Brick Died...

[Guest-a99415f]

Hello,

I've had two bricks since 2002. After tests on an autoset (could not sleep at the center with wires), Doc recommended nasal CPAP 6cm H20 for OSA, no Central Apnea and return in a month. AHI ranged from 3.9 - 6.9 for the four day autoset test at home. Max pressure ranged from 5.4 - 7.2. Could not tolerate humidifier with the test, as it caused asthma.

Over the years titrations yielded 11cm with ramp. Then at least 10 yrs ago 9cm with ramp, then a year later 8cm w ramp. Can't do a study right now. Been sleepy for a year. Asthma, allergies, pneumonia several times in 10 yrs, nebulizer machine at home if needed, steroids when I get sick and expiratory wheeze is common. Sleeping light and waking at least twice nightly, sometimes more. Sound of motorcycles passing...oh never mind, just took my mask off while sleeping. (Eson nasal mask) Most current CPAP setting is 8.0 for years now.

I borrowed an Intellipap DV54 Auto for a few days. Wow, there's data available now. With autoset, I still woke tired. Wonder if I slept light and woke each time it tried to raise pressure, no idea. Data below:
SmartCode - FB7F-F9D-F3K6
95th % pressure - 6.5
90th % pressure - 6.0
Pressure Plateau time - 0%
Apnea/Hypopnea Index - 5.0
Non-Obstructive Index - 1
Exhale Puff Index - 0
% High Leak Flow > 95 L/m - 0%
The DV54 will not be my machine. I have access to a Dreamstation that has several modes. DSX700###. I will need a load of help if I use that one as it can be CPAP, BIPAP, BIPAP AUTO. Would this be a good fit? Look for another machine? If so, I will save up. Skill to change the DSX700### = 100%. Knowledge & wisdom to make changes = 0%. Help?

Burying the Brick and hoping for help. Registered over 2 weeks ago, but not activated yet.
Thank you in advance oh ye of much knowledge.

[Pugsy]

It should do a fine job for you. Get it and we can help with the settings and using the software available to see the data it gathers.
See here for a couple of examples
viewtopic/t103468/Need-help-with-screen-shots.html

I have the one model older in the same Respironics machine...the PR S1 model 760 BiPap Auto.
It's not hard to figure out.

Go here and request the clinical manual so you can read up on what it offers.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

[chunkyfrog]

Congratulations. You done good.

[Goofproof]

Bury it deep, sometimes on a full moon they dig themselves out. Jim

[chunkyfrog]

Donate it to a mad scientist.

[Guest-a99415f]

Thank you all for your replies.

@ Pugsy >>It should do a fine job for you. Get it and we can help with the settings and using the software available to see the data it gathers.
See here for a couple of examples
Link removed.
I have the one model older in the same Respironics machine...the PR S1 model 760 BiPap Auto.
It's not hard to figure out.

Go here and request the clinical manual so you can read up on what it offers.
Link removed.

1. I requested the manual via email.
2. Sleepyhead is loaded and I will practice screenshots tonight.
3. DSX700### in hand. I can get into the clinical menu. Anxious to sleep tonight. Any guidance on settings is appreciated.
4. Very dry nose & throat lately. From snoring? Air in nasal Eson mask?

Thank you!!
MLK "I have a dream." Guest-a99415f "I want to have a dream."

[Pugsy]

I have no idea at all what settings to try because we don't know what was going on with the old brick.

Gotta start somewhere though.

I would give these a try and see what happens. Fully expecting to probably need to tweak them a bit.

Auto mode...might as well make use of it and see where it wants to go.

Minimum EPAP...7

Maximum IPAP ...20

Minimum PS...3
Maximum PS...4

BiFlex...that's a comfort feature. I suggest people try all the settings including off and simply use the one that feels the best to them no matter what the setting.

[Guest-a99415f]

All settings are entered. Since my login registration is not completed, I don't think I can post SH screens. I will go back and read your notes again to see if that was explained on how to provide you the data if not logged in as a registered user. Meds = bronchodilator and BP pills.

Looking forward to sleeping.
Guest-a99415f

[Pugsy]

If you use imgur to host your image and post the url address and make a space or substitute (dot) for .com
we can usually figure out how to go look at the image.
It won't be an active link as long as we can change it a little we can use it.

[nickdanger1]

Ding Dong the brick is dead

[D.H.]

If you did wake each time the pressure went up (as you theorized), you would need to raise the minimum pressure to prevent this from happening.

Als0, if you have an auto, you can still put it in set mode and the pressure won't change. Alternatively, you can set the min and the max to the same number.

[Guest-a99415f]

I am having trouble sending you the file info, since my registration is not yet completed. I have changed the url string multiple times, but I keep getting rejected. Are you able to see the files on the imgur website by going directly to imgur? Or are you able to piece these together by looking at an old file you have to get the missing pieces that belong at the end so it won't be a large file for you?

