??? leak free mask = WORSE???

[Chivalry]

Well heres 2 detailed graphs from 2 nights... the first lot is with my old mask that leaks... and you can clearly see where ive woken up with the leakage and turned the machine off/on to reset it.. but look at the very low events even though itas leaking like mad!

Then the second set...i just got a new mask,,,the first time ive ever had a mask that doesnt leak!!!.. but the pressure is mad and loads more apneas..
Also i have already increased my min pressure to 8 as you can see..



First leaky mask graphs!





Now the new non leaky mask,,




weird huh..... i allways assumed once i had a mask that fit me right.. that alot of my waking up with a gale force 20 in my face would be sorted... how has it gotten worse now my mask doesnt leak!! :0(

[Pugsy]

Something is driving the pressure way up there to gale force territory. Looks like maybe the flow limitations.

Did you have a certain pressure advised from titration? Any idea why the wide open range? Have you tried reducing the maximum pressure?

[Chivalry]

Here in the UK they dont tend to do bother with getting a set tritration... they just issue you with an Auto machine and leave it wide open and let it work out what you need and when you need it,,, mine was initialy set at 5 - 20 but i increased it up to 8-20 by myself..
How would lowering the max pressure help? surely if 20 isnt enough to keep my flow limitation good wouldent a lower pressure make it even worse? :0(

[jdm2857]

Many people believe that a high leak rate reduces the machine's ability to detect events. (The manufacturer's have not verified this observation.) If you look at the AHI graph for your leaky mask, you'll see that no data was recorded from the beginning of the session until about 4:30 am, which corresponds to the period of very high leaks. interestingly enough, however, flow limitation and snores were recorded during this period. Don't know if that is significant.

I'm not quite sure why Pugsy suggested lowering the maximum pressure. To me, if the pressure is continuously being limited by the upper pressure limit, then that limit should be raised. Of course, since your S9 AutoSet has a maximum pressure of 20, you would need a bilevel machine to try this out.

[jdm2857]

Here in the UK they dont tend to do bother with getting a set tritration... they just issue you with an Auto machine and leave it wide open and let it work out what you need and when you need it(

You don't have CPAP police in the UK?

[Pugsy]

I wasn't suggesting the max be lowered. I was asking if it had been tried.
Just to see if it had been tried, did it make any difference with the runaway pressure.
Something is driving the pressure up but I don't think it is leak.
The leak rate line looks pretty darn straight to me, one tiny blip. On the second report with new mask.

What was the overall breakdown on the AHI numbers and leak from the summary page?

[Janknitz]

I'm suspecting your bottom pressure is still too low, and that's forcing your machine to "chase" the events. That may make the pressures go higher. So try gradually upping your lower pressure and see if that helps at all (maybe 1 cm every few nights). It certainly looks like you need a higher pressure than 20 cm, but if you get your bottom pressure raised enough to stop the chasing, it may decrease the top pressure needs.

I'm no good at reading ResMed data--are many of those events centrals, by any chance? If that's the case, then you may need a different approach.

I don't know what to make of those flow limitations--there's something going on there. UARS perhaps????

[Chivalry]

I'm suspecting your bottom pressure is still too low, and that's forcing your machine to "chase" the events. That may make the pressures go higher. So try gradually upping your lower pressure and see if that helps at all (maybe 1 cm every few nights). It certainly looks like you need a higher pressure than 20 cm, but if you get your bottom pressure raised enough to stop the chasing, it may decrease the top pressure needs.

I'm no good at reading ResMed data--are many of those events centrals, by any chance? If that's the case, then you may need a different approach.

I don't know what to make of those flow limitations--there's something going on there. UARS perhaps????

no idea ...... basicly 12 weeks ago i was diagnosed with OSA and sent home with an apap machine .... thats pretty much it..

Also...... about 4 weeks ago i had 1 night,,, my very first that was leak free...... and here is the graphs from that night...

Whats happened in 4 weeks that has made 1 leak free mask be so massivly different to another?

ok,, here it is,,, my results from my first `perfect night`






check that leakage flatline! lol i bet i dont get so lucky 2 nights in a row... hehe

[jdm2857]

Pugsy --

Sorry if I misunderstood what you said.

[snnnark]

Probably a silly question, but are you cleaning the mask seal daily?

[Pugsy]

Oh wow, huge difference.
Anything you can think of that might account for the difference? Added meds, meds taken away, ??? Illness?

[Pugsy]

Pugsy --

Sorry if I misunderstood what you said.

No problem. I probably could have worded it better. Sometimes I forget that people can't read my mind from so far away.

[Chivalry]

Probably a silly question, but are you cleaning the mask seal daily?

the leak free set on stats in the very first post were from a mask fresh out the bag.. brand new.. but even though it was leak free the flow limitation andthe apnea ammounts were massivly differnt to the latest leak free mask in the post above.. :0(


And Pugsy .. nope.. nothing has changed..... no ilness..no medication... no weight gain or anything else that i can think of that may effect it....... its the weirdest thing :0(

[Pugsy]

The old report looks great. Can't ask for much better.

Do you suppose the problem is in the mask? Could it be defective? Loose connection? Anything that might be giving the machine the urge to increase pressure? Could there be a hole somewhere in the hose? It should show up on the leak line but maybe the machine is blowing so much air it is fooling the leak line? Just tossing out maybes here. Check all your connections in the mask, hose and machine & humidifier.

The auto machines do not increase pressure unless it feels there is a need. Sometimes the need isn't events but something else. I don't understand how much flow limitations are factored in here. Obviously the machine is sensing a lot of flow limitations but from where? It does not appear to be chasing events.

This is a puzzler. Forgive me if this question has already been asked but how are you feeling with these results as compared to the perfect night?

[snnnark]

Sleep position? Some people are much worse on their backs.