events & setting query

Ms Piggy · Post by **Ms Piggy** » Sat Oct 14, 2006 3:44 pm

1st partial night on 420E, due to 1 runny nostril then a blocking nostril, allergy problem, I switched back to old cpap machine for balance of the night as for some reason I felt that a continuous flow of air would stop it blocking and, strangly enough, it did stop. I know 420 has cpap also but I hadn't set it and in the dark I wasn't sure of the buttons anyway.

In June I used a resmed spirit auto for 9 days which confirmed my tritration setting (to my suprise) at 7.

Here is last nights synthesis report for the 3 hrs 44 mins. on apap with the pressure set at a min.6, initial 7 and max 10.

pressure of 6 - 4%: 7 - 10%; 8 - 12%: 9 11%, and a wacking big 10 for 63%, I was really suprised; have felt pretty lousy today.

Events: apneas 1 index 0.3; apneas/CA 1 - 0.3; hypops 0 - 00;
acoustical vib. 1 - 0.03: runs 189 - 50.6. Leaks 1.6L/sec.

That doesn't sound too bad, but I don't know enough about it, the pressure rise concerns me. Would it be as well to leave the setting the way it is for a week or so or change it now? to maybe 5 or 6 to 12??

I turned it off for bathroom break, was that right? I thought "on" may show as a massive leak! no pun intended of course.

Any info will be greatly appreciated.

snoozie_suzy · Post by **snoozie_suzy** » Sat Oct 14, 2006 6:23 pm

It sounds from the like of it, that you spent a good portion at 10, and that the machine possibly would have gone higher, but that was your Max number. Perhaps reign the numbers in a little tighter, like 8cm for your low and 12 for your high. Your numbers look good for your data though, perhaps you're feeling lousy because it could have stood to go a slight bit higher than 10cm. Try dialing the numbers in a little tighter. Many others here on this forum have reccomended doing so and most people do better with the high and low a little closer together.

turning it OFF for bathroom breaks is a good thing!

Suzy

Peterau · Post by **Peterau** » Sat Oct 14, 2006 6:45 pm

Ms Piggy

Hi. Couple of things with the numbers you posted. I believe your leak rate may be an issue. I don't know what mask you are using but 1.6 is very high. I use a Hybrid mask which has one of the highest leak rates and my leak rate is .7. You may want to fill in you profile with the equipment you are using so the people here can fous in on any equipment related issues you may be having. As to switching the 420 off for a bathroom break you can, I don't the 420 will switch into an idle mode when you take the mask off or have a major leak. It will show up in the detail information but then that is what happened for the night. You could lift your upper pressure a couple of CM to give the Auto some more room to move but I think you need to sort the leak rate problem first.

Peterau

Ms Piggy · Post by **Ms Piggy** » Sat Oct 14, 2006 9:00 pm

thank you both. i realized too late I had not stated which mask, I used a Breeze nasal pillows, which if I slack off too much, to avoid the piggy nose, tends to leak when I turn over. I will change the range- extend the upper and crank up the nose peice tonight, and probably try the CL2 on another night.

rested gal · Post by **rested gal** » Sat Oct 14, 2006 9:40 pm

Ms Piggy,

I'm not a doctor, but here's what I'd try.

If you raise the upper pressure and find you still hit it too, try turning off IFL1. You can turn it off in the menu if you use the buttons (it's called "FL" if you use the buttons), or use the software to go into the clinical menu, then into the "Advanced Settings", where it's called IFL1.

In Advanced Settings, turn off IFL1, but always leave IFL2 on. Leave "Maximum pressure for Command on Apnea" set at 10 in the Advanced Settings.

Using the buttons, IFL1 is called just "FL" in the display window.

Using the software, IFL1 is called IFL1...in the Advanced Settings.

See what kind of pressures get used with IFL1 turned off. If you don't hit the ceiling of your range anywhere near as much with IFL1 off, leave it off from now on.

ozij · Post by **ozij** » Sat Oct 14, 2006 11:23 pm

Ms Piggy:
The vent flow of the Breeze - which I take to mean the rate at which air escapes the vent - for a pressure of 10 is 23 L/min. Masks leak more than the vent flow, so we can't expect to be at the vent flow rate.

However, your leak rate, of 1.6 L/sec translates to 1.6*60 = 96 L/min - that seems huge. The Breeze's vent flow rate , at a pressure of 35 is 40.

Here' where you can get detailed leak data in Silverlining:

Click on the "Details" tab:
In the middle of the screen, click on the button that has two squiggly lines on it.
That should open the pressure and leak graphs on the right part of the screen.
Your leak rate, in green, will show as green dots on the yellow background, the maximum leak rate will show in pink, on the same yellow graph. If the green line is consistently above the pink, you're not getting any therapy at all, and the AHI is meaningless.
Edit Oct. 18: The last was a wrong sentence - having given it some thought, I am now convinced that when leaks overwhelm the machine, they will be seen as a single spike above the >4 column. You can however find good info about the time spent in those high leaks by looking at the left panel of the "Details" screen in the "Pressure" area - and by looking at the the average pressur, as explained in the next paragraph.

Click on the "Pressure" tab, and then on the histogram (colored columns) button in the middle of the screen (it might be the default presentation).
In the middle of the right side of the screen, you'll get info about your:
Average leak (min, max)
Low Leak (min , max)
High Leak (min, max)

Can you tell us what those numbers are?

