Efficiency results...your thoughts?

Rumur · Post by **Rumur** » Wed Apr 09, 2008 6:59 am

Ok...after a week on bi-pap, I have some results to share. I would really appreciate your thoughts.

First (drum roll please) last nights results...
Leak 0.10
VT 360-780
Resp Rate 12-18
MV 6.1-9.2
Press 12.0
AHI 11.4
AI 1.6

and without further ado...
for the week...
Leak 0.10
VT 340-780
Resp Rate 12-19
MV 6.1-9.2
Press 12.0
AHI 11.0
AI 1.2

So...what do you think?
I think the Leak and AI numbers look good, I am concerned about the AHI, and the rest I really don't understand what the numbers are telling me.

Thanks

Russ

By the way...my pressures are 14 and 10

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CPAPopedia Keywords Contained In This Post (Click For Definition): AHI

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CPAPopedia Keywords Contained In This Post (Click For Definition): AHI

Slinky · Post by **Slinky** » Wed Apr 09, 2008 8:51 am

That data looks pretty good to me. Quite consistent data thru out, even the AHI and HI. Yup, you'd like to see the HI lower. BUT - how are you FEELING after these 7 nights on your Bi-Level?

Resmed's reputation here is that they report higher AHIs, notably HIs, than the others. I'd have to go back and check the downloads from the 3 weeks and 1 week stints I did on the Respironics pre-M Series Auto w/C-Flex as compared to my time before, after and in between those stints to see how my HIs compared between the two brands to say whether that was my experience as well.

I only have 13 nights on my new Resmed S8 VPAP Auto (bi-level) so I'm still figuring stuff out myself. Plus I started w/a new mask at the same time which confuses any comparisons a bit. And then one week into bi-level therapy I discontinued the 2L of 2 supplementation per my sleep doc's suggestion just to confuse any comparisons even more. I'm anticipating a change in size w/the new mask from a Medium to a Small.

Rumur · Post by **Rumur** » Wed Apr 09, 2008 8:58 am

I still feel like crap. Still fighting with the mask to keep it comfortable. Still fighting rainout even with a hose cover....last night was the worst. One thing I have noticed is that the machine does not seem to be blowing as hard in the morning as it does at night. I am chalking that up to the auto function of my machine, but I really don't know. Seems like I am constantly waking up around 330am and then struggling with rainout and mask comfort issues.

Slinky · Post by **Slinky** » Wed Apr 09, 2008 9:20 am

Last night:

Leak: 1.0 L/s
VT: 200-460
Resp Rate: 14-20
MV: 3.6-7.5
Press: 10.8
AHI: 7.4
AI: 0.2

Past 7 nights:

Leak: .96 L/s
VT: 200-480
Resp Rate: 13-20
MV: 2.6-7.5
Press: 10.8
AHI: 10
AI: 0.1

My pressure settings are: IPAP: 13 cms and EPAP: 8 cms

Have you tried turning your humidifier down a notch or two? Or taking your hose under the blankets w/you? You might want to consider making or buying a hose cover if neither of those two work. Or even buying an Aussie Heated Hose (if it can be used w/your bi-level) if a fleece hose cover doesn't work to get rid of that rainout.

Yep, I've noticed the pressure doesn't seem as strong in the AM too, but I also noticed that on straight CPAP a 8 cms. And I noticed a difference w/less smooth transitions between EPAP and IPAP between the Resmed Mirage Micro nasal cushion and the Respironics Simplicity simple nasal cushion masks as well.

IF it is any consolation I still wake up once during the night and have to fuss w/my mask as well. Not so much comfort, just they don't want to fit as well as far as leaks are concerned and it takes awhile to get either of them leak free before I can go back to sleep.

But I'm not running out of steam in the late afternoon as I had been doing w/the straight CPAP!!! And breathing is easier w/the bi-level than the straight CPAP as well. And I didn't think breathing was difficult w/the straight CPAP until I started w/this bi-level!!!

Slinky · Post by **Slinky** » Wed Apr 09, 2008 9:46 am

Ha! Neither do I!!! However, here's the definitiions:

Tidal Volume (mL) = the volume of air inspired or expired in one respiratory cycle (breath).

Respiratory Rate = the frequency of breathing, expressed as the number of breaths per minute.

Minute Ventilation (L/Min) = the volume of air breathed in (or out) w/in any 60 second period.

Snoredog · Post by **Snoredog** » Wed Apr 09, 2008 9:49 am

you need to increase EPAP by 1, IPAP by 2,

Increasing EPAP will lower AI,
Increasing IPAP will lower HI,

you want your AHI looking more like Slinky's (but lower hehehe)

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CPAPopedia Keywords Contained In This Post (Click For Definition): AHI

Rumur · Post by **Rumur** » Wed Apr 09, 2008 9:55 am

Thanks Slinky and Snoredog.

Would anything there indicate that I am mouth breathing?

I don't think I am, I think it would wake me up as I am sleeping rather lightly right now.

ozij · Post by **ozij** » Wed Apr 09, 2008 10:24 am

Rainout can be unpleasant, sleep disruptive, and in addition confuse the machine.

So I would certainly drop the humidity to below rainout level, and if it turns out that's too dry, you have to start considering a heated hose.

O.

Snoredog · Post by **Snoredog** » Wed Apr 09, 2008 10:27 am

Rumur wrote:Thanks Slinky and Snoredog.

Would anything there indicate that I am mouth breathing?

I don't think I am, I think it would wake me up as I am sleeping rather lightly right now.

Don't see leak being a problem, value returned by the machine is liters per second, to get liters per minute for your mask flow chart, you need to do some math, yours is 0.10x60=6 or 6 liters per minute, that is pretty darn low, you would have to get up over 50 L/m for it to be a problem with most masks.

if the machine reported leak 1.0 or 1.4 like Slinky, then you may have a problem with leak, as 1.4x60=84 liters per minute, when you get that high machine stops recording events and results become skewed (most do anyway).

If you are mouth breathing you should see leak climb high well over 50 L/m (0.8-0.9 L/m) or like what Slinky shows

Slinky · Post by **Slinky** » Wed Apr 09, 2008 11:02 am

Yep, I"m not mouth breathing but I do have air escaping thru my lips (the lip flutters) on occasion.

ozij · Post by **ozij** » Thu Apr 10, 2008 8:04 am

On April 10
viewtopic/t29997/I-ACTUALLY-SLEPT-LAST-NIGHT.html

[quote="Rumur"]Granted, I didn't sleep all night, but I slept better last night than I have in YEARS!

Had an AHI of 9.5 with an AI of 0.6 without making any pressure adjustments to the machine. Just turned down the humidifier one notch to cut down on rain out!

I feel pretty darn good right now!!

Russ