1st night of stats - not good imo

[sleepyowl]

I've finally received a new machine (after 6 years of avoiding therapy). I have an AirSense 10 Auto and also received a new Dreamwear mask. The mask is very comfortable but I think I had it too loose. My wife reports loud snoring all night and some choking/gasping for breath. She woke me up once when the mask was in full leak, and near morning I awoke to several small leaks. So here's my SleepyHead stats. Again, this is only one night with all new stuff, and I'd like to confirm that the mask leak was to blame. Any help/insights would be greatly appreciated.

[ChicagoGranny]

I'd like to confirm that the mask leak was to blame.

Mask leak is a problem - 32% over red line. I'd like to see the leak line and only these graphs:

The graphs that are usually helpful are:
1. Event Flags
2. Flow Rate
3. Pressure (not mask pressure)
4. Leak
5. Flow Limit (only with Resmed machine)

You may also have other problems. For instance, the minimum pressure of 4.0 is probably too low. But, you should work on the leak first.

Tips

To reduce unintentional mask leak -

- Make sure the mask is fitted properly. (See mask manufacturer's video.)

- Make sure the headgear is adjusted properly (See mask manufacturer's video.)

- Make sure to use good hose management - the hose should not pull on the mask. Notice how your hose is positioned between machine and mask. It should be positioned to minimize any pull on the mask. Hose management is an individual practice. How it is done depends on the mask, the position of the machine, your sleeping position and other factors specific to the individual.

- If you still have problems, learn from the forum what mask liners are available.

- If your mask still has excessive leak, try other masks. Many people report trying several masks before they find one that works well for them.

Note: Links to just about all of the mask manufacturers' instructional videos can be found on the forum host's website - https://www.cpap.com/cpap-masks.php

- CG

[sleepyowl]

Thank you Chicago Granny! Here's the requested fields from SleepyHead.

[ChicagoGranny]

Looking at the pressure line, the machine runs up to 11.0 and stays there most of the night. This is an indication that your minimum pressure (4.0) is too low. It could also be that the maximum (11.0) is too low.

So, you need to work on the mask leak. Are you having any dry mouth? This would be a sign that you might be mouthbreathing or leaking pressure out the mouth. Did your wife say anything about this?

[palerider]

no, the mask leak isn't to blame, the fact that you've got your autoset hobbled to a minimum of 11cm pressure is to blame.

I agree with Granny, your *MINIMUM* needs to be raised, probably to 12, and your max should go to max, till you figure out what pressure you need.

also, thanks for providing a great example of an auto machine *LOWERING* pressure in response to excessive leaks

and, yes, you need to fit the mask at a higher pressure so you can get the leaks under control.

[Julie]

And if you're a back (vs sides) sleeper, which provokes many more apneas, do whatever you can to keep off your back overnight, even if it means wearing a backpack (or sewn-in ball) til you've converted. I also suggest using a soft cervical collar to keep your head off your chest (if it applies), your airway more open (you could be cutting off air quite a bit otherwise) and your mouth closed.

[Chevie]

do whatever you can to keep off your back overnight, even if it means wearing a backpack (or sewn-in ball) til you've converted.

Nope. He needs to get leaks solved and pressure settings for whatever position(s) he normally sleeps in. You only make it more difficult by telling him to get in an unaccustomed position.

[Julie]

You mean he can't walk and chew gum at the same time?

[Chevie]

You mean he can't walk and chew gum at the same time?

Maybe that's your problem - you can't chew gum and make sensible recommendations in a CPAP forum??

[sleepyowl]

Looking at the pressure line, the machine runs up to 11.0 and stays there most of the night. This is an indication that your minimum pressure (4.0) is too low. It could also be that the maximum (11.0) is too low.

I'm almost certain the settings are too low. My Dr. is working off of a sleep/titration study from 6 years ago. I was unable to pay my deductible for another (this year at least), so that's why he ordered an APAP. I suspected this would be the case.

