Sorry But I don't understand

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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tmbarber4
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Sorry But I don't understand

Post by tmbarber4 » Wed Feb 04, 2009 7:12 pm

Okay here are some #'s off the machine he has been on it for 4 days, Cpap mode Pressure at 10
Leak .30l
AHI 9.1
AI0.7
HI 8.4
Can you explain this and give me advice

by Wulfman on Wed Feb 04, 2009 1:55 pm

Hopefully, one of our ResMed "experts" will jump in on this one.
Maybe EPR wasn't available (at all) on the S7/Autospirit.

Wulfman on Wed Feb 04, 2009 2:25 pm

tmbarber4 wrote:
This is what the the machine says in options
Mode CPAP
Start CPAP 8.0
CPAP 10.0
MAX RAMP 10
Mask Standard
Tube length 2m
Humid Humidaire
Smartstart OFF
Leak Alert: off


I think I'd change the mask setting to "Swift".

Den

by Wulfman on Wed Feb 04, 2009 4:02 pm

tmbarber4 wrote:
So that is the only change to make, the one for the mask?

Well, if you want to bump the pressure up 1 more cm. and see what that does for the next few nights, that would be the only other thing I can think of.

Den

The mask settings are Mirage, mir full, ultra, and standard
I really don't know a lot, I have been reading for a while but I am so confused.
Den Thanks for your help

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Slinky
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Re: Sorry But I don't understand

Post by Slinky » Wed Feb 04, 2009 8:33 pm

I'm not all that familiar w/the S7s. I've had the S8 Elite and AutoSet Vantage. However, LEAVE your Mask Selection at Standard. That is the proper setting for ANY non-Resmed mask. The Standard setting automatically deducts 24 L/M when reporting the Leak rate.

The intentional Leak rate for the OptiLife at 10 cms of pressure looks to be 27-28 L/M (I really do dislike these mask literature leak rate table charts, they just are NOT clear or easy to read).

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tmbarber4
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Re: Sorry But I don't understand

Post by tmbarber4 » Wed Feb 04, 2009 8:42 pm

Slinky wrote:I'm not all that familiar w/the S7s. I've had the S8 Elite and AutoSet Vantage. However, LEAVE your Mask Selection at Standard. That is the proper setting for ANY non-Resmed mask. The Standard setting automatically deducts 24 L/M when reporting the Leak rate.

The intentional Leak rate for the OptiLife at 10 cms of pressure looks to be 27-28 L/M (I really do dislike these mask literature leak rate table charts, they just are NOT clear or easy to read).
Okay good maybe you can help if you would just read my posting in "Sorta new". A couple wonderful people have tried to help but they say someone that knows resmed needs to help. If you could just read that post and let me know if you can help. Thanks so much

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Wulfman
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Re: Sorry But I don't understand

Post by Wulfman » Wed Feb 04, 2009 9:32 pm

tmbarber4 wrote:The mask settings are Mirage, mir full, ultra, and standard
I really don't know a lot, I have been reading for a while but I am so confused.
Den Thanks for your help
Sorry 'bout that. I grabbed a list of mask settings for the ResMed machines (out of my computer files)......unfortunately, they were for the S8 machines. It didn't occur to me that the Swift might not have been available when that (your) machine was designed. My bad.


Den
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
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jules
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Re: Sorry But I don't understand

Post by jules » Wed Feb 04, 2009 9:36 pm

but the leak is high - .3 translates to 18 l/min above the leak rate in the machine which I understand is 24 for standard mask (understand standard was what was used)

so the overall flow is 42 (95 % ile) and the reported flow for the optilife at 10 is under 30 - so that leak rate needs to come down

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tmbarber4
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Re: Sorry But I don't understand

Post by tmbarber4 » Wed Feb 04, 2009 9:43 pm

jules wrote:but the leak is high - .3 translates to 18 l/min above the leak rate in the machine which I understand is 24 for standard mask (understand standard was what was used)

so the overall flow is 42 (95 % ile) and the reported flow for the optilife at 10 is under 30 - so that leak rate needs to come down
How do we do that
Sorry I'm asking so many questions but I don't know how to have him fix it.

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Wulfman
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Re: Sorry But I don't understand

Post by Wulfman » Wed Feb 04, 2009 9:59 pm

Could it be mouth-leaking?

With regard to the mask leak rates at pressures, according to the chart in this link that one of our forum members ("Bob...") created some years ago, it shows that the leak rate for the "Swift" and the "Standard" settings are pretty comparable.

viewtopic.php?f=1&t=13659&p=114356&hilit=Chart#p114356

It's in a .jpg format, so it could be downloaded and saved into your computer for reference material.

Den
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
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jules
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Re: Sorry But I don't understand

Post by jules » Wed Feb 04, 2009 10:06 pm

k - slinky has posted 24 for standard at all pressures (which didn't make sense to me but who am I to question her math?) - wonder who is right?

so this would be 33 + 18 or 51 which is a lot worse leak

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tmbarber4
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Re: Sorry But I don't understand

Post by tmbarber4 » Wed Feb 04, 2009 10:19 pm

Oh my, I am way out of my league, this stuff is way over my head. I am almost in tears. If we could just simplify this in lay terms.

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Wulfman
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Re: Sorry But I don't understand

Post by Wulfman » Wed Feb 04, 2009 10:27 pm

Here's a leak rate (Vent Flow Rate) chart for the Optilife.
(Found it in a post by "robbieh" from 2007)


Image



Den
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
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jules
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Re: Sorry But I don't understand

Post by jules » Wed Feb 04, 2009 11:00 pm

yes Den - I knew she has posted it - I have it somewhere in my paperwork too but I had gone back on found her post tonight too as referred others to her post over time. At 10 the flow rate is under 30, maybe 27 or 28.

-----------------------------------------------------------------------------------------------------------------------

There are excessive leaks which will make therapy worse and the AHI will be under reported.

That AHI that is too high already (most likely - we don't know all the details of the titration regarding centrals and all) is probably actually worse than that LED information indicates.

Now the AI wasn't bad but the HI is high and both Den and I are Respironics users and people say that some of the HI's for resmeds are snores really.

Get the leaks under control. You may need to get the software to determine more about leak pattern.

Leaks under control means a full face mask, tape or polidents strips, chin straps or making sure there isn't leaking around that nose with that mask (it was not a good one for me by any means).

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tmbarber4
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Re: Sorry But I don't understand

Post by tmbarber4 » Wed Feb 04, 2009 11:30 pm

Okay he has a chin strap but hasn't been using it I will see to it that he has that on tonight. I will post his numbers tomorrow. You mentioned centrals, on the paper I got from the sleep clinic he had 92 oa's 7oha's and 0 centrals. Thankyou so much

jules
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Re: Sorry But I don't understand

Post by jules » Wed Feb 04, 2009 11:49 pm

centrals during the titration part - you didn't have those papers before - you need to get that information for when they tested him with their cpap

a chin strap might not be enough - we will see

good night

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tmbarber4
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Re: Sorry But I don't understand

Post by tmbarber4 » Thu Feb 05, 2009 12:04 am

Oh your right that was without the cpap, on his first study, I haven't got the one from the 2nd time

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tmbarber4
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Re: Sorry But I don't understand

Post by tmbarber4 » Thu Feb 05, 2009 9:58 am

Okay I have the #''s off the machine for last night I think they look much better. As per Den I moved the pressure up to 11. And w/chin strap
Pressure 11
Leak .08 L/S
AHI 3.6
AI .04
HI 3.2
Now could you also tell me what these #'s should be if he is doing very well. I want to write down what I should be getting so I have something to compare it to
Thankyou