn't leaking more then normal for the airfit f10 why am I waking up about every half hour all night with my heart pounding? I've never experienced this until the last 3 nights. it scares me. and the sleep center I'm with works with a totally different company than where I got my s9 in 2016 and they said they can't give me a new machine until 5 years so the brand new respironics dreamstation has to be returned and only until after they receive everything can they try to help me. but that won't be for like another week or so. I'm finally getting some cbd oil today to help with my pain and anxiety and it might help with my sleep (i take both 10mg Ambien and 300mg seroquel to sleep but with all this apnea business it's not helping). any help and insight is greatly appreciated. to add I'm also on lamotrogine 400mg which gives me horrible dry mouth so my humidifier and heated hose are both on max but it's not enough because of the meds. I see my psych next week to start tapering off of it so I won't see improvement in dry mouth for maybe a month. oh and my recommended cpap pressure is 7 also tried 8 then auto and sleepyhead shows it going from a min 7.20 to max 9.72 and 90% pressure 8.92 average epap 7.76 min epap 7.20 max epap 9.72
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Mask: AirFit™ F10 For Her Full Face Mask with Headgear |
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Additional Comments: I'm trying to figure things out so I don't consistently use the same masks etc so bare with me |
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Re: help heart pounding
Leaks are measured by the volume of the leak. The measurement being used is the Liter. A liter is about a quart.
The allowable leak depends upon the mask being used but it doesn't look like you need to worry about leaks. My mask has an acceptable leak rate of 24 liters per minute. Your leak rate is much lower than that. That is a good thing.
As far as your pressure goes, it looks like your maximum is being hit. Consider a pressure range of something like 7 minimum to 11 maximum.
The allowable leak depends upon the mask being used but it doesn't look like you need to worry about leaks. My mask has an acceptable leak rate of 24 liters per minute. Your leak rate is much lower than that. That is a good thing.
As far as your pressure goes, it looks like your maximum is being hit. Consider a pressure range of something like 7 minimum to 11 maximum.
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Additional Comments: Machine is an AirSense 10 AutoSet For Her with Heated Humidifier. |
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Re: help heart pounding
The higher the worser.
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Re: help heart pounding
No, the allowable leak depends on the brand of machine being used, not the mask.
Resmed doesn't care what kind mask you have, the machines's allowable excess leak limit is 24lpm
Last edited by palerider on Mon Apr 16, 2018 10:36 pm, edited 1 time in total.
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Re: help heart pounding
Welcome to the forum.
Your leak rate is low so don't worry about that.
Your heart pounding could be due to having an apnea event, or maybe something unrelated.
I recommend that you keep a written log and document every morning your AHI and how you think you slept, and how many times you woke up with your heart pounding. Share the results with your health provider and with this forum if you would like.
Your leak rate is low so don't worry about that.
Your heart pounding could be due to having an apnea event, or maybe something unrelated.
I recommend that you keep a written log and document every morning your AHI and how you think you slept, and how many times you woke up with your heart pounding. Share the results with your health provider and with this forum if you would like.
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Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear |
Humidifier: DreamStation Heated Humidifier |
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Re: help heart pounding
Phillips seems to offer different leak rates for different masks at different pressures...
https://www.continuedcare.com/wp-conten ... -ports.pdf
If you look at the ResMed Swift LT mask, the vent flow rate at a pressure of 12 is 37 l/min
https://www.resmed.com/us/dam/documents ... er_eng.pdf
Looking at the ResMed Quattro mask the vent flow rate at a pressure of 12 is 41 l/min.
https://www.resmed.com/us/dam/documents ... er_eng.pdf
This seems to indicate that the mask design has an influence on the acceptable leak rate along with the pressure the mask is being used at.
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Additional Comments: Machine is an AirSense 10 AutoSet For Her with Heated Humidifier. |
Last edited by HoseCrusher on Mon Apr 16, 2018 9:06 pm, edited 1 time in total.
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Re: help heart pounding
That has nothing at all to do with the allowable leak rates.HoseCrusher wrote: ↑Mon Apr 16, 2018 8:39 pmPhillips seems to offer different leak rates for different masks at different pressures...
https://www.continuedcare.com/wp-conten ... -ports.pdf
Yes, the *intentional* leak rates vary by pressure, since the vent opening is fixed, the more pressure, the more vent. And while there are *minor* differences between different masks, they all vent something around 20lpm at 4cm pressure up to around 40-50lpm at 20cm pressure..
But, again, that has *nothing at all* to do with the acceptable leak rates, which are something the machine itself determines... because the acceptable leak rate is 1) a flow level that the machine can sustain, and 2) a flow level that the machine can still differentiate reliably between centrals and obstructives.
Has nothing to do with the mask.
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Re: help heart pounding
So the suggestion is that if I need a pressure of 12 and want to use the Quattro mask that has a vent rate of 41 l/min at that pressure I will not get the best performance from the ResMed AirSense 10 machine because while it is capable of producing around 136 l/min at a pressure of 12 it is only accurate to 24 l/min...?