So, you need to work on the mask leak. Are you having any dry mouth? This would be a sign that you might be mouthbreathing or leaking pressure out the mouth. Did your wife say anything about this?"

Thank you. I use a chin strap and it works very well. I don't have dry mouth, just an ever so slight dry nose after this new mask, but I also had that with my Wisp (my older one).

[sleepyowl]

And if you're a back (vs sides) sleeper, which provokes many more apneas, do whatever you can to keep off your back overnight, even if it means wearing a backpack (or sewn-in ball) til you've converted. I also suggest using a soft cervical collar to keep your head off your chest (if it applies), your airway more open (you could be cutting off air quite a bit otherwise) and your mouth closed.

Thank you Julie. I've already trained myself to sleep on my side after a lifetime of sleeping on my back. I start out on my back, then I turn off the TV and go immediately to my left side and flip left to right all night. I also use a memory foam neck pillow. The soft cervical collar made me think of my idea to somehow tie the neck pillow around the back of my neck so it keeps my jaw from dropping. I instinctively use a body pillow against my cheek though.

[palerider]

Looking at the pressure line, the machine runs up to 11.0 and stays there most of the night. This is an indication that your minimum pressure (4.0) is too low. It could also be that the maximum (11.0) is too low.

I'm almost certain the settings are too low. My Dr. is working off of a sleep/titration study from 6 years ago. I was unable to pay my deductible for another (this year at least), so that's why he ordered an APAP. I suspected this would be the case.

I'm 100% certain your settings are too low, that's why you're having constant hypopneas and apneas!

would you zip up your entire SD card and upload it to me, RobySue and I would like to examine how the machine is behaving during the really large leaks.

if you would do that, here's the upload link: https://www.dropbox.com/request/0LalWvEsijRIgX8sdM7H

[sleepyowl]

Looking at the pressure line, the machine runs up to 11.0 and stays there most of the night. This is an indication that your minimum pressure (4.0) is too low. It could also be that the maximum (11.0) is too low.

I'm almost certain the settings are too low. My Dr. is working off of a sleep/titration study from 6 years ago. I was unable to pay my deductible for another (this year at least), so that's why he ordered an APAP. I suspected this would be the case.

I'm 100% certain your settings are too low, that's why you're having constant hypopneas and apneas!

would you zip up your entire SD card and upload it to me, RobySue and I would like to examine how the machine is behaving during the really large leaks.

if you would do that, here's the upload link: https://www.dropbox.com/request/0LalWvEsijRIgX8sdM7H

Thanks palerider. It's uploading now. I appreciate it.

[sleepyowl]

Also - I think it's incredibly stupid for the Airsense 10 to give all smiley faces with the little "sleep report" after a night like this. A smiley for mask seal? Really?

[robysue]

Again, this is only one night with all new stuff, and I'd like to confirm that the mask leak was to blame. Any help/insights would be greatly appreciated.

The leaky mask is to blame for only some of this ugliness. Your leaks are excessively high for an excessively long period of time. The data when large leaks are detected could be even worse than it looks here because the machine can lose track of your breathing.

But there's a whole lot of ugliness that can't be blamed on the large leaks. In particular, that cluster of events between 5:15 and 6:00 can't be blamed on a leaky mask. The clusters that happen between 7:40 and 8:15 (between the large leaks) and the clusters that happen after 8:30 also cannot be blamed on a leaky mask.

Now as palerider and others have commented, your machine is limited with a max pressure of 11cm. And the machine zoomed right up to 11cm at the beginning of the night and sat there except for the pressure decreases when the machine was trying to "fix" the large leaks.

Question: Did you have a titration study? If so, what was the recommended pressure setting? If not, why did the doc decide to tell the RT to set the machine up in Auto mode with a pressure range of 4-11cm?

Next Question: How long were you awake before falling asleep at the beginning of the night? How long were you lying in bed awake before deciding to get up this morning?

Final Question: What was your AHI on your diagnostic test?

We need that kind of information to tease out exactly what might be happening here.