The weeks numbers... thoughts or suggestions?

Still one of the noobs in here, and to that end, will milk it for all I can

I do not have a card reader or software for my device, and been on it for about 2 weeks now...

Since learning (in here) how to review the data, I have been logging it for the last 6 nights, and wanted to post it up here, for feedback and to see if anyone thinks I need to adjust my settings.

By the way, I posted up a question on what is EPR yesterday... My machine was at 3? I changed it to 2 last night, exhaling was difficult! I put it back to 3 and was happy once again.

In any event, here is my numbers for the last 6 nights: your thoughts/suggestions on if I need any adjustments?

Leak AHI AI HI
0.08L/s 7.1 1.8 5.3
0.64L/s 7.2 2.1 5.1
0.20L/s 7.3 3.3 4.0
0.10L/s 6.4 1.7 4.7
0.12L/s 8.0 1.2 6.8
0.10L/s 8.7 2.5 6.2

I have not mentioned my headgear in my sig. line, I am not sure what to put there. I have a respironics device. I believe they are called nasal pillows? It is nasal plugs I guess you would call them... it has headgear I think... a strap that goes around the back of my head, one on the top of my head and a chin strap.
I know the device I have S8 is known to have incorrect readings for the leak on these machines... not sure what I should have in the machine for the mask type? I started with a nose mask but it cut me too badly and had to have my DME exchange it after a few nights of bleeding and suffering.

Thanks guys!

Can you also put your mask on your equipment profile? Also, I didn't think you could use the M Series Humidifier with a ResMed machine....the M Series Humidifier is integrated for the Respironics M Series Machines. Just a thought.

For the EPR, once you have been on it a little longer, you will probably be able to turn it down....or completely off. I have been on for a month now and used to use the ramp for 30 mins and had my C-Flex (similiar to your EPR) set at 3. I now use no ramp and only a C-Flex of 1.

I am still new, but in my opinion, except for the one day, your leaks looked ok, but your AHI is still a bit high. General concensus is to have it below 5. If at all possible, I would try to get the software so you can see when you have the most apneas/hypopneas. That way you can determine if the leaks are causing them or if you need to go up on your pressure. Again, just my opinion. I hope the seasoned vets don't beat me up too bad....

sorry if the noobness is showing here, still working thru it.

I did not see the mask type in the descriptions so left it blank. It is a respironics (nasal pillows?) the thing that plugs the nostrils... If I can get confirmation on that is what it is, I will pick the closest thing in the descriptions for here...also not sure what I should put in the machine for mask as well.
Did I put the wrong heated humidifier in the bio here too? (bangs head against desk). It is attached as part of the S8, not sure what to put for that either.
The only other thing I think I left out of the original post is my setting is at 9...
Not sure if my ENT would prescribe the sw and card reader or not, and do not have the coin to get one as of yet...
my ENT wanted to see me 2 weeks after I started on this thing, and it has been 2 weeks now, but not calling him yet.
The DME wants the memory card sent back after 50 days to ensure compliance; I am waiting until that goes back before I call the ENT again. (besides, the ENT was sort of an idiot, not too crazy about him either)

check this link to see if it looks like the mask and head gear you are using.

https://www.cpap.com/productpage/OptiLi ... -Mask.html

Sounds like what I came home from the sleep study with. I think with ResMed mask selection settings they suggest to select standard for other brands not listed and then they factor in a standard leak rate of 24 L/min (I think that is what I read). Someone needs to help me out here, to get L/s do we divide by 60 then? Vice versa multiply L/s times 60 to get to L/m? Then you have to look at the acceptable leak rate for your mask and compare apples to apples. Both my Optilife and now my Swift LT show rates as L/min so you may need to convert and look at a chart since the ResMed doesn't have your mask rates to use.
Also you have to factor in the treatment pressure into acceptable leak rates because the acceptable rate increases with increased pressure. I didn't see your treatment pressure listed. Did I miss it? If not, this would help someone give you more specific leak rates and you need to determine for sure which mask you are using.