Here's a link to Setting up the Breeze. The Breeze has many "tinker" points to it - you should really try them all.

In addition, women have different skull shapes from men - and I - a woman - find that a folded, thick cotton sock under the outrigger - part 8, (forward stabilizer part on top of the head) is very helpful. It lets me pull out the other partts, and not suffer from "piggy nose".

O.

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

Ms Piggy · Post by **Ms Piggy** » Sun Oct 15, 2006 8:19 pm

thanks for the replies.
Had a leaky night last night, set up not good I guess - pressure was set at
6 to 15 & 7 theIFL1 was on and the 2 was off, i have now reversed them.
and set the pressure to 6 -12 & 7 and pressure for Command Apnea set at 10 in advanced settings.
Last night I had lots of leaks& snored plus bloated, altho had mouth taped but it leaked, ranged thru the settings up to 15 - awful night, changed to CL2 around 6 a.m. and when things gradually calmed down from 15 it was the lowest leak period of the night at 0.4 and 0.5. a score of 1 apneas .1 index; 2 apneas/CA .3; 15 Hypopneas 2.0; 5 hypopneas(FL) .7:
5 accoustical Vib .7 ; Runs (FL) 355 index 47.4 . for the 14th.
The Green Line was below the pink with the exception of one big spike above.
the Average leak 0.83 .57 - l.16
Low leak 0.57 .42 - l.l6
High leak l.l6 .68 - l.l6 these figures are for the 2 nights average. i didn't get the individual.
I coundln't wait to use the stuff even though I don't know much about it yet. It's just like being a "Newbie" again. goodnight, sweat dreams..
I actually had a few dreams lately for the first time. Hope this makes sense, I am tired.

Ms Piggy · Post by **Ms Piggy** » Mon Oct 16, 2006 11:36 am

thank you all for your good advise, your replies are so helpful and encouraging when you are feeling 'lost'.

I have, or we have, got the little beast under control it would seem, RG's switching off the IFL1 etc must have done the trick. My results this a.m. look much better, yesterday's gave me a jolt!
average presure used 6.3 , it only ran at 6 and 7 pressure, and was set at low 6 high 12 and 7. maybe I should adjust this a bit.

zero apneas; apnea/CA l 0.1 ; hypops 5 0.7; zero hypops FL; acoustical vibrations 2 0.3; Runs 328 43.3. not sure if all of it is good as have to find out what the last 2 mean.

LEAKS averaage 0.50 low 0.49 high 0.50 using CL2 mask w nasal pillows.
will try the Breeze again soon, after all we were not used to 15 Pressure!

I had already bent the metal bar on the Breeze to fit closer to my head so cannot try the sock idea, but will see how it goes and do more adjustment and keep that in mind, thanks for the link.

Have you any idea what figures i would need to print to show the sleep doc. ? As I only see him once a year I can't give him too much to plow through!
he wouldn't have time..

ozij · Post by **ozij** » Mon Oct 16, 2006 2:25 pm

Ms Piggy wrote:...Have you any idea what figures i would need to print to show the sleep doc. ? As I only see him once a year I can't give him too much to plow through!
he wouldn't have time..

You can export synthesis data from the right panel - it will give you text file with most of the pertinent data.

Keep in mind that Silverlining only keeps 200 (two hundred) sessions of data - when you're at about 198 save copy you *.pat file to another name (firs200) and clear the session data so you have a new clean 200. you can eventually decide if you want to show the doc the last 200 hundred sessions, or if you want to combine info from more.

O.

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

ozij · Post by **ozij** » Wed Oct 18, 2006 11:10 am

I've just edited a previous message on this thread - I believe I wrote somthing wrong, here it is with the correction.

[quote="ozij"]Ms Piggy:
The vent flow of the Breeze - which I take to mean the rate at which air escapes the vent - for a pressure of 10 is 23 L/min. Masks leak more than the vent flow, so we can't expect to be at the vent flow rate.

However, your leak rate, of 1.6 L/sec translates to 1.6*60 = 96 L/min - that seems huge. The Breeze's vent flow rate , at a pressure of 35 is 40.

Here' where you can get detailed leak data in Silverlining:

Click on the "Details" tab:
In the middle of the screen, click on the button that has two squiggly lines on it.
That should open the pressure and leak graphs on the right part of the screen.
Your leak rate, in green, will show as green dots on the yellow background, the maximum leak rate will show in pink, on the same yellow graph. If the green line is consistently above the pink, you're not getting any therapy at all, and the AHI is meaningless.
Edit Oct. 18: The last was a wrong sentence - having given it some thought, I am now convinced that when leaks overwhelm the machine, they will be seen as a single spike above the >4 column. You can however find good info about the time spent in those high leaks by looking at the left panel of the "Details" screen in the "Pressure" area - and by looking at the the average pressur, as explained in the next paragraph.

Click on the "Pressure" tab, and then on the histogram (colored columns) button in the middle of the screen (it might be the default presentation).
In the middle of the right side of the screen, you'll get info about your:
Average leak (min, max)
Low Leak (min , max)
High Leak (min, max)

Can you tell us what those numbers are?

Here's a link to Setting up the Breeze. The Breeze has many "tinker" points to it - you should really try them all.

In addition, women have different skull shapes from men - and I - a woman - find that a folded, thick cotton sock under the outrigger - part 8, (forward stabilizer part on top of the head) is very helpful. It lets me pull out the other partts, and not suffer from "piggy nose".

O.