new mask-what is encore telling me?

sweetdreams · Post by **sweetdreams** » Sat Mar 31, 2007 8:27 pm

Hello all,
I used Activa from starting cpap in oct-06 until 2 weeks ago and am trying the Optilife. Things seemed to be working with activa, sleeping all night for the most part, feeling much better. Thought I was on track and wanted a less bulky mask and got an Opti. Really like the light weight, can wear my glasses, sleep on side, just not able to sleep all night yet, but adjusting to the differnce of air blowing in my nose. Tried the small pillows, then med and back to small (not as comfortable though), but I think I am having a leak problem and going to work sleepy and foggy for about 3 hours.

So, I get the software to see if I can figure anything out. I always tape my mouth with both masks. Should I be concerned that my 90% is at 14 a lot when my titrated is 13. I have resmed auto with c-flex and humidifer, set at 10 and 15.

HEre's some numbers if someone can help me.
First 144 days
Avg pressure 90% 13.1
Avg pressure 11.4
Avg AHI 4.6
Avg 90% leak 45.8
Avg leak 38.2

Last 2 days
90% at 14
AHI 90% 9.2
total 5.7
max leak 96.4
ave 90% leak 56
Avg 42

Are the leaks high? Could I be sleeping through the leaks? What brings down AHI,controlling leaks or pressure settings? I have a lot to learn, sorry so long, but appreciate any thoughts.

Thanks,
Sweetdreams

Linda3032 · Post by **Linda3032** » Sat Mar 31, 2007 9:23 pm

For one thing, I think you mean a Remstar Auto with cflex, not a Resmed.

Titration pressures are sometimes off a little -- after all, it was only one night in adverse conditions. The 90% means you were at 14 pressure or under for most of the night -- not that you were at 14 90% of the night.

What is your Auto set at, minimum and maximum?

Your Encore Pro report - on page 4 and above, should show you what kind of apneas you had at what pressures. Look at the bottom of page 4. It breaks the apneas down to OAs and HIs.

Most of your apneas could be HIs, which can be caused by too low of a minimum pressure. So if you see that's the case, then you can bump the minimum pressure up a bit to stop some of them.

I'm not that familiar with Leak rates, so I'll let someone else address that issue. Basically, disregard the Max leak on page 3, and post what the Large Leak is starting on page 4.

sweetdreams · Post by **sweetdreams** » Tue Apr 03, 2007 8:28 pm

Thanks Linda for making me not feel totally neglected. You're right my machine is Remstar, duh.

My auto settings are 10 and 15. Dr's rx was for 8 and 15. Couldn't manage a start at 8. Titation is 13.

These numbers are for for sat/31st. Forgot to put the card back the last two nights. Can't believe it.

You asked about OA and H's, this is from pressure of 10 to 14
OA - 4.8, 2.9, 3.1, 7.7,8.5
H - 1.6,0.0,3.1,0.0,1.3
Total AHI 6.6

Just don't know if it is leaks or pressures. I did change from Activa and it was usually 5 or under. With the Optilife its getting higher. I can feel it too. I can't imagine how you can get down to the 1's.

Thanks again Linda for taking the time.

bdp522 · Post by **bdp522** » Tue Apr 03, 2007 9:23 pm

For the optilife mask the leak rate is 25 at a pressure of 8 and 35 at a pressure of 16. You do seem to be having leaks. The pressure is what's needed to hold the airway open and stop the obstructions. Leaks let the pressurized air out and allows the airway to close. So the pressure treats the apnea, but the leaks stop the pressure. You have to have your leaks under control to get this to work. Could you be knocking the mask out of position while you sleep? You could sleep through even large leaks.

Brenda

Linda3032 · Post by **Linda3032** » Tue Apr 03, 2007 9:33 pm

From what you wrote, pressures of 11 and 12 seem to be the best for you. That is, if the leaks aren't interferring with the data. At pressures of 13 and 14, your AHI goes up.

If you bump down your pressure a bit, you might be able to stop some of the leaks, but probably not enough to help much.

I think you probably are mouth leaking. That can only be improved with a full face mask, or mouth taping. Some people use Poligrip Strips instead of tape. Sorry for the bad news.

Here's a link for some mouth taping info. There are many posts regarding taping and poligrip strips.

viewtopic.php?t=8011

Snoredog · Post by **Snoredog** » Tue Apr 03, 2007 10:18 pm

the "timeline" is probably more important than anything, if you are to mouth breathe it would most likely happen during REM sleep periods when you are least likely to control it.

This would be about 90 minutes after you first fall asleep (or thereabouts) and every 90 minutes thereafter with most early in the morning around 4AM-6AM or until wakening. These are all times when you are more likely to be in REM.

If your leak follows those, then you can suspect mouth breathing. Your avg leak will tell you how you did for the whole night, the "max" leak tells you what the short term leak was.

Guest · Post by **Guest** » Wed Apr 04, 2007 5:24 pm

I appreciate hearing from you all. I have alwasys taped, using 1" gentle paper tape which I learned about here. I really don't mind it. It's really hard to tell if there is a leak with the exhaust right in front of the pillows, but I have awakened with the pillows out of place on occasion not that often though. BOth the small and med pillows fit with no apparent leak to start out. The head gear crawls on me a bit . Maaybe I should try the large.

With the info on the leak rate for the Opti up to 35 , I must be leaking more than I realize, but the two numbers above, 42 and 38 are they enough to make the AHI as high as it is? What about the average number in apnea being 4 minutes, bad?

Remembered to put my card back last night and here are my numbers if you don't mind looking at these. Pressures are 10 to 14
minutes- 106, 101.5, 134.5, 36.0, 47.0
OA - 2,3, 3.5,3.1,5.0,2.6
H - 4.0, 3.5, 1.8, 1.7, 2.6
AHI - 6.2, 7.1,4.9,6.7,5.1
AVG AHI 5.9
Avg time in apnea 4 min (bad?)
Leaks Avg Max 97.0
Avg 90% 42.0
avg leak 34.0
Avg large leak 0

Thanks so much.