If you do what most people here suggest to do with your AHI and redo the HI by cutting it in half and then adding it to the AI, you will be well below that magical AHI of <5 that seems to be the a good goal to start with. Even if you are leaking a bit, your numbers aren't bad at all. I would sure be happy with them for a newbie. I can tell you right now mine aren't so good.
Brenda

No worries, it's alot to absorb. Fortunately, I did a lot before I went to the DME the first time.....saved me ALOT of grief. If you have the S8, you probably have the H3i or the H4i humidifier. As for the mask, I am not sure what the Respironics brand of nasal pillows/prongs are called. As for the software, check out https://www.cpap.com and look for the ResScan software and reader, that is what you will need to read your own data. It's good that you did figure out how to record the data you have so far. Alot of people don't even know they can do that. Your off to a good start!

Pugsy wrote:Someone needs to help me out here, to get L/s do we divide by 60 then? Vice versa multiply L/s times 60 to get to L/m?

That's right!

Pugsy wrote:check this link to see if it looks like the mask and head gear you are using.

https://www.cpap.com/productpage/OptiLi ... -Mask.html

That is exactly what I have. It does not show a rear view, but there is also a strap around the back of the head. My setting is 9... I have all of my original paperwork here from the DME and all it says is "heated humidifier" does not speficy the model. It is attached to the front of the S8 machine, and the cpap can be used with or without it. I will update my profile as best I can after writing this...
I am kicking myself now for not staying awake in Math class! If I need to figure out these fornulas, that will be a challenge
I really just have minimal faith in my ENT, and do not expect to see him anytime again soon, so want to configure my optimal settings on my own as much as I can... Still not feeling a difference using cpap, besides not snoring (so I am told)
not a lot of difference yet.

I have a pdf of Respironics mask leak rates. For 10 cm of pressure 23 L/min is the intentional(for Optilife). Your 9 cm treatment pressure would equate to just slightly less but this gives you a ball park. Hard to say what your leak numbers mean because they are in L/s and we don't know which mask is factored in. If we simply multiply by 60 to get L/min we will get close but then you have to factor in what ResMed is already deducting (I think). My machine doesn't give a mask choice, I just get a L/min leak rate and I then compare it to what my mask allows.

I just the other day read a thread where it was discussed which mask setting to use with non ResMed brand masks. Since you use pillows it may change things a bit but I do remember reading "when in doubt choose standard mask from the options". If there is a ResMed mask that has similar intentional leaks then that would be a likely choice but I just looked at mine and 10 cm it is roughly 30 L/min.

I am sure someone will chime in to give very specific details on how to look at your leak rate, converting to L/min and how to compare what you see with the chart. I will be watching so that I can learn.

While my numbers aren't quite as good, they aren't so bad either and like you I have yet to see the improvement I had hoped for but I know it does take time. Tonight will only be #7 for me. Software to look at everything is supposed to arrive today.
Brenda

ok I am starting to see stars with all of the multiply by 60, divide by 60...
I think I picked the wrong day to quit sniffing elmers glue.
na, seriously though, thanks everyone for the input so far... From what I can gather, the leak rate is not so bad...
from what I can gather, the only time that I notice leaks is when I move around (toss and turn). if I start on my side and stay that way, im usually pretty good. Same thing for laying on my back. If I move around, or if I yawn I get some air blowing around...
I am more focused on the AHI numbers... and if the results I am pulling warrant a slight adjustment... I know going from a 9 to a 10 is not going to blow me thru the wall into the back yard, but wondering it if would be too strong?

