Bad leaks and fits from AC11 and P30i

[alancalan]

First, is there anyway to get the statistics on the left side of the daily reports to print on the Daily Report, either separately of near the graphs, like the leak percentages. Once the next day has been collected, that information cannot be printed out. In other words, you have to printout the CPAP Statistics every day or write them into the printed Daily Report. It would be logical to have it print with each Daily Report.

June 10 AHI 2.03 Av Leak Rate 16.78 95% Leak Rate 49.20 % of time Over LR Threshold 27.96 Hrs 6:25
June 09 AHI 1.75 Av Leak Rate 20.40 95% Leak Rate 50.40 % of time Over LR Threshold 46.40 Hrs 5:08
June 08 AHI 8.49 Av Leak Rate 02.48 95% Leak Rate 44.40 % of time Over LR Threshold 25.09 Hrs 7:04
June 07 AHI 2.33 Av Leak Rate 14.40 95% Leak Rate 48.00 % of time Over LR Threshold 39.93 Hrs 6:00
June 06 AHI 0.80 Av Leak Rate 10.80 95% Leak Rate 38.40 % of time Over LR Threshold 31.15 Hrs 6:14
June 05 AHI 2.64 Av Leak Rate 26.40 95% Leak Rate 48.00 % of time Over LR Threshold 51.31 Hrs 7:58
June 04 AHI 1.22 Av Leak Rate 09.60 95% Leak Rate 39.60 % of time Over LR Threshold 31.51 Hrs 6:35
June 03 AHI 2.53 Av Leak Rate 16.80 95% Leak Rate 52.80 % of time Over LR Threshold 45.53 Hrs 5:08
June 02 AHI 2.11 Av Leak Rate 03.60 95% Leak Rate 42.00 % of time Over LR Threshold 12.40 Hrs 4:16


Here are my results. On the MyAir app I am scoring horribly. Last night was 75. I lost 5 points on sleep time, 16 points on Mask Seal and 4 points on taking mask on/off . When I test the seal it is always fine so I don't know if it is me or the machine, Tonight I am switching to an old Mirage Activa mask to see if there is a difference. I tubing seems fine but I am just concerned with the water looseness, It is in put you can press down on the back. It would be nice if ResMed reads these messages. How pathetic and disconnected and aloof it would be if they weren't monitoring what is happening out there? Maybe I will send this to them in Twitter, they have Cust Service there.

[robysue1]

It would be much easier for us to help you if you would either post some screen shots from MyAir or (even better) download OSCAR and post some screen shots of your data from OSCAR.

You write:

June 10. AHI 2.03 Av Leak Rate 16.78 95% Leak Rate 49.20 % of time Over LR Threshold 27.96 Hrs 6:25
June 09 AHI 1.75 Av Leak Rate 20.40 95% Leak Rate 50.40 % of time Over LR Threshold 46.40 Hrs 5:08
June 08 AHI 8.49 Av Leak Rate 02.48 95% Leak Rate 44.40 % of time Over LR Threshold 25.09 Hrs 7:04
June 07 AHI 2.33 Av Leak Rate 14.40 95% Leak Rate 48.00 % of time Over LR Threshold 39.93 Hrs 6:00
June 06 AHI 0.80 Av Leak Rate 10.80 95% Leak Rate 38.40 % of time Over LR Threshold 31.15 Hrs 6:14
June 05. AHI 2.64 Av Leak Rate 26.40 95% Leak Rate 48.00 % of time Over LR Threshold 51.31 Hrs 7:58
June 04 AHI 1.22 Av Leak Rate 09.60 95% Leak Rate 39.60 % of time Over LR Threshold 31.51 Hrs 6:35
June 03 AHI 2.53 Av Leak Rate 16.80 95% Leak Rate 52.80 % of time Over LR Threshold 45.53 Hrs 5:08
June 02 AHI 2.11 Av Leak Rate 03.60 95% Leak Rate 42.00 % of time Over LR Threshold 12.40 Hrs 4:16

The first most important impression I have from this numerical data is that you have a serious leak problem. On 6 of these 9 nights, your leak rate was above the Large Leak threshold for over 30% of the night. (That means Mr. Red Frowny Face should have shown up on the machine's on-board "sleep report".). On 3 of these nights, your leak rate was above the Large Leak threshold for almost (or more) than 50% of the night.

That's enough large leaks to have a potential affect on the efficacy of your xPAP therapy. In other words, the nice low AHIs on nights where the % of time over the large leak threshold is greater than 30% may be misleading---your machine may be having enough trouble tracking your breathing to not detect all the events. And it may be having enough trouble maintaining pressure to prevent events from happening.

It's also enough large leaks to raise the question, "Are the leaks affecting your ability to get to sleep or stay asleep?"

