First night with Elite, and have some questions...(long)

[lummusc]

First of all, thank you to all who responded on my "overwhelmed" post. that helps more than I can say.
I used my elite last night, and it is much noiser than my escape was. I'll try to describe the noise.....it seems like it is cycles through loudly each breath, the loudest part of the cycle seems to be when I inhale (does that make sense?) It also seems to be "whining" (kind of like me, huh?) or whistling (not really whistling, just don't know how to describe it).
It was so annoying, that I went into the menu and put the EPR(I think that's the initials) on "OFF" thinking that maybe that was the noise. It might have helped some, not much though. Then I thought it might be the ramping, but I only had it on a 5 minute ramp, and it didn't seem to quite down after the ramp stopped. I put earplugs in, and it helped some.
The escape wasn't "whisper quiet" but it didn't seem to cycle through an up and down kind of noise. If the noise was a constant sound, it would be more like "white noise" and it probably wouldn't bother me, but the up and down is annoying. My husband wasn't here last night, but he will probably complain.
Also, I pressed stop this morning after I took off the mask, and it is quiet, seems to be off, but there is a small stream of air coming from the mask, as if it is still on?
Okay, now for my numbers, if you don't mind telling me basically what they mean for me?
My pressure is 10 ( think I understand that one) this was set by the DME
Leak 0.16 (am using the Breeze, and have the setting on the mask setting to "standard" since they only offer the ResMed masks as choices.
AHI is 5.1
AI is .6
HI 4.5
I don't really understand exactly what these numbers should be telling me, I mean, I know that it is apnea/hypoapnea index, but which is worse, and why are the numbers still so high?
Is there any other numbers or data in the machne that I need to be looking at?
I am seriously considering buying the AutoScan software and the card reader to help me with this, although I don't need to spend over $200 dollars right now. Do you think it will still be available in a few months, or will ResMed make Cpap.com quit selling it?

I am so sorry this is so long, but I am so lost, and appreciate all of you for your help.

[DreamStalker]

Who knows if the software will be available in a few months. A year ago it would not have even been a question. The software becomes more useful when you have an “auto” adjusting machine … aside from that, it only makes keeping a record of your daily data more convenient when used with an S8 Elite.

I would not say those numbers are high. Generally, anything less than 5 is good. Apneas (complete airway obstruction) are often worse than hypopneas (partial airway obstructions). In addition, some feel that the ResMed machines are extra sensitive to counting hypopneas.

Your leak rate is also acceptable although I always was able to get zero leak rate when using my Breeze with the ResMed machine set to either standard or Swift mask setting. That is because the mask setting for ResMed machines subtracts the leak rate designed for ResMed type masks (all of which are generally higher than the Breeze).

The numbers you listed are the only really important numbers for monitoring and tweaking your treatment. The DME is generally only interested in compliance hours so they can bill your insurance.

Machine noise seems to be different for each individual machine. My first machine was an Elite and it was super quiet. Then I got to trade it out for a Vantage and the Vantage sounded as you describe your Elite to be. Then I got a new Vantage as part of the ResMed recall and it sounded quiet like my Elite did. I also have the Remstar auto “tank/classic” and it is super quiet and I recently got an M series w/ AFLEX and it too is super quiet. Guess I have been lucky.

[RosemaryB]

I don't have a ResMed machine, but occasionally, my Remstar will become noisy. This occurs when things aren't hooked together quite right. Just in case that's happening, you might want to make sure everything is fitting tightly together, humidifier, hoses, etc.

The mask leaking sounds unusual.

[RiverDave]

lummusc,

I use the Vantage line and at times have noticed the same noise issues you have (the whining and whistling). When the machine is turned off, it does continue to blow small amounts of air through it for a while - wish I knew why.

Your numbers look good, especially for the first night on a new machine. Your leak rate is OK, but zero is better. For me, my leak rates went down after I had adjusted to the machine. Your AHI is supposed to be 5 or less, so you are close.

Leak rate, AHI and pressure are what you need to be keeping up with. The only other data your machine is keeping up with the compliance and duration information (how many nights and how long each night you used the machine)

The software makes it easier to keep up with these numbers and to look at trends in the data. So if you are interested in the details of your therapy, its a benefit (in my opinion, anyway). Ass to availability - my crystal ball quit working a long time ago.

Good Luck,

[DreamStalker]

Forgot to add .. the ResMed machines continue to blow air at a low rate after turning them off to help remove moisture that may be left in the hose.

[darthlucy]

I agree with most of the comments, but am curious about the leak rate responses. The S8 Elite manual says that treatment could be compromised if the leak rate is over 0.40 L/s, and someone here (Slinky maybe?) said she was happy if her S8 leak rate was under 0.30. I typically get around 0.26 L/s, though one night I went as low as 0.16 L/s. Obviously 0 is always better, but isn't 0.16 L/s pretty darned good anyway? Especially for a newbie, I'd hate to see them get discouraged for not having a zero leak rate if that's pretty tough to accomplish.

[DreamStalker]

My comments were specific to using the Breeze. The Breeze leak rate is lower than the Swift and so a "true" zero leak rate would show as a negative value on the ResMed (but ResMed shows zero instead of negative numbers).

So it depends on what mask you are using, 0.2 is great when using the Swift on a ResMed machine with a Swift mask setting. Using the Breeze would be great if you can keep it under 0.1 but still acceptable for values under 0.2 ... once you get to 0.3 using the Breeze, your leak rate is about 50% more than the designed leak rate and could indicate mouth leaks or other leaks.

[ozij]

The Breeze, like the Headrest, and I believe other nasal pillows masks as well, is not very silent, and the inhale is always more audible than the exhale.

It bothered me a lot the in the beginning. Two things helped me:

1. I realized that I was sort of "waiting for the noise to stop" so I could fall asleep, and it wasn't stopping. So I kept reminding myself that this noise is here to stay.

2. I reminded myself of the noise near the seashore - where you hear the sound go up and down - and tried to remember how it was to fall asleep near the sea.

By the way - the AHI is the Apnea Hypopnea Index - simply the total of AI and HI.


O.

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

[billbolton]

AHI is 5.1
AI is .6
HI 4.5
I don't really understand exactly what these numbers should be telling me, I mean, I know that it is apnea/hypoapnea index, but which is worse, and why are the numbers still so high?

Your numbers aren't "high", they are fine. The AI number is the really significant one. Basically any AHI ~5 or less is good.

IMO, there is no point in getting fixated on the daily numbers. It is worthwhile looking for longer term trends but there are going to be night-to-night variations but unless they are large variations, it not really worthwhile sweating on them if the trend is going well.

Cheers,

Bill

[itchysmom]

My vantage is very quiet although I did build a special 2-level box for it. The bottom level is open and my alarm clock, cell phone and a drink are in there and the upper half is enclosed and my machine and pur-sleep are in there.

I can send pics if you want. Might help if you enclose the machine as far as noise goes.

As for the leak rates. I have had the Vantage for only 2 weeks, use a non-ResMed mask (F&P Opus) and my leak rates are quite frequently 0.00. I do have it set on Swift for mask because I felt that was the closest thing to what I am using.

My AHI is generally 4.5 - 5.5 and it is usually all HI or mostly HI. I wish the HI were lower, but overall I'm satisfied and am starting to feel better.