I would make sure that you could keep your leaks managable and steady, before increasing pressure. Once you do that and you are still a little high on the AHI, increase by 0.2 or 0.5cm and then see how it goes for a week. You don't want to raise it too high, too quickly. Too high of a pressure has been noted on this board to be associated with CSA (central sleep apneas). I was at 10 and went up to 10.5. On a good leak night, I am down to 0.2 - 0.0 AHI.

viewtopic.php?f=1&t=41785&p=367329&hili ... lf#p367329

When you have time take a look at Rested Gal's comments about HI's reported by ResMed machines. That should explain how to then view your AHI's in a little different perspective.

I am too new to comment on upping the pressure a bit. My machine is auto and I have seen 90% ranges from 9 cm early in week to 12 cm this night. My leak rate is fine for the most part and my AHI's are in the 5.5 area. Until I get the software I cannot see the actual AI and HI stats. I hope I am not mouth breathing because I really need to use the pillows. I suspect my next experiment will be with some sort of chin strap.
Brenda

viewtopic.php?f=1&t=40871&st=0&sk=t&sd= ... e&start=15

check out the above thread especially Slinky's comments, note there are 2 pages.

24 L/min = 0.4 L/s 60 is the multiplier or division factor depending on what you are doing

your recent .10 L/s rate reported by ResMed would equal 6.0 L/min . If you had chosen the "standard" mask setting then ResMed automatically deducts 24 L/min from what was the gross leak rate to give you the equivalent 6 L/min rate. Obviously that number would be 30 L/min.

So if I have done my math correctly (and you had chosen the standard mask setting) your leak rate would have been originally 30 L/min and your mask shows an intentional leak rate of approx 21-22 cm for your pressure setting then you have an excess leak of 8 L/min. Please someone stop me if I am figuring this wrong...........
Now these figures are based on the ResMed mask selection for you non ResMed brand mask to "standard". We have no way to know what you have actually chosen and what the automatic deduction is that ResMed does before reporting your leak rate.

You need to standardize your mask setting on your machine so that you know the proper factors are subtracted, then re-evaluate your numbers to see if the leak rate is still a bit too high. If it is still a bit too high this could account for the slightly elevated AHI's and before you go fooling with pressures you might go leak hunting instead.

Again this is where the software would help. If the graph showed leak spikes where the mask was either removed or repositioned briefly then those numbers could falsely elevate the overall leak rate. I understand that it is a lot to come up with $270 just to read the detailed results. Do the best you can with what you have now. It is still more than a lot of people can do.
Brenda

wow, now my head is really spinning!

Does that link indicate I should change my mask selection (on the S8) to standard?

I forget what the options are, and will check them later. Using the limited tools I have now, I want
to ensure I am as effective as I can be... I really did not think my leak rate was that bad,
when I see some of the other users leak rates I felt pretty good about it. Sadly though, it is probably inaccurate.

If this were me I would change the mask setting to standard. I read yesterday that ResMed allows 24 L/min deduction for it. So then you have a standard rate to go by.

Then watch your data. Multiply the L/s reading you get by 60 to get a L/min rate which is what masks are rated at. Add back in the 24 L/min then you will have apples to apples comparison to look for on leak charts. I will try to find where I got that Respironics mask pdf and post it here.

If your leak rate doesn't change much and IF my backwards way of figuring things is correct, then you may have a slightly elevated leak rate. Not huge by any means. I would completely discount your initial higher readings (.62 I think because that wasn't the norm).

If I am correct with how I figured this based on reading other threads, it really isn't hard. I can do it easier than I can explain it.

Brenda

off to find that pdf file link....

Too bad you don't have a ResMed mask......you could just put the type of mask you have, into the machine, and it would calculate everything out without having to use a calculator and slide rule.

klockemy wrote:Too bad you don't have a ResMed mask......you could just put the type of mask you have, into the machine, and it would calculate everything out without having to use a calculator and slide rule.

Don't need one. I have Pugsy

I will change it to Standard tonight and see if that changes the rate of leakage...
Just because of yawning, tossing and turning, I just do not think a 0 is ever gonna happen.