Need some help with Respironics Auto M-series

[jeff123816]

I was diagnosed with severe OSA about three months ago and was put on a Resmed Elite II CPAP machine with a Swift nasal mask. I later switched to a Redsmed Liberty mask because my lips were separating when I would fall asleep. (I taped my lips for several weeks but it wasn't a very good solution. I experimented with pressures between 9cm and 10cm but had problems with aerophagia and high AHI numbers (5.0-7.0). After waiting months and months for an appointment to get back to my sleep clinic, I literally begged for a automatic machine prescription, which they they wrote for me.

About two weeks ago, I got a Respironics Auto M-series machine. I really don't know how to explain my current situation. Over the last two weeks I have had maybe 4 fantastic nights (meaning I felt really good after 8 hours of sleep). The other 10 days or so have been horrible. Now, I don't have a card reader/software for this machine and I realize that I should have one. I just don't have another $200 lying around at the moment to throw at this problem. I have been monitoring the on screen display of the machine which gives 7 day averages. Over the last 7 days, my AHI average is 2.0. However, I've had only one "good" night in the last 7 days. The funny thing is that the machine shows the leak average as 30.1 l/m. This makes no sense to me. My old Resmed Elite let me see the leak numbers on a nightly basis and I never had anything over 0.08 l/m with this Liberty mask. I am wondering if I need to designate to the machine the type of mask that I am using. I was able to do this on the Elite but there does not seem to be a setting for this on the M-Series.

What I don't understand is, if my leak numbers do indeed average 30.1 l/m, how is it possible that I have an AHI of 2.0? Furthermore, if I am averaging an AHI of 2.0, why am I waking up tired with apnea headaches so much of the time? My 90% pressure average over 7 days is 9.2 cm. Could it be that my mask is actually leaking as much as the machine is reporting? I don't feel any leaks when I go to sleep.

Thanks everyone for your time and any advice that you may have.

[BleepingBeauty]

Hi, Jeff, and welcome to the forum.

Respironics machines differ in their leak and data reporting from ResMed machines. With the M Series, you don't have to enter your mask into the machine, and the leak you see reported is your actual leak. You have to compare that number to the intentional leak rate for the mask you're using at the set pressure. Respironics machines don't subtract the intentional leak rate like the ResMed machines do.

If you want to see your daily (or nightly) data on an M Series machine, you need to reset it every day. To do so, unplug the power supply from the back of the machine. Hold down the right and left arrow keys while you plug the power back in and wait to hear two quick beeps; then release. Now push the > button to get to the Therapy data screen. Hold down the minus key for a few seconds, until the data resets to 0. Push the On/Off button to exit the menu.

HTH

[jules]

the m series leak info is the "real flow" rate average in L/min - the resmed is excess leak over what is in the menu in L/sec

it's kind of like when you go to another country and are used to F and all of a sudden all the temperatures are in C - you got to figure out based on the temp what to wear - there is a conversation that needs to be made

compare that LED number with what is in the mask pamphlet based on your pressure

[6PtStar]

If you subtract the design exaust rate for your mask you will see how much you are leaking. I does vary with your pressure. The design exaust rate should have come with the instructions that came with your mask. I am not sure what the design rate is for the Liberty but 30.1 L/M sounds pretty good and I would bet it is not much over the design rate.

Jerry

[jeff123816]

Thanks very much to both of you. So I looked at the manual for the mask and it says that the "flow" for a pressure of 8cm is 32 l/m (+ or - 6.0 l/m). So all in all, it sounds that the mask is doing quite well in terms of leaks.

Any idea then what is going on? My numbers are not fluctuating as much as they were before. The AHI average has greatly improved since I switched to APAP. I have had a few days of really good sleep. On Saturday night, I slept better than I have in years. And was only in bed for eight hours. Sunday night, I used the same machine, same settings, same mask, went to bed at the same time and woke up today feeling like crap. I even allowed myself to spend an extra two hours in bed, based on how lousy I felt after eight hours of sleep. Still feel like a zombie after ten hours of sleep. I don