CPAP not working, or adjusting?

[WindCpap]

I wouldn't change a thing if you are not uncomfortable. It surprises me that you can get enough air at your start pressure of 4, but if you are comfortable with it, that is great. One of the advantages of autoramp is that you can see when you fall asleep, and the machine doesn't respond to or record events until then. If you lived where I live, you wouldn't have been prescribed CPAP as a constant pressure of 9 is all you really need. If you are curious, you can try setting it to CPAP mode, and see what happens, but it wouldn't be to gain any real benefit as the APAP is working quite well for you. Also, if you camp, the APAP will give you a big advantage on battery usage.

The reason the air doesn't rush out when you open your mouth is that you have gained airway control. You won't have that control when you are

[WindCpap]

The total system leak is the essentially the average flow rate. The graphs that show flow rate for breathing are normalized to this average so that they go up and down through zero. The leak that is reported is the total system leak minus the expected vent flow rate.

Very small leaks may not be reported as leaks. Is your mask set correctly in the Airsense 10?

[OkyDoky]

Regarding leaks, is it normal to have air blowing out of your mask? My wife complaints about the whistling noise keeping her awake, which I hope to also solve, but I am primarily concerned about leaking so much air. Also I often wake up with a dry mouth. Yet the leak data always looks good. This is what puzzles me. What is this leak data looking for, major events like disconnected hoses?

ResMed states your machine can handle data interpretation and adjust up to 24L/min and that is what they consider large leak. That is what the Line in the left column is talking about when it talks about Above the Red Line. Your 95% leaks (which means that for 95% of the time you were at or BELOW) shows 4.8L/min. You did have a maximum of 120 but I'm guessing that was either before getting the mask on or after taking it off, either way not important as it was short lived.
Now the other side of leaks is even small ones can wake you but we usually get used to making adjustments as we turn etc. if that is causing leaks. Yours look well controlled.

It is normal for air to blow out the venting area of the mask and some masks have more blowing than others. Check that the air is coming out the holes and not around your mask seal. Some have the venting diffused which decreases what we feel. As far as the whistling, is it from the beginning of the night or does it develop during the night? Sometimes the piece that snaps into the cushion is a little loose on one side, sometimes moisture can cause whistling but I would think you would notice that. Maybe someone that has used your mask will have other suggestions.
I have noticed that my machine will whistle if the water tank is not closed solid or inserted well. Sometimes I just push on the tank a little and it goes away.

[Robear]

Thanks, OkyDoky, for the information on formatting & posting info. I will definitely use it in the future as I begin using SleepyHead.

Thanks also for your "understanding of the frustrations of others", especially newbies, both to the forum & to CPAP. I know from experience how hard it can be sometimes to explain problems; especially when I don't know how things (should) work &/or what would be the ideal situation.

[garrett1812]

I wouldn't change a thing if you are not uncomfortable. It surprises me that you can get enough air at your start pressure of 4, but if you are comfortable with it, that is great. One of the advantages of autoramp is that you can see when you fall asleep, and the machine doesn't respond to or record events until then. If you lived where I live, you wouldn't have been prescribed CPAP as a constant pressure of 9 is all you really need. If you are curious, you can try setting it to CPAP mode, and see what happens, but it wouldn't be to gain any real benefit as the APAP is working quite well for you. Also, if you camp, the APAP will give you a big advantage on battery usage.

The reason the air doesn't rush out when you open your mouth is that you have gained airway control. You won't have that control when you are

The way it was explained to me, is I use an APAP and not a CPAP because I never had a full sleep study. I originally signed up for a split night sleep study, where first they would measure sleeping conditions, then if found to have sleep apnea, test different pressure levels to know where to set a CPAP to. In my case, the technician "forgot" the second portion of the sleep study. My insurance company refused a second sleep test, so we will never have that information, but they did approve getting an APAP machine. My doctor said it was no problem, and he would change it back to CPAP mode if needed, but expects it to work fine as it.

[garrett1812]

The total system leak is the essentially the average flow rate. The graphs that show flow rate for breathing are normalized to this average so that they go up and down through zero. The leak that is reported is the total system leak minus the expected vent flow rate.

Very small leaks may not be reported as leaks. Is your mask set correctly in the Airsense 10?

