A few newbie questions - with Data!

[plaqueman]

I have a few questions that I am hopeful you veterans can help me with. I have a Resmed 11, pressure set at 5-15 with auto ramp and EPR of 2, heated tube, and am still trying out different masks, but generally find the f20 Airtouch medium (foam) to be the most comfortable. I need a full face because sometimes my nose gets congested and I mouth breath. My AHI score during my sleep test was 59.2.

1. When I insert the SD card and wait an appropirate amount of time, the machine writes all of the data folders and files onto the card, and it writes the folder for the nightly data. But it does not put data in the file....the daily data file is always empty. What am I doing wrong?

2. With the f20 airtouch medium mask, I am quite comfortable and don't feel or hear any leaks. But my leak rate on it generally reports around 30-35 l/min leak on Myair. But on the same night, the machine will report on the screen that my leak rate was "great." I take "great" to mean acceptable, as opposed to significant. Is that leak rate bad, and if so, why does my machine say "great."

3. If my leak rate is too high, it does not seem to correspond with a bad nightly AHI. In fact, I have recorded a much lower leak rate with the F30i mask, or a smaller size f40 soft touch, but my AHI rate is usually lower with the f20 airtouch medium, even though the leak rate reports as higher than some othe masks. The "alternate" masks will give me a leak rate of virtually zero to 15, but it feels like they are leaking worse, and they have more "blowouts" when pressure ramps up to over 10. The f20 feels better and seems like it fits better, and i don't feel leaks of air blowing into my eyes with it, nor around my nose like with the f30i (Perhaps the foam diffuses the leak air so I don't feel a stream of air.) My apple watch "events" report confirms the results of my air apnea events are accurate. They are always very close, so I have to think the my air app is giving me pretty accurate AHI numbers despite the higher leak rates. FYI, my ahi number with therapy is usually between 7-10, and I would like to get it lower. I feel SO MUCH better though, and posted a succes story in the proper thread with all the details.

Thanks in advance for any suggestions!

[Dog Slobber]

1. When I insert the SD card and wait an appropirate amount of time, the machine writes all of the data folders and files onto the card, and it writes the folder for the nightly data. But it does not put data in the file....the daily data file is always empty. What am I doing wrong?

There are two broad categories of data.
- Summary & Compliance data - these are the totals.
- Detail data - these are the hi-resolution graphs and traces.

The summary data is stored in memory of the device and is written to the SD card upon insertion. The detail data *must* be written during the session, therefore the SD card must be in the device during the sleep session.

If the SD card is not in the machine, the detail data is lost.

2. With the f20 airtouch medium mask, I am quite comfortable and don't feel or hear any leaks. But my leak rate on it generally reports around 30-35 l/min leak on Myair. But on the same night, the machine will report on the screen that my leak rate was "great." I take "great" to mean acceptable, as opposed to significant. Is that leak rate bad, and if so, why does my machine say "great."

Because the screen and MyAir are motivational and not diagnostic. OSCAR (assuming you get your SD card worked out) will properly display your leaks. You can't represent thousands of data points over hours with a single value.

[plaqueman]

That explains it! I was not leaving the card in the machine overnight. I will give it a shot tonight.

Thanks!

[plaqueman]

Last night I left the card in the device overnight, but still got no data. Is there a setting somewhere in the Resmed 11 menu that has to be turned on in order for the device to write data?

[ChicagoGranny]

No.

Was the SD card unlocked? Was it full inserted?

[plaqueman]

The SD card is clicking in cleanly, and the machine is writing a new folder with the date each day for data, but not adding any data. The physical switch on the card is in the unlocked position. I assume it is in properly and unlocked, or the machine wouldn't place a new data folder on the card each day. Perhaps I shoud try antoher card

[plaqueman]

For whatever reason, it recored last night, I was traveling, and got in bed late and had a short night's sleep. But I did get some data, and my total AHI was decent, for me. I will keep building data. While last night was not a good night of sleep, it was indicative of what I struggle with, I think. What I struggle with is that when the pressure goes up in the 11 plus range, I often wake up. I don't want to reset the machine and knock the pressure all the way back down to 5, but I struggle going back to sleep when it is 11-13 pressure. Any suggestions on what I might try with pressure/erp to get the benefit of the machine without the pressure waking me up as much?

