Possible incorrect Event analysis

[Ralph437]

I’ve been lurking here for some time to try to assist my wife in her struggles with her cpap therapy,
Still have not found a solution to her leaks and have applied many, if not all, of the advice on this forum so it’s an continuing journey.
But my question or request for comment has to do with clustering of her events.
Attached are a couple of recent Oscar reports, and what finally struck me was that her events seem to cluster during periods of leaks over 24 liters per minute. When she is under that threshold, she seems to have no, or very few, analyzed events.
Someone recently had mentioned that when leaks are above 24 or so, the Resmed event detection software systems in the machine start to fail.
So could someone take a look at these last two days of charts and tell me if she is REALLY having AHIs that are this high, or it is just a distortion caused by leaks.
Any thoughs/comments???
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[Miss Emerita]

Welcome! Unfortunately, this site is not able to accommodate attachments. (There's a "sticky" on this subject if you want to learn more.) Could you use an image-hosting service like Imgur and post links for your screenshots? People will be happy to try helping once they can see the charts.

[Pugsy]

Was she by chance awake during those clusters you see?

[Ralph437]

No, she was definitely asleep.
Here's another try using Imgur.


Even I can see that didn't work !
Here's sending using BBC code:
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[Pugsy]

The leaks are so excessive that the machine can't prevent the airway from collapsing.
Look at the time where the leaks aren't so bad (like below 30 L/min) .... there really aren't many events when leaks aren't a problem and stay below the 30 L/min line.

Since we can't blame awake breathing since she was asleep....I am betting those are the real deal because the machine simply can't deal with things in the face of leaks so deep into large leak territory.

Gotta get the leaks better under control.

When you see leak line above 35 L/min....all bets are off and the machine simply can't do its job very well at all.

[Pugsy]

https://imgur.com/a/ERqz8SN

https://imgur.com/a/DktXMkI

I don't know what you are doing wrong but see if the above links work for everyone.

[Ralph437]

On the images:
Interesting, I can't see the images on my end when I load up cpaptalk. But I can see them when I click on the links you sent in your message.

Leaks, we are on her 5th try with Full Face Masks, and have tried everything that folks here have suggested. The only thing that works (near zero leakage) is a really big 431 mask that she refuses to use because it is so big and bulky and leaves marks on her forehead etc. For the two weeks that I coaxed and cajoled her AHI averaged 0.2 at 95% pressure of 7.2, that's why I'm wondering if the leaks are not "real deal", but a result of the flow rate readings being messed up by the leaks and that results in a 16.1 Unclassified Apnea out of the 18,4 total apnea index.

[Pugsy]

The leaks are very real and the reason you see "unclassified apnea" flagging is because the leaks are so bad that while the machine senses something going on it can't tell what it is.

How about trying some sort of nasal mask? Less surface area that needs to seal so should be easier and more comfortable and even if there is a little leaking or mouth breathing....I am betting it isn't nearly as bad as this leaking is.

[ChicagoGranny]

Even I can see that didn't work !

I see what you are doing wrong, but just post the links. It's so easy for us to click on them and open your images in another tab. Plus, when posting several images in a thread, posting the links only keeps the number of pages the thread covers down.

[Ralph437]

We went from the pulmonologist (who said too much nasal constrictions) to the ENT who confirmed that without major nose reconstruction, a nasal mask just won't work. Besides, she already had already informed me that if she had to tape her mouth, she would rather just die. So there's that!

The other factor that I haven't mentioned yet is that she tells me that she had a good night, slept well and is alert all day ....... with an AHI of 18 ????

That's the other reason why I'm skeptical about the "events"

[Ralph437]

Even I can see that didn't work !

I see what you are doing wrong, but just post the links. It's so easy for us to click on them and open your images in another tab. Plus, when posting several images in a thread, posting the links only keeps the number of pages the thread covers down.

Thanks,
As a new guy here, I'd like to get it right. I carefully followed the directions that jlFinkles gave in the attachment sticky:

1. Go to Imgur.com
2. Click on “new post”
3. Either drag your images into the “drop images here” area or click on “chose photo/video” and follow the prompts to either select it from your photo library or other source
4. Click on the picture once uploaded, then click on the “copy link” button when it appears
5. Come back to the forum and add it to a post using the little image icon Image and paste the link from step 4 between the img and /img - note you may have to add a “.jpg” extension to the pasted link for it to work

Is this not correct?
It's bizarre that Pugsy can see the image but I can't. Can you see any image I posted?

[Pugsy]

Is this not correct?

Something wrong with steps 4 and 5 somewhere.
Where did you find those instructions....certainly not mine.

It's bizarre that Pugsy can see the image but I can't. Can you see any image I posted?

I know a little trick that sometimes works when someone does something wrong.
I right click my mouse over the word "image"...just the word and not that other thing that is half an image bracket and choose "open in a new tab" and it takes me to your image on imgur.
I couldn't get the image itself to show up though no matter what tricks I tried.

Let me see if I can find some better instructions for you.

The events and leaks are the real deal....no way around it despite her not feeling the crappy report.
The people with no leaks and a low AHI and still feel like crap...they are going to hate your wife.

Has she ever tried one of the newer hybrid types of full face masks? Might leak less.
take a look at these

https://www.cpap.com/productpage/resmed ... -face-mask

https://www.cpap.com/productpage/philip ... k-fit-pack

https://www.cpap.com/productpage/resmed ... k-headgear

https://www.cpap.com/productpage/f-p-ev ... r-fit-pack

Let me go try to find better instructions for imgur posting.....or else I will make up some.

[Pugsy]

viewtopic.php?t=158560

Take a look at my thread above for different instructions.

[Pugsy]

If she hasn't tried any of those 4 full face masks that I linked to above and she spots something she wants to try....
let me know because I might have one that I will just give to her from the donations box.
I don't remember what I have but if she is interested I will go look.

[Ralph437]

Something wrong with steps 4 and 5 somewhere.
Where did you find those instructions....certainly not mine.

In answer to you question about where I got those instructions:
Jlfinkels posted that on Thursday Dec 1 2022, I found it in the last postings of the "attachment sticky".
I think what was missing was use BBCode share link at Imgur and DO NOT click on the image icon on the Cpap message options.
Simply paste what you selected at the BBCode link in Imgur,

Getting late, so quick reply.
We tried a couple of hybrids, but the cut outs for the nostrils tended to block her nostrils and made nose breathing which was already compromised even more so.

Thanks for your help, till later !