1st night reading with my s9 Autoset

[mcejsul]

Hello,
Just downloaded my copy of ResScan and wanted to share my first nights readings. It seemed to me that I had a lot of leakage but not sure how to read the numbers. Any advice appreciated.
Pressure (auto setting 14-20)
Median. 14.0. 95th percentile. 15.5. Max. 16.7

Leak
Median. 14.4. 95th percentile. 57.6. Max. 112.8

AH & AI - events / hour
Apnea index. 4.4. AHI. 5.1. Obstructive. 0.5
Central. 2.3. Unknown 1.5. Hypopnea index 0.7

Thanks for reading.

Mike

[apneawho]

Hi Mike,
Yeah, that's a lot of leak. With that much leak, you cannot trust the AHI numbers. Take a moment to go to User Control Panel and Edit Equipment in text format so we can see what machine and mask you are using.

[mcejsul]

Hi Mike,
Yeah, that's a lot of leak. With that much leak, you cannot trust the AHI numbers. Take a moment to go to User Control Panel and Edit Equipment in text format so we can see what machine and mask you are using.

Not sure what you mean by edit.... It says S9 autoset and quattro FX mask. That is what I am using
Mike

[RandyJ]

Hi Mike,

I have been told that if the leak rate is too high (and yours is too high at 57.6 for 95th percentile) you cannot trust the other numbers. Therefore I wouldn't look too much at these numbers, but rather wait until you can get that leak rate significantly below 24L/min for 95% of the time.

When the leak rate is under control, then you can look at AHI etc.

I use a similar mask and need to use a mask liner and anti-leak strap to get a decent leak rate. One option is padacheek.com. You could try working with the mask another few nights though first: make sure your face is freshly washed and dry to minimize oils, mask is clean, etc to ensure a good seal. Mask has to be snug enough to seal out leaks but not so tight that it causes discomfort.

Actually I just noticed you are not a newbie so you should know all this.

[apneawho]

Not sure what you mean by edit.... It says S9 autoset and quattro FX mask. That is what I am using

Sorry Mike. Forgive me. Must have been a glitch in my system. I could not see any equipment listed at the end of your post. I do now.

[mcejsul]

Actually I just noticed you are not a newbie so you should know all this.

Doesn't mean I don't need to get hit over the head with a sledgehammer, feel like a newbie as I am starting over again.
Thanks for the advice. Just got the mask. Was choosing between this one and the original Quattro. I am just starting my 30 day trial, so I may try another mask after a few days. I knew the leak seemed bad.

Mike

[Pugsy]

On the software daily detail graphs....look for leak graph.
There is a red line at 24 L/min. The line where ResMed says the data and therapy may be impaired.
ResMed deducts mask vent rate prior to reporting leak so all you see reported is excess leak and unwanted.

You want to be below the red line as much as possible. If there are any spikes above the red line you don't want them prolonged.

[RandyJ]

Was choosing between this one and the original Quattro. I am just starting my 30 day trial, so I may try another mask after a few days. I knew the leak seemed bad.

Mike

People who have tried both the Quattro FX and the original Quattro seem to prefer the FX. The original Quattro is the only FF mask I have used and I have gotten to a point w/mask liner + anti-leak stap where I can keep my leak rate below 8L/min most of the time.

Have you tried nasal masks? I have tried the Mirage FX nasal mask through cpaplibrary.com's Mask Trial Program and really liked it (but haven't ordered one yet).

Good luck w/whatever you decide about masks, and I'm sure if you are committed you'll get the leak rate where it needs to be eventually and then you can trust your data.

[mcejsul]

Have you tried nasal masks? I have tried the Mirage FX nasal mask through cpaplibrary.com's Mask Trial Program and really liked it (but haven't ordered one yet).

The first mask I tried years ago was a nasal mask, but I was a dreaded mouth breather at time and we all know how well that goes with a nasal mask. two years ago, I had the Liberty Hybrid type mask with nasal pillows and that worked well, with some modifications. I was determined to try the original Quattro when I went to the supplier, we tried both there and the FX seemed to fit better.
I didn't think to wash my face prior to putting the mask on, so I shaved and washed my face beofre putting the mask on last night and although I didn't sleep as long, I did not appear to have the leaks that I had the night before. Although, I did not look at the software yet.
I also went onto paddacheek and ordered the cheek guard and also the Leak strap as well. Thank for the advice.

Mike

[RandyJ]

I didn't think to wash my face prior to putting the mask on, so I shaved and washed my face beofre putting the mask on last night and although I didn't sleep as long, I did not appear to have the leaks that I had the night before. Although, I did not look at the software yet.
I also went onto paddacheek and ordered the cheek guard and also the Leak strap as well. Thank for the advice.

Mike

The mask liner from Padacheek goes between your skin & the silicone seal of the mask, but if you're not using a mask liner I would wash the seal of the mask everyday with soap & water, or some people like the mask wipes, which are like special baby wipes that are safe for silicone. Starting each night with a clean face & silicone seal will help w/leaks. If that doesn't work you could try the mask liner.

[mcejsul]

Ok, I seem to have gotten leak issue under control for the most part. Two night ago, 95% rate was 15, last night leak it was only 8, very nice! Ahi was 5.2, which is probably a little high than I would like, but just re-starting cpap and first time with an Auto-Set, not sure.
9.9 hours of usage though..WOOT!

[Pugsy]

Ahi was 5.2, which is probably a little high than I would like, but just re-starting cpap and first time with an Auto-Set, not sure.

Give it a few days with leaks under control and if the AHI still stays up there just a little, you might consider either reducing EPR slightly (if you are using it) or a slight increase in minimum pressure.

[mcejsul]

Thanks for the reply. EPR setting is 1, I believe. Sleep study results showed this time and last that my best pressure results were at 16. Dr had them set the pressure for my Auto-Set at 14-20.

[Pugsy]

Thanks for the reply. EPR setting is 1, I believe. Sleep study results showed this time and last that my best pressure results were at 16. Dr had them set the pressure for my Auto-Set at 14-20.

Sometimes there is just the tiniest of thresholds where the machine's pressure is a little bit closer to ideal pressure so the APAP can get the pressure increased to where it needs to be in a timely fashion.
I use 10 min and 20 max.. It works for me and my threshold is 9.5 minimum...when I use that amount my AHI doubles.
My overall average will be 12 to 13 but on a rare occasion I need much higher. So it works for me.

Your 14 might be like my 9.5.....almost enough of a head start to really do a good job.

[mcejsul]

I use 10 min and 20 max.. It works for me and my threshold is 9.5 minimum...when I use that amount my AHI doubles.

Thanks for the response. Last night seemed to be a very good night, if not slowly improving. Don't want to get too excited about it too early though. Last night my AHI was 4.4. (centrals 3.6, Hypopnea index 0., max pressure was 15.8 (I believe avg pressure was 14. and my 95% leak was 8, max leak was 24. Which all sounds great to me.
In looking at the graphs, which I don't have in front of me right now, it showed numerous events in a two hour span in the middle of the night (assuming this might be REM,not sure). This was also when my pressure was up near the max of 15.8. Now, I am not preparred to make changes after 4 days, but could this mean that my minimum would be better set to 15?
Please explain what you mean by "threshold" pressure and how are you determining that.

Thanks, again for your responses and assistance.

Mike