Yes, it is set correctly. There are only a few options I believe, nasal, nasal pillow, full face.

[garrett1812]

Regarding leaks, is it normal to have air blowing out of your mask? My wife complaints about the whistling noise keeping her awake, which I hope to also solve, but I am primarily concerned about leaking so much air. Also I often wake up with a dry mouth. Yet the leak data always looks good. This is what puzzles me. What is this leak data looking for, major events like disconnected hoses?

ResMed states your machine can handle data interpretation and adjust up to 24L/min and that is what they consider large leak. That is what the Line in the left column is talking about when it talks about Above the Red Line. Your 95% leaks (which means that for 95% of the time you were at or BELOW) shows 4.8L/min. You did have a maximum of 120 but I'm guessing that was either before getting the mask on or after taking it off, either way not important as it was short lived.
Now the other side of leaks is even small ones can wake you but we usually get used to making adjustments as we turn etc. if that is causing leaks. Yours look well controlled.

It is normal for air to blow out the venting area of the mask and some masks have more blowing than others. Check that the air is coming out the holes and not around your mask seal. Some have the venting diffused which decreases what we feel. As far as the whistling, is it from the beginning of the night or does it develop during the night? Sometimes the piece that snaps into the cushion is a little loose on one side, sometimes moisture can cause whistling but I would think you would notice that. Maybe someone that has used your mask will have other suggestions.
I have noticed that my machine will whistle if the water tank is not closed solid or inserted well. Sometimes I just push on the tank a little and it goes away.

The whistling and increased leaking occurs later at night, usually around 3-4 hours after I fall asleep (according to when my wife tells me I woke her up!). The whistling definitely comes from the mask area, not the machine. I usually feel the airflow too, as it normally points toward my eyes. I notice the headpiece is more loose when I wake, and slides up on the back of my head, so I am sure that is a big part of it. I have a beard, which I know does not help with the seal. I am going to try a nasal pillow mask instead of a nasal mask and see if that helps.

[garrett1812]

Just weighing in here. Much of the detail about your CPAP use is quite useful. You did mention sight leaking from your mask and losing weight (good stuff;) With the use of an adjustable chinstrap you may very well eliminate the small leaks that rob you of consistent pressure and effective treatment.

Here's a site that shows chinstrap selection :

https://www.cpapclinic.ca/show-CPAP-pro ... s/Chin.php

Hope something piques your interest.

Thanks, I will look at these. I have this chinstrap now, but it gives me a jaw ache using it. Very uncomfortable.
http://www.amazon.com/gp/product/B0148JL24G

[palerider]

I can read it quite fine. No need to be a jerk. I will look into the other image hosting site.

you used the right image hosting site, but you shrunk the pics so the print on them is TINY and unreadable, and if one resizes the pic, then it's really fuzzy.

don't shrink the pics before uploading.

there's also no need to post everything, follow this guide, *ALL THREE PAGES* of it:
https://sleep.tnet.com/resources/sleepyhead/shorganize

[palerider]

Julie, thank you but you're assistance is not required here. I will leave this open for others to comment.

this kind of attitude isn't needed.

[palerider]

Good girl, kick the frog--just leave the newbies alone.

frog's a tough old broad, be careful though, she kicks back

[palerider]

I usually feel the airflow too, as it normally points toward my eyes. I notice the headpiece is more loose when I wake, and slides up on the back of my head, so I am sure that is a big part of it. I have a beard, which I know does not help with the seal. I am going to try a nasal pillow mask instead of a nasal mask and see if that helps.

your mask seal is leaking, check into mask liners, the often help tremendously at taming excess leaks.

the nice lady that owns padacheek.com is a member of the forum, and cares more about helping people with their masks than just making a buck. give her a call and see what she can do for you and your wife.

[palerider]

What is this leak data looking for, major events like disconnected hoses?

the leak data isn't looking for anything, it's simply reporting the calculated excess leak, based on the minimum baseline flow rates at various pressures, and a lot of math.

your leaks aren't perfect, but they are good, they look nearly flat, because that chart has a very large vertical axis, right click on the vertical scale on the left, then y-axis, and either set it to 'autofit' or put in a reasonable range, say 0-30.