Thoughts anyone??

[drjsparker]

well...not sure what to make of this...anybody care to offer some interpretation?

Thanks in advance!

[drjsparker]

I guess I'm doing something wrong with the images...

[Jersey Girl]

To post images, you will need to first upload them to an internet site. Some people like to use Photobucket. (http://www.photobucket.com) Then you can copy the code for the Image and post it.

Best regards,

Jersey Girl

[drjsparker]

To post images, you will need to first upload them to an internet site. Some people like to use Photobucket. (http://www.photobucket.com) Then you can copy the code for the Image and post it.

Best regards,

Jersey Girl

when you say copy the code, do you mean 'copy and paste' the link to the picture... I uploaded it to a myspace account then copied the link in between the [IMG]'s?

[BleepingBeauty]

First, you have to save the pertinent page(s) from your software program on your pc as .jpg files. The procedure I follow may seem a little involved, but it's really not, once you get used to it.

When you have one of those pages on-screen, here's what to do:

1. Be sure your viewing window on the pc is at full-size, so all the data is visible. Scroll up/down, if need be, so that all the data is on-screen.
2. Hit the Print Screen key on the keyboard. (That copies the entire image you see.)
3. Open your photo editing program. (I use MS Photo Editor.)
4. Open a new file in your photo program and paste (Ctrl+V) the image in.
5. Scroll down enough that the Toolbars in the image disappear and you only see the graph, and then crop the image to remove extraneous info (like your name, for instance).
6. Save the cropped image to your pc as a .jpg file (perhaps on the Desktop, so it's easy to find).
7. Upload the .jpg to a free photo-sharing site (like Photobucket or flickr).
8. Name and save the image.
9. Copy the Image code on the newly-uploaded file (on Photobucket, hover the mouse over the image, and then copy the [IMG] code from the drop-down that appears).
10. Open a new post here, and paste the Image code into the post. Make sure the [ Img ] [/Img ] codes surround the link.

Then click on the Preview button to see if the image shows up correctly in your post. If it does, hit Submit.

Hope that helps.

[drjsparker]

AH HAH!!!

Thanks, Ms. Bleeping

[jnk]

The main thing at this point may be working on getting a nice flat leak line. That will make the scoring of the machine a lot more accurate to know how your therapy is going to begin judging your range of pressures.

Have you tried another size of pillows?

It takes some of us a while before our brain gets used to the mask so that we don't knock it around too much in our sleep. But you may be able to try making some adjustments to get the leak line flatter.

jeff

[drjsparker]

I've been using the medium pillows...I tried the large ones a few nights ago...I'll try again tonight. Is it realistic to expect a 0 leak flatline all night?

[KatieW]

drjs parker....you have very high leaks. Probably from your mask or your mouth.

I printed out your graph, then took a pencil and ruler and drew lines from the apneas, all the way down the page. If you do that, you will see the leaks that are the highest have the largest clumps of apneas. The numbers are the length, in seconds. That is not good, because it means you are not getting the oxygen you need, and it's disturbing your sleep.

With previous Resmed xpap's, they said that any leak over 24 liters per minute would affect therapy, and also the data results, and many of your leaks are over that red line.

The Yellow flags say "unknown apneas"--not sure what that means, as this is a new definition. They do seem related to your leaks though.

I'm not familiar with your mask, but perhaps you have the wrong size pillows. I think I remember some people have had seal problems with the Swift FX. Or perhaps you are a mouth breather, and that's causing the leaks.

It's great this you have this software, to analyze what's going on, so you can take corrective action.

Edited to add: I found a definition for Unknown Apneas: an apnea during which a leak higher than 30 liters/minute occurs, precluding accurate determination of whether the apnea is obstructive or central.

[jnk]

A perfectly flat line is something to rejoice about, and is very much possible with a ResMed machine that deducts your expected leak rate. But I know it took me a while to get leak down. It can take some patience and experimentation.

Katie makes excellent points. Those very well may be mouth leaks. Sometimes a chin strap helps with that. Other times, not so much. I used a mandibular advancement device in conjunction with my PAP therapy for a while to learn to keep my jaw closed, and I used a sort of stretchy headband for a while to keep my lips closed to prevent lip-flutter. Others have used tape. Many go to a full-face mask once they establish they are dyed-in-the-wool mouth-breathers.