Hopefully my registration sent on Aug.2 will be ready soon, so that I can post.

AHI was 0.92.
I woke up 4 minutes before the clock rang and it was set extra early. I had energy for at least a couple of hours. Then I ran out of gas. Hoping each day improves. BIG leak. Getting a new mask this week. Any other suggestions to tweak? My nose is really stuffy...still. I set humidity at 1, since I have asthma, I can't afford it higher.
Thank you so much!

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[Pugsy]

I can't do anything with that address because there are other // and stuff missing and I don't know where to put them.

That's okay for now though.
The setting of 1 is really a very low setting. I don't know if your lungs will rebel with more humidity or not but often people with asthma say that the moisture helps.
If it doesn't with you then you need to hydrate the nasal mucosa really well before bed...Something like Simply Saline used a lot right before bedtime might help.

What is telling you that you had a big leak and how much was it?
Was it the SleepyHead statistic that you spent so and so Percent of the time in large leak or did you see big Large leak flags on the events graph?

AHI is nice and low...leave the settings alone for now.

[Guest-a99415f]

From SH - Here are the daily statistics.
Statistics
Channel Min Med 95% Max
EPAPExpiratory Pressure (cmH2O)
W-Avg: 7.15 4.50 7.00 8.30 9.70
IPAPInspiratory Pressure (cmH2O)
W-Avg: 10.22 7.50 10.00 12.00 13.70
PSPressure Support (cmH2O)
W-Avg: 3.08 3.00 3.00 4.00 4.00
Minute Vent Amount of air displaced per minute (L/min)
W-Avg: 6.45 0.12 6.25 9.88 34.25
Resp. RateRate of breaths per minute (Breaths/min)
W-Avg: 14.66 7.60 14.60 17.80 50.00
Leak RateRate of detected mask leakage (L/min)
W-Avg: 8.70 0.00 0.00 44.00 57.00
Total LeaksDetected mask leakage including natural Mask leakages (L/min)
W-Avg: 37.80 18.00 31.00 75.00 88.00
SnoreGraph displaying snore volume (?)
W-Avg: 0.08 0.00 0.00 1.00 4.00
Insp. TimeTime taken to breathe in (Seconds)
W-Avg: 2.05 0.50 2.00 3.04 10.08
Exp. TimeTime taken to breathe out (Seconds)
W-Avg: 2.09 0.10 2.14 3.40 5.40
Tidal VolumeAmount of air displaced per breath (ml)
W-Avg: 438.85 13.33 420.00 700.00 2693.33

Time over leak redline 15.795%
---------------------------------------------------

Philips Respironics DreamStation
Auto BiPAPModel 700X110 - J18539928EB70
PAP Mode: Auto Bi-Level (Variable PS)
Min EPAP 7.0 Max IPAP 20.0 PS 3.0-4.0 (cmH2O)
Date Sleep Wake Hours
8/14/17 23:10:40 06:46:31 07:35:51
Periodic Breathing 2.00%
Large Leak 8.96%
Clear Airway 0.00
Obstructive 0.26
Hypopnea 0.66
RERA 0.39
Flow Limitation 0.26
Vibratory Snore 0.26
Vibratory Snore (VS2) 1.58
Breathing Not Detected 0.00%
Pressure Pulse 0.39
-------------------------------
Large Leak 3 events
#001: 05:22:00 (438)
#002: 06:11:16 (1132)
#003: 06:34:43 (882)
-------------------------------

=) Thank you for reviewing the data.

[Pugsy]

Okay, you had some large leak but it was less than 10%.

This one

time over leak redline 15.795%

is based off the wrong baseline number. SleepyHead defaults to a ResMed excess leak number and Respironics machines don't use that same number.
Go to Preferences/CPAP tab and on the right you will see the red line leak stuff...the default is 24 L/min which is where ResMed's large leak territory begins. Your Respironics machine reports leak differently and uses a different red line for large leak territory.
Respironics never tells us an exact red line number because it can vary quite a bit with masks used and pressures used and even more so when variable pressures are used.

Either turn that statistic off by removing the check mark or change the 24 L/min to something more in line with your machine with your mask and pressure. If I could see the screen shot I could maybe get a close idea where that might be but for now change it to 60 L/min and we can adjust it later if that's not close. It's a nice conservative number..more likely your threshold is a bit higher but it hurts nothing to be conservative.

Large Leak 8.96%

Now this data point is correct because it comes from the machine and not SH doing calculations.
So yes...you had some large leak but not as much as the other statistic says.
At this point just watch it and do what you can to try to reduce it but if it isn't waking you up...it's not horribly horrible.
Any leak that wakes us up is unwanted because it disturbs sleep even if it isn't a large leak.

Keep the same settings...I think they probably will do well for you.
Don't worry about the PB time right now. It's not very much and there's a good chance some of it is awake breathing anyway.