input on my EncorePro report please

girlsaylor · Post by **girlsaylor** » Thu Mar 22, 2007 7:12 pm

Here's my report from last night. Please offer suggestions.

Thanks!

girlsaylor

jskinner · Post by **jskinner** » Thu Mar 22, 2007 7:54 pm

I think I would try increasing the pressures a bit. (assuming your not central prone?) I'll leave the real analysis to the more expert members here though. (particularly since its BiPAP)

Goofproof · Post by **Goofproof** » Thu Mar 22, 2007 7:58 pm

A lot of your problem came from excessive leak rates. If leaks aren't under control, nothing else will work. Jim

I couldn't take the Hybrid, any time my leak rate goes over 40, my numbers go bad. If I can hold the leak rate 32 to 38, I'm in good shape, If higher I pay the price.

Snoredog · Post by **Snoredog** » Thu Mar 22, 2007 8:01 pm

I think you need to increase Minimum EPAP from 8cm to 10cm, other than that it is not too bad with a AHI=5.4. Leak could be improved, try and keep any leak below 50L/m.

Your goal should be to get those OA's a bit lower, if you count up the runs you had 4-5 of them, most likely in REM sleep during those periods.

You could also do nothing because your report really doesn't look all that bad.

SleepySandy · Post by **SleepySandy** » Thu Mar 22, 2007 8:04 pm

I don't have a bi-level so I don't understand much of this report.

Why are OAs listed under EPAP? Wouldn't obstructive apneas happen when you're inhaling? And why would there be so many OAs? For example, I think it's showing her OAI is 10.3 when the exhalation pressure is 11. Why wouldn't it just go to a higher pressure to prevent those apneas?

Straight CPAP reports are so much easier to read. I would like to understand this bi-level stuff, though. It's very interesting.

Snoredog · Post by **Snoredog** » Thu Mar 22, 2007 8:10 pm

[quote="SleepySandy"]I don't have a bi-level so I don't understand much of this report.

Why are OAs listed under EPAP? Wouldn't obstructive apneas happen when you're inhaling? And why would there be so many OAs? For example, I think it's showing her OAI is 10.3 when the exhalation pressure is 11. Why wouldn't it just go to a higher pressure to prevent those apneas?

Straight CPAP reports are so much easier to read. I would like to understand this bi-level stuff, though. It's very interesting.

bdp522 · Post by **bdp522** » Thu Mar 22, 2007 8:13 pm

The chart seems to show about an hour with the machine at the ipap of 15. Wouldn't it be a good idea to raise the ipap? Would it have helped stop those apneas?

Brenda

Goofproof · Post by **Goofproof** » Thu Mar 22, 2007 8:38 pm

bdp522 wrote:The chart seems to show about an hour with the machine at the ipap of 15. Wouldn't it be a good idea to raise the ipap? Would it have helped stop those apneas?

Brenda

If it wasn't chasing leaks, but it was. More pressure makes more leaks. After the leaks are controlled bringing the lower pressure up a little so the machine can get control faster may help, but the first order of business is get the leaks controlled, even if it takes a mask that has a better leak ratio. Jim

I don't do Bi-PAP, but I fight leak rates.

Snoredog · Post by **Snoredog** » Thu Mar 22, 2007 8:49 pm

Goofproof wrote:
bdp522 wrote:The chart seems to show about an hour with the machine at the ipap of 15. Wouldn't it be a good idea to raise the ipap? Would it have helped stop those apneas?

Brenda
If it wasn't chasing leaks, but it was. More pressure makes more leaks. After the leaks are controlled bringing the lower pressure up a little so the machine can get control faster may help, but the first order of business is get the leaks controlled, even if it takes a mask that has a better leak ratio. Jim

I don't do Bi-PAP, but I fight leak rates.

I agree, the top green line on the report is IPAP maxium, between hour 1-2 there was flat-lining indicating it was bumping up on 15cm pressure, so when you look down at the leak rate it gets up over 75L/m which was probably why it was running the pressure up. The rest of the night leaks were under better control and the pressure stayed down well below 15cm on IPAP. It depends on the event and the PS setting, I'd say the PS setting is at 3cm?. If you had flat-lining like between hour 1-2 and leak was normal, then I'd say you need to increase the IPAP ceiling.

bdp522 · Post by **bdp522** » Thu Mar 22, 2007 9:38 pm

I think I've got it now. Thanks guys!

Brenda

MikeRobert · Post by **MikeRobert** » Fri Mar 23, 2007 12:18 pm

I guess I am showing my ignorance here. According to a leak rate site that I found on the forum, the vent rate for a Hybrid @ 15cm is 60L/M. Do I have bad info? Or am I misunderstanding it?

girlsaylor · Post by **girlsaylor** » Fri Mar 23, 2007 6:00 pm

Thanks for the input all.

As for the questions, my pressure support is set at 7, the max it will go with the 15/8 pressures setting.

I'm also interested in this leak rate site, as when I called Respironics to ask about the leak rate, I was advised it was within what they would consider normal system leak. Hmmmmm

As far as being central-prone, it was noted on my titration night that with straight cpap I was getting centrals; it was listed as the reason they switched to bipap.

The general consensus seems to be if any numbers are to be changed, possibly the EPAP could be a bit higher. And, the leak numbers are confusing to me, particularly with the post from MikeRobert....

girlsaylor

Snoredog · Post by **Snoredog** » Fri Mar 23, 2007 7:08 pm

[quote="girlsaylor"]Thanks for the input all.

As for the questions, my pressure support is set at 7, the max it will go with the 15/8 pressures setting.

I'm also interested in this leak rate site, as when I called Respironics to ask about the leak rate, I was advised it was within what they would consider normal system leak. Hmmmmm

As far as being central-prone, it was noted on my titration night that with straight cpap I was getting centrals; it was listed as the reason they switched to bipap.

The general consensus seems to be if any numbers are to be changed, possibly the EPAP could be a bit higher. And, the leak numbers are confusing to me, particularly with the post from MikeRobert....

girlsaylor

Snoredog · Post by **Snoredog** » Fri Mar 23, 2007 7:12 pm

MikeRobert wrote:I guess I am showing my ignorance here. According to a leak rate site that I found on the forum, the vent rate for a Hybrid @ 15cm is 60L/M. Do I have bad info? Or am I misunderstanding it?

No you are correct, that mask has a much higher leak rate than other masks.

Goofproof · Post by **Goofproof** » Fri Mar 23, 2007 7:57 pm

Snoredog wrote:
MikeRobert wrote:I guess I am showing my ignorance here. According to a leak rate site that I found on the forum, the vent rate for a Hybrid @ 15cm is 60L/M. Do I have bad info? Or am I misunderstanding it?
No you are correct, that mask has a much higher leak rate than other masks.

And that is why I wouldn't waste my money on it, unless it came with a new Remstar APAP, that had a modified flow rate of twice normal. You can't design a mask leak higher than the pump can handle. that doesn't make sense to me but they still get customers.

input on my EncorePro report please

input on my EncorePro report please

filling in the blanks

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