And to repeat another point Katie made, the really nice thing is that you have the software, so you know not to worry much about your other numbers until your leak is better. Don't let that knowledge discourage you at all. It is good to know specifically what we can do to make things better, and your software has given you that powerful knowledge.

jeff

[Guest]

drjs parker....you have very high leaks. Probably from your mask or your mouth.

I printed out your graph, then took a pencil and ruler and drew lines from the apneas, all the way down the page. If you do that, you will see the leaks that are the highest have the largest clumps of apneas. The numbers are the length, in seconds. That is not good, because it means you are not getting the oxygen you need, and it's disturbing your sleep.

A perfectly flat line is something to rejoice about, and is very much possible with a ResMed machine that deducts your expected leak rate. But I know it took me a while to get leak down. It can take some patience and experimentation.

Katie makes excellent points. Those very well may be mouth leaks. Sometimes a chin strap helps with that. Other times, not so much. I used a mandibular advancement device in conjunction with my PAP therapy for a while to learn to keep my jaw closed, and I used a sort of stretchy headband for a while to keep my lips closed to prevent lip-flutter. Others have used tape. Many go to a full-face mask once they establish they are dyed-in-the-wool mouth-breathers.

I do believe I've got some duct tape in the garage

Thank you both for your insight...I have woken up w/ my mouth ballooning w/ air trying to escape so that's probaby where a good number of the leaks are coming from. My sleep study indicated that the pressure I needed was 12, so they set my apap min/max at 4-16. Any thoughts as to whether I should tweak those numbers?

[drjsparker]

oops forgot to log in for that last post

[kteague]

Just thinking that minimum pressure of 4 makes it a long climb to a therapeutic pressure of 12. Between fixing any mouth leaks and raising your lower pressure, I'm thinking you'd see a big improvement in your data. I'm not an autopap guru though I did use one for at least a year, but if it were me I'd bump the bottom number up to about 8 see what the numbers look like for a while.

[drjsparker]

Just thinking that minimum pressure of 4 makes it a long climb to a therapeutic pressure of 12. Between fixing any mouth leaks and raising your lower pressure, I'm thinking you'd see a big improvement in your data. I'm not an autopap guru though I did use one for at least a year, but if it were me I'd bump the bottom number up to about 8 see what the numbers look like for a while.

Funny you suggest that, I made that change last night but was about to move it back to 4 because I figured it was part of the reason I was having more leaks

[dave21]

Hi drjsparker,

As JNK and Katie has already mentioned, your leak rate spikes up way to high. If you're using the Swift FX then I would either check the pillow size you are using or try to understand if you keep rolling over to dislodge the pillows to create those large spikes. It's not a continually high leak rate just spikes so it suggests you're doing something to cause these leak rates, e.g. pillows are falling out of your nostrils possibly when you move your head or when you roll over. When your leak rate spikes you appear to have a cluster of Unknown Apneas.

It could also be mouth breathing like you suggest if you're waking up and you're mimicking that your a fish blowing bubbles (that happens to me now and again). You might want to see if you can get a chin strap. Usually blowing bubbles for me either means I have a very full stomach and that's making it uncomfortable and rather than breathing the air I'm trying to swallow the air and it's filling up my stomach and getting to a point where I can't take the pressure. Or that your pressure is too high, be careful on changing those numbers.

The Yellow flags say "unknown apneas"--not sure what that means, as this is a new definition. They do seem related to your leaks though.

I'm not sure what these are either, this is the first time I've seen Unknown Apneas. I'm guessing the machine is noticing you're stopping breathing for that time but it's not been able to differentiate between what type of Apnea it is. It probably senses there's no reduction in flow (obstructive) and likewise it doesn't think it's a Central Apnea but it does know you've stopped breathing.

Edited to add: I found a definition for Unknown Apneas: an apnea during which a leak higher than 30 liters/minute occurs, precluding accurate determination of whether the apnea is obstructive or central.

Aha, that will be why then, you have to get your leak rate down to a somewhat lower and consistent rate.

It also looks like your Min pressure is set too low, you seem to be fluctuating quite a lot between 9cm and 12cm, this is quite a difference, increasing the Min might help a little bit but I would first try and address the leak rate otherwise by increasing the pressure could mean that you are going to get more leaks if you're not careful.