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Mask: Brevida™ Nasal Pillow CPAP Mask with Headgear |
Additional Comments: Machine is an AirSense 10 AutoSet For Her with Heated Humidifier. |
SpO2 96+% and holding...
Re: help heart pounding
Are you being deliberately obtuse, or do you simply not understand the concept?HoseCrusher wrote: ↑Mon Apr 16, 2018 9:29 pmSo the suggestion is that if I need a pressure of 12 and want to use the Quattro mask that has a vent rate of 41 l/min at that pressure I will not get the best performance from the ResMed AirSense 10 machine because while it is capable of producing around 136 l/min at a pressure of 12 it is only accurate to 24 l/min...?
Resmeds are good for up to 24lpm of *excess* leak, above and beyond whatever the masks built in vent rate is.
Respironics machines have no published maximum leak amounts, because they are not smart enough to calculate the mask leak levels, so they just flag "large leak" whenever your leak amount exceeds whatever the machine feels is it's limit at whatever pressure.
Once again, *it has nothing to do with the mask, and everything to do with the machine.*
Perhaps you just missed the word "excess* in the post above.
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Re: help heart pounding
OK, let me see if I understand...
From a design perspective, ResMed simply adds 24 l/min to the mask selected and any leak above that is excess leak.
From a users perspective I need to select the proper mask in order for this to work properly.
If I select full face mask and am using nasal pillows the excess leak number will be off. This means that the results are dependent upon mask selection even though the design is to simply add 24 l/min to whatever mask is selected.
Am I close...?
By the way Respironics seems to measure intentional leak at the start of the session and then uses double that leak rate to flag excessive leaks. I believe the algorithm is somewhat dynamic.
From a design perspective, ResMed simply adds 24 l/min to the mask selected and any leak above that is excess leak.
From a users perspective I need to select the proper mask in order for this to work properly.
If I select full face mask and am using nasal pillows the excess leak number will be off. This means that the results are dependent upon mask selection even though the design is to simply add 24 l/min to whatever mask is selected.
Am I close...?
By the way Respironics seems to measure intentional leak at the start of the session and then uses double that leak rate to flag excessive leaks. I believe the algorithm is somewhat dynamic.
_________________
Mask: Brevida™ Nasal Pillow CPAP Mask with Headgear |
Additional Comments: Machine is an AirSense 10 AutoSet For Her with Heated Humidifier. |
SpO2 96+% and holding...
Re: help heart pounding
No.HoseCrusher wrote: ↑Tue Apr 17, 2018 5:45 pmOK, let me see if I understand...
From a design perspective, ResMed simply adds 24 l/min to the mask selected and any leak above that is excess leak.
No.HoseCrusher wrote: ↑Tue Apr 17, 2018 5:45 pmFrom a users perspective I need to select the proper mask in order for this to work properly.
No.HoseCrusher wrote: ↑Tue Apr 17, 2018 5:45 pmIf I select full face mask and am using nasal pillows the excess leak number will be off. This means that the results are dependent upon mask selection even though the design is to simply add 24 l/min to whatever mask is selected.
Not really.
No, they don't. Where are you getting this impression?HoseCrusher wrote: ↑Tue Apr 17, 2018 5:45 pmBy the way Respironics seems to measure intentional leak at the start of the session and then uses double that leak rate to flag excessive leaks. I believe the algorithm is somewhat dynamic.
Respironics doesn't do *anything* with excess leak... all it cares about it the total leak, and some undocumented behavior in their machines. They have a mask *resistance* setting on the newer machines that's documented as being used to fine tune pressure delivery at the mask, by compensating for mask airflow resistance.
Resmed is *totally different*. Their machines *calculate* baseline leak by examining the flow waveform and doing complicated math. They then show you *excess* leak.
Resmed primarily uses the mask settings to adjust the pressure at the machine to give more accurate pressure at the mask (respironics copied that in their 60 series).
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Re: help heart pounding
OK, now I am totally confused...
How does ResMed define excessive leaks?
If the mask selection doesn't matter why offer a selection to choose from?
Perhaps you can offer what you think in reference to how this works...?
In particular I am looking for acceptable leaks with my regular nasal pillows and comparing them to the use of a full face mask.
I am sorry you haven't done research on Respironics algorithms. All therapy involves addressing leak issues and I think the Respironics approach is a valid approach.
How does ResMed define excessive leaks?
If the mask selection doesn't matter why offer a selection to choose from?
Perhaps you can offer what you think in reference to how this works...?
In particular I am looking for acceptable leaks with my regular nasal pillows and comparing them to the use of a full face mask.
I am sorry you haven't done research on Respironics algorithms. All therapy involves addressing leak issues and I think the Respironics approach is a valid approach.
_________________
Mask: Brevida™ Nasal Pillow CPAP Mask with Headgear |
Additional Comments: Machine is an AirSense 10 AutoSet For Her with Heated Humidifier. |
SpO2 96+% and holding...
