First Time to cpaptalk and questions on some readings

[Pugsy]

The leaks had zero correlation with the 20 cm max. The leaks happened when the machine was at it's highest point of pressure being delivered which is 14.5. The machine being able to go to 20 doesn't do anything if it doesn't go to 20.
If the machine could go to 100 and you set the max to 100 and it never goes beyond 15...the max setting becomes a moot point.
However limiting the max does potentially let apnea events or warning signs happen.
This will be true with your new ResMed machine as well....just remember that.

Now with Respironics machines...and leak lines...
Some of that increase in the leak line is nothing more than normal reflection of the pressure.....the pressure goes up and the leak line goes up because of how these Respironics report leak. Respironics report total leak which is mask venting plus any excess leaks...more pressure means more venting so the total leak is going to go up and it doesn't mean it's always excess leak.
Yes..you did have some excess leak as well and it went to large leak territory and likely woke you up since you changed the maximum.

So...when the machine did go to 14.5 probably in response to the snores....I don't know if the sensor is faulty or you are having real snores which are indications of the airway trying to collapse. Given the amount of snores and the fact that sometimes this does mean a faulty machine sensor....I think it is good you got the new machine. Lets see what it reports as snores.

[xathras1982]

Hi All,

So, the new CPAP arrived yesterday. I set it up and give it a whirl. Existing mask (Quattro Full Face) and no chin strap so i could do some side by side comparisons.

Overall, I felt a great night considering :
a) My wifes cat seemed to harass me around 11ish - which led to me briefly switching off treatment whilst I put him outside of the bedroom
b) The weather outside was pretty loud and since had window open the noise at 5:30am was too much and was cold

Good signs:
* Snore was way down
* Leak rate looked excellent
* The increased AHI I observed time with some events I moved in my sleep when wife came into bedroom much later
* There seems to be a much better improvement on the events graph

Despite it being under 6 hours. I felt like I had good quality sleep.

Here is a chart from last night.

Wayne

[Dog Slobber]

I'd rearrange the charts a bit, it's difficult to see the exact values your traces are at.
Remove either Pressure or Mask Pressure, add Flow Limitation. Increase size of the remaining Pressure.

You've left the machine at the default pressure range of 4-20. That likely explains the increased AHI. I'd set the minimum pressure to 9, that's what your previous machine had.

Then we'll watch how you do for a few days. You're also in for Her mode. Nothing wrong with that. After a few days on 9, consider trying Not-for-Her mode, and compare.

[Pugsy]

The for Her mode does something a little different with the pressure increases and might account for the perception that your pressure went up and stayed up all night.

When we have 2 OAs within a couple of minutes it automatically adjusts the minimum pressure upwards in hopes of preventing the OAs better. So the 01:45 little cluster might have had something to do with the fact the minimum didn't go down much after that.
It will do this even if the flagged OAs are false positive arousal related.

Did you ever go to sleep before the cat came in to annoy you at the beginning of the night?

[xathras1982]

Here we go with the changes per request. I'll make the modifications tonight and see how things go.

[Amishboy51]

My apologies if I’m slightly hijacking this thread, but I’ve always wondered but didn’t want to ask, what’s the difference between the “for her” and “not for her” AirSense?

[So as to keep this somewhat “clean,” let me be clear that I’m referring to ResMed’s intention. ]

[Pugsy]

what’s the difference between the “for her” and “not for her” AirSense?

The for Her AutoSet machine has 3 modes of operation
CPAP mode....fixed single pressure
Auto Mode....auto adjusting single pressure...regular auto algorithm
For Her Auto mode....a different auto adjusting mode....different auto algorithm.

The regular AutoSet machine has 2 modes of operation
CPAP mode
Auto Mode
It lacks that 3rd auto/apap algorithm.

Otherwise the 2 machines are identical.
That 3rd optional auto algorithm may or may not be of benefit to some people but it's always better to have something and not need it than need it and not have it...IMHO.

[Miss Emerita]

Wayne, congratulations on the new machine! I'm glad to hear you had a good first night with it. It'll be interesting to see how things go with the higher minimum pressure.

I like your commitment to making one change at a time. After you give a new minimum a few nights and see how that goes, you might want to consider turning on some EPR (expiratory pressure relief). That's a bit like flex on PR machines. You can set it to 1, 2, or 3, and that will be the amount the pressure drops when you exhale. The reason I mention this is that it might help to reduce the flow limitations and hypopneas.

Before adding any EPR, though, you'll want some expert advice based on the results from the new minimum.

[Amishboy51]

Thank you once again, Pugsy, for clarifying.

(But, honestly, if the main difference is an additional feature, which seems to have no connection to gender, could ResMed have thought up a stupider, less effective name than “for her”? )

[Pugsy]

Thank you once again, Pugsy, for clarifying.

(But, honestly, if the main difference is an additional feature, which seems to have no connection to gender, could ResMed have thought up a stupider, less effective name than “for her”? )

I have said all along that ResMed shot themselves in the foot with the gender specification target marketing.
It has more to do with appeasing the female market who has rightfully complained about the products still not being really designed with women in mind than it does with functionality. There's no reason in the world that a man might not benefit from that extra mode.
At least they went with leaves instead of flowers or that horrid pink color.

My personal opinion....ResMed should save money and just make one AutoSet and have it include the 3 modes and be done with it.
But they haven't asked my opinion yet and it's doubtful they ever will since ResMed (and the other brands) don't really see us as their customers....they see the DMEs and doctors as their customers and everything they do is with those customers in mind.
We are just peons in their eyes.
There's a lot about what ResMed does that I simply don't care for but they do make good products...so while I am known to cut off my nose to spite my face sometimes....I won't in this case. At least I did a small rebellion when I switched from the P10 to the Bleep.

[xathras1982]

Day 3 of the new machine.

Changes here:

• Changed pressure to minimum of 9 and max of 20
  I also have started to use the Humidifier. Don't normally use but was reading this can help for those with nasal congestion

Results I see today:

• My AHI in places was higher. I see flow limitation in places was higher. Not sure how to understand why
  Slept longer (YAY). Last few days were shorter due to our cat waking me up

My wife has commented the machine is a lot quieter and snoring is way down (or a lot quieter).



Unfortunately, I missed day 2's therapy data as I forgot to put the memory card back in and only got high level data.

[Pugsy]

For tonight....change over to the regular apap mode and out of the for her apap mode.
Same settings though.

The clusters of Flow Limitations also tend to come at the same time as the clusters of OAs. Not unexpected at all.
Flow limitations are reductions in air flow that don't make criteria to be called an OA or hyponea.

[xathras1982]

Here we go. Not as much sleep last night but had a few drinks and when i woke up around 6:30 for rest room couldn't get back to sleep.

I did have humidity up to max last night (you'll see that as a wake up). At one point that caused my Quattro Mirage start making some interesting gurgling sounds and thus I switched over to airfit F30 mask i had recently bought - that went very well i though.

[Pugsy]

Do you have a heated hose or non heated hose?

[xathras1982]

Do you have a heated hose or non heated hose?

Non heated hose