All of which brings up the questions:

What mask are you using?
How are you fitting the mask at the beginning of the night?
Are you a mouth breather?
Is your jaw dropping significantly when you are asleep?
When was the last time you changed the mask cushion? What about the hose?
Have you checked for small pin-sized holes in your mask cushion and hose?

You also write:

On the MyAir app I am scoring horribly. Last night was 75. I lost 5 points on sleep time, 16 points on Mask Seal and 4 points on taking mask on/off .

It's not a competition to see who gets the best MyAir score.

In general: Do you think you are sleeping enough for you to wake up rested and refreshed and ready for the next day? If so, ignore how many points you lose for sleep time. If you are waking up tired, you've got a big problem with leaks and it's more important to fix that right now than it is to worry about getting your decent usage times up to the point where you don't lose MyAir points.

It's no surprise you lost 16 points on Mask Seal: You were leaking at a rate of over 24 L/min for more than 25% of the night. That's enough for Mr. Red Frowny face to show up on the machine's on-board sleep report as I recall. And some of those leaks were really big---your 95% Leak Rate is 49 L/min, so at some points in the night, your unintentional leak rate was almost twice the Large Leak threshold set by Resmed.

As for taking the mask on/off (i.e. turning the machine on/off): This again is not so much a competition as a potential flag about how soundly you were sleeping. Do you remember waking up and turning the machine off and on? If so, was it because you needed to go to the bathroom? And then you went right back to sleep each time? Or was it because you were waking up because of a large leak and turning the machine on and off in an effort to deal with the leak? Or do you simply not remember waking up and turning the machine off?

When I test the seal it is always fine so I don't know if it is me or the machine,

The consistent problem with leaks being over the Resmed Redline for Large leaks for substantial parts of the night point to the problem being with the mask springing leaks during the night rather than the machine.

How are you testing the seal at the beginning of the night? While you're sitting up in bed? You need to fit the mask (and test it) while you are lying down in your normal, preferred sleep position. And then there's this: Once you are asleep, your facial muscles are most likely relaxing and if you're using a full face mask, when your jaw and lower face relax too much, that can cause the mask's seal to break. If you're using a nasal mask and your mouth pops open when your jaw relaxes, that also will cause a large leak. Looking at the data in OSCAR will help you figure out when the leaks are occurring. And that will help you figure out what you need to do in order to fix the leaks.

Tonight I am switching to an old Mirage Activa mask to see if there is a difference.

Just make sure that the mask cushion is still in good shape. A worn out mask is more prone to leaks.

I tubing seems fine but I am just concerned with the water looseness, It is in put you can press down on the back.

Check the tubing. I don't know what you mean by "the water looseness". Are you talking about whether the humidifier tank is inserted correctly? If your tank is loose and you can't get it to insert correctly, it may be time for a new humidifier tank. Or, if the tank is less than 6 months old, it's time to call the DME (not ResMed) who sold you the machine and let them know you are concerned about how lose the humidifier tank seems to be.

It would be nice if ResMed reads these messages. How pathetic and disconnected and aloof it would be if they weren't monitoring what is happening out there? Maybe I will send this to them in Twitter, they have Cust Service there.

My guess is that no-one at ResMed reads this forum. No one at your DME reads this forum either.

But you have to start with your DME: Complain to them about the humidifier tank. And ask them if their Respiratory Therapist can help you with troubleshooting the leak problem. They most likely won't be of much use, but if there is a mechanical problem with the humidifier tank OR if a brand new mask cushion is defective, they're the ones who Resmed will listen to for "customer complaints" because, quite frankly, from Resmed's point of view, their customer is the DME.

[alancalan]

June 11 AHI 217 Av Leak Rate 10.10 95% Leak Rate 34.80 % of time Over LR Threshold 10.10 Hrs 6:00 Mirage Active Pretty tired

June 10 AHI 2.03 Av Leak Rate 16.78 95% Leak Rate 49.20 % of time Over LR Threshold 27.96 H but rs 6:25 P30i
June 09 AHI 1.75 Av Leak Rate 20.40 95% Leak Rate 50.40 % of time Over LR Threshold 46.40 Hrs 5:08
June 08 AHI 8.49 Av Leak Rate 02.48 95% Leak Rate 44.40 % of time Over LR Threshold 25.09 Hrs 7:04
June 07 AHI 2.33 Av Leak Rate 14.40 95% Leak Rate 48.00 % of time Over LR Threshold 39.93 Hrs 6:00
June 06 AHI 0.80 Av Leak Rate 10.80 95% Leak Rate 38.40 % of time Over LR Threshold 31.15 Hrs 6:14
June 05 AHI 2.64 Av Leak Rate 26.40 95% Leak Rate 48.00 % of time Over LR Threshold 51.31 Hrs 7:58
June 04 AHI 1.22 Av Leak Rate 09.60 95% Leak Rate 39.60 % of time Over LR Threshold 31.51 Hrs 6:35
June 03 AHI 2.53 Av Leak Rate 16.80 95% Leak Rate 52.80 % of time Over LR Threshold 45.53 Hrs 5:08
June 02 AHI 2.11 Av Leak Rate 03.60 95% Leak Rate 42.00 % of time Over LR Threshold 12.40 Hrs 4:16 P30i

The water chamber doesn't feel tight. It take a very low effort to pull it back. Something tells me it's the chamber but I was waiting to see what happened with the Mirage Active mask (I have about lots of new ones sealed and never opened) before I went to Lincare. It looks like I did better last night.