Re: help heart pounding
ResMed subtracts a generic vent rate prior to reporting excess leak.
They never tell us what it is or exactly how they come up with it but it's based somewhat on the mask pressure selection in the setup menu and partly on the pressures used because obviously pressure impacts vent rate.
ResMed is the only brand that reports only excess leak....why...beats me...they just decided to do it.
So about the best you can do is make the correct mask selection and trust the machine that the generic vent rate it subtracts is close and if you don't get a large leak flag...you are good to go.
FWIW...my personal opinion is the 24 L/min that ResMed came up with is an ultra conservative number and the machine can really handle quite a bit more excess leak than 24 L/min...meaning sense, report and respond.
It just gets iffy the higher above 24 L/min excess leak you have...I don't really give it much thought until I hit 35 L/min and then only if it's very prolonged. I don't get in a panic over 5 or 10 minutes of I don't care how big the leak is.
Trust your machine and if it isn't saying "large leak" then I wouldn't worry about it.
You have zero way of figuring out total leak with a ResMed machine with any certainty because we don't know what generic vent rate they use.
They never tell us what it is or exactly how they come up with it but it's based somewhat on the mask pressure selection in the setup menu and partly on the pressures used because obviously pressure impacts vent rate.
ResMed is the only brand that reports only excess leak....why...beats me...they just decided to do it.
So about the best you can do is make the correct mask selection and trust the machine that the generic vent rate it subtracts is close and if you don't get a large leak flag...you are good to go.
FWIW...my personal opinion is the 24 L/min that ResMed came up with is an ultra conservative number and the machine can really handle quite a bit more excess leak than 24 L/min...meaning sense, report and respond.
It just gets iffy the higher above 24 L/min excess leak you have...I don't really give it much thought until I hit 35 L/min and then only if it's very prolonged. I don't get in a panic over 5 or 10 minutes of I don't care how big the leak is.
You can't really do much about it...ResMed never tells us exactly how they come up with the excess leak only numbers.HoseCrusher wrote: ↑Tue Apr 17, 2018 8:31 pmIn particular I am looking for acceptable leaks with my regular nasal pillows and comparing them to the use of a full face mask.
Trust your machine and if it isn't saying "large leak" then I wouldn't worry about it.
You have zero way of figuring out total leak with a ResMed machine with any certainty because we don't know what generic vent rate they use.
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Re: help heart pounding
I ANSWERED THIS
"Their machines *calculate* baseline leak by examining the flow waveform and using math. They then show you *excess* leak."
I ANSWERED THISHoseCrusher wrote: ↑Tue Apr 17, 2018 8:31 pmIf the mask selection doesn't matter why offer a selection to choose from?
"Resmed primarily uses the mask settings to adjust the pressure at the machine to give more accurate pressure at the mask"
I ANSWERED THISHoseCrusher wrote: ↑Tue Apr 17, 2018 8:31 pmPerhaps you can offer what you think in reference to how this works...?
"Their machines *calculate* baseline leak by examining the flow waveform and doing complicated math. They then show you *excess* leak."
24lpm or less.HoseCrusher wrote: ↑Tue Apr 17, 2018 8:31 pmIn particular I am looking for acceptable leaks with my regular nasal pillows and comparing them to the use of a full face mask.
Which part are you not understanding?HoseCrusher wrote: ↑Tue Apr 17, 2018 8:31 pmI am sorry you haven't done research on Respironics algorithms. All therapy involves addressing leak issues and I think the Respironics approach is a valid approach.
Respironics doesn't do *anything* with leaks, they report the total amount of outflow, without any calculations, which leaves you to guesstimate what the excess is, at whatever pressure you have, based on the ball park (not precise) numbers in the back of the mask manuals.
Last edited by palerider on Tue Apr 17, 2018 11:10 pm, edited 1 time in total.
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Re: help heart pounding
OK, I think I get it, or part of it...
The Respironics information I was reviewing was related to their ventilators. I don't know if they use a similar approach in the CPAP and BiPAP machines. All I could find for those machines was a mask fit function that gave you a go - no go indication if the leaks exceed the ability of the machine to flag problems.
Just for fun... Since the idea that mask selection doesn't matter I am going to try a couple of nights selecting full face while using my nasal pillows to see if I can notice differences in the leaks or any other differences.
The Respironics information I was reviewing was related to their ventilators. I don't know if they use a similar approach in the CPAP and BiPAP machines. All I could find for those machines was a mask fit function that gave you a go - no go indication if the leaks exceed the ability of the machine to flag problems.
Just for fun... Since the idea that mask selection doesn't matter I am going to try a couple of nights selecting full face while using my nasal pillows to see if I can notice differences in the leaks or any other differences.
_________________
Mask: Brevida™ Nasal Pillow CPAP Mask with Headgear |
Additional Comments: Machine is an AirSense 10 AutoSet For Her with Heated Humidifier. |
SpO2 96+% and holding...