Edit: I got a second night for comparison. The first night 9/26 was with the n30i, and the second night 9/27 was with the f20. The f30i seems to reduce apnea events better, and that is the trend when I was not recording data too. It also seems like it is harder for me to exhale through my nose with the f30i than with the f20. Perhaps that is responsible for my improved results but also the reason i find it less comfortable. Suggestions for different mask or tweaks to settings?

https://sleephq.com/public/teams/share_ ... /dashboard

[ChicagoGranny]

I struggle going back to sleep when it is 11-13 pressure

This sounds like the initial phase of mentally adjusting to CPAP. When you awaken, think about something pleasant to distract you from your breathing. Do not concentrate on your breathing. The machine follows your breathing; you don't need to follow the machine's algorithm. It follows you. If you can relax enough to fall asleep, you will breathe gently and naturally. What you have experienced is a typical startup issue.

Your median pressure was 11. Your minimum pressure setting is 5. The range is too wide. Change the minimum to 7.0 as a first step. You can leave the ramp pressure setting at 5. What is your ramp pressure minutes setting?

[plaqueman]

I will make those changes tonight. The ramp is currently set to "auto." Shoud I change it to a set time, and if so, what do you recommend?

I will make the changes tonight, and also wear my new f20 airtouch medium, which arrived today. The f20 med airtouch I had was a knockoff brand, and foam system was much more rigid than the resmed brand mask I received today. I think the mask I received today will seal well and be comfortable. I will know in the morning!

Thanks so much!

[Dog Slobber]

The ramp is currently set to "auto." Shoud I change it to a set time, and if so, what do you recommend?

Leave it on Auto.

When I used to use AirSense, I found It's AutoRamp did a great job of determining when I fell asleep.

Add to that, timed ramp has a problem in that if you do fall asleep it won't provide therapy. AutoRamp monitors events and will exit ramp mode if it needs to.

Since moving to AirCurve, the one AirSense feature I've missed is AutoRamp

[plaqueman]

Thank you for the reply, and suggestion. I am going to leave auto-ramp on, and adjust pressure to 7-15, and try the new Resmed F20 with foam. I should be in for a good night's sleep!

With that said, as bad as my charts look, they are much better than before. I am not getting up any to urinate during the night, vs 3-4 times pre-cpap, and feel much more rested. I think it will only get better as I get used to the mask and get my settings dialed in.

[plaqueman]

Last night (Monday) I used the new Resmed brand f20 airtouch - it was comfortable, I did not have to strap it as tight, and my leak rate was virtually zero. The knockoff brand I had bought off Amazon fit poorly, and the silicon was so firm I had to strap it tight, to no avail.

I also adjusted the pressure settings up to 7-15. I slept better - still had trouble going back to sleep after it woke me up during the night with high pressure, although it may be the apnea event that is waking me up. Then the pressure makes it hard for me to go back to sleep, but I did find the new mask more comfortable and the pressure feeling/leaking less bothersome to get back to sleep.

It was an improvement for certain, and I uploaded two more nights of data. Last night was my record low for AHI events at 6.19

[ChicagoGranny]

I also adjusted the pressure settings up to 7-15.

Do you want us to have a look at your chart?

[plaqueman]

That would be outstanding! I've been trying different masks, and the mask data in sleep HQ may not be accurate. However, the 9/29 (most recent) night's data was with the resmed f20 airtouch, medium, and I have found it to give me the best fit, lowest leak rate, and lowest AHI. I am going to stick with it going forward.

https://sleephq.com/public/teams/share_ ... 663bbc5967

[ChicagoGranny]

https://sleephq.com/public/teams/share_ ... 663bbc5967

Your obstructive apneas plus hypopneas index is about 3. Personally, I like mine to be around 1 or less. Raising the minimum pressure to 9.0 might help. I would do it.

Then the pressure makes it hard for me to go back to sleep,

Your brain might still be adjusting to CPAP. How's your sleep hygiene? Browse the internet for descriptions of good sleep hygiene. Good diet, moderate exercise, relaxation techniques near bedtime, and more. If your sleep hygiene is poor, try to correct just a few things at a time.