I am or was a mouth breather but I have been forever and I didn't feel this tired in ages. As a kid I always breathed through my mouth but since bipap I think tat was minimized I may not be a moth breather anymore. I have been using the P10 and the P30i so the mouth breathing wasn't a problem with those I wonder if it is Ambien withdrawal?

To fit the mask I am sitting up in bed, otherwise I can't see the machine. I guess I could lay down afterwards but then I have to get up again to shut off the fitting routine. I am a side sleeper, getting my head a little further from the center so I won't slip down. I have no idea how it says I shut off the machine because I didn't wake up till 9:30 AM. I rarely wake up to go to the bathroom until I am up for the day. Lately, I have been going to sleep too late and I think last night I forgot to take the melatonin,

The other thing I have to add but I have no idea if it has an effect is that 2 Fridays ago I took an Ozempic shot. While reading the info on it I saw something about thyroid issues and I remembered I had a needle biopsy maybe 15 years ago and maybe before I go ahead with tis I should talk to my internist about getting those records because I don't remember what records he got. Last week I found out he doesn't look at records on thumb drives. So, he suggested get an ultrasound of the thyroid or go off Ozempic. So I did both for the time being. So, there was only one .25 dose of Ozempic.

I will go to the DME tomorrow. 2 weeks ago I got a new machine there. They sent out the old machine that was having fan failures, opened a new box and and gave me the new AC!! but left me with the old water tank. that might have been a mistake.

I brought up the MyAir scoring because the fact that I am losing so many points leads me to believe the problem is big and happens and closes again and maybe that is what the app thinks is me shutting off the machine. About a week and a half ago I was woken up because the machine was going crazy so I took everything apart and finally got it all together again with no problems. I really feel something is not right there> What about the Air Sense 11s? Are their water chambers going in firmly and you see absolutely no movement when you press the back of the water tank?

Thanks for your help, Ruby,

Alan

[ozij]

To fit the mask I am sitting up in bed, otherwise I can't see the machine.

There is no need for you to see the machine when doing the mask fit.
Do the mask fit lying down, in your favorite sleep position, try to fit the mask so that the only air blowing out is out of the vent.
If you're hard of hearing, check with for the sensation of air blowing out on the back of your hand.
Try to change to you second favorite positon.
Let the "Mask Fit" program run its course, no need to turn it off.
Do all that when when you're wide awake not when all you want to do is sleep now.
When the mask fit program stops, it will show you (frowny face or smiley face) how well you've managed to fit your mask.

[alancalan]

I had no idea the mask program turns itself off. It fills your nose and your head with air no? It feels like you're in a landing airplane. It's a little uncomfortable but I didn't realize it lasts and shuts itself off. I wonder if it looks for pin like holes getting released anywhere else than from the mask. The next machine will have AI checking for leaks everywhere. It's not really AI unless it tells the designers where to put the sensors, it's just putting in controls and testing.

I thought once you get the okay and you can move around a little bit, you stop when you want. In other words I thought it goes on forever and when you're satisfied you just stop it.

So you put the mask on, and then you press start? Then, you lie down, roll around you keep it on until the pressure stops and it shuts itself off. Then you look at the screen and it tells you whether or not it was good. For that you have to get up and turn around and maybe move the mask around a little bit in the position that it wasn't in while you were taking the test, but that's okay? You get up turn around and look at it, because you can't see smiley faces and frowning faces if you don't get up and turn yourself around unless it's sitting on a night table right in front of you. After it shuts off you leave it on and the air curve 11 will start it's therapy? I never had any of this on the S9.

Thanks, Alan

[Pugsy]

I thought once you get the okay and you can move around a little bit, you stop when you want. In other words I thought it goes on forever and when you're satisfied you just stop it.

You thought wrong. Think about it....something that seals when sitting up might not seal at all when laying down.

You need to test the seal when in the position you are most likely to be in while sleeping to have any chance of not having leaks from either mask movement or mouth opening. Those are the only culprits for leaks like you are having....mask movement or mouth opening or maybe a combination of both.

[vandownbytheriver]

For Resmed, Mask Fit starts at the *highest pressure allowed*... so, if you have the factory default 4-20cm set, it will start at 20cm! It then steps down after every 5min, 5cm at a time IIRC.

Chances are you will not be able to get a good fit at 20cm. Best to set your machine to your normal peak pressure and then fit the mask from there. There is nothing to be gained from setting the fit at a low pressure.