Too much pressure?

[Landrew]

Here's my problem:

I have been using my apap machine for nine nights. It is a ResMed Airsense 10 Autoset and I am using a full-face mask. Each night, at least once, I am awakened with the feeling that I am drowning in air. The unit seems to be pumping enough air to leak out of my mask and I can't seem to cope with it or get it down. I ultimately turn off the machine and then turn it back on so it can ramp up again. The pressure range is set at 6 to 16.

I downloaded the data to sleepyhead and it appears that at those events the pressure is at about 10 or 11. I'm at a loss. I have not had one night of undisturbed (at least what I would interpret as undisturbed) sleep since I started therapy.

Any insight would be appreciated.

[Julie]

Hi, first of all, you're ramping all the way up from 4 (the default low setting) to 6. That's nothing at all, and starting the ramp over each time you have trouble is only making things worse... I suggest you turn it off entirely for now as it's not helping. Second, have you looked at the screen at the times you're awoken to see if it gives any message, any indication of what pressure it's at when that happens? Something is off, but without further info, it's hard to help. If your machine is routinely going above 16 you need to know why. Is it a new machine, or one you found somewhere besides a regular DME (dealer)?

Do you have SleepyHead (software) downloaded? If you use it when sleeping (free, from the 1st 'Announcement' on main pg) it'll show what's going on... you can post info to Imgur.com, then link it to this thread so we can see the graphs, etc. and try to help.

There IS air (CO2 actually) coming out of your mask, from the small patch of tiny holes, and that is normal and necessary. Never cover it with bedding because you don't want to rebreathe it.

[JDS74]

Are these leaks from around the mask rather than from the mask vent holes?
If so, then perhaps one of two things are happening.
1) you are experiencing jaw drop which makes the mask lose seal and begin to leak. If that is the case, then getting a soft cervical collar to support your jaw will help. I get mine from Amazon.com as they are much softer than the ones I can get locally. Jaw drop occurs when your facial muscles fully relax as you get into deeper sleep.
Or
2) when your mask was adjusted for fit, it was not done with you lying down in sleeping position and/or not at a pressure above, say, 12 cm H2O. That means that at pressures below 10 cm H2O, the seal is fine but above that, it leaks. If that is the case, then you need some help getting the fit correct.

The vent holes in the mask allow the incoming air to mix with your exhaled breath to flush out your exhaled CO2. That is the normal way CPAP masks work.

[Landrew]

I need to reformulate my question. If I have an event and the pressure goes up, then when I awake or when the event is over, shouldn't the pressure go back down?

There is exhaust coming from the vent in the mask, the squeaky leaks are coming from below my eyes at the top of the mask.

[BlackSpinner]

I need to reformulate my question. If I have an event and the pressure goes up, then when I awake or when the event is over, shouldn't the pressure go back down?

No because that is the pressure you need in order to prevent future events. I would adjust my lower pressure up to prevent it having to work at it.

There is exhaust coming from the vent in the mask, the squeaky leaks are coming from below my eyes at the top of the mask.

Th mask is not adjusted right or you may need a a mask liner. Getting a perfect fit in that area is hard because it depends on the shape of both your nose and check bones plus any fleshy bits. Also your face relaxes when you sleep and soft parts change shape.

[Pugsy]

You need to understand how the auto adjusting algorithm works. The machine doesn't sense a lone event and then jack up the pressures trying to blow the airway open. Instead it responds to a combination of various things.

See this thread where RobySue compares the PR S1 APAP and the ResMed S9 AutoSet
viewtopic/t94287/viewtopic.php?f=1&t=82 ... 5&#p866535
Especially the algorithm explanation. You will need to scroll down a bit in RobySue's post to find the Auto Algorithm section.
The S9 Auto algorithm is unchanged in the AirSense 10 Autoset except for the "For Her" special mode.
Unless you are using the AirSense 10 AutoSet for Her in that special mode the mode she describes is what you are using.

[jlaw3x7]

I had this feeling until I enabled the exhale relief feature on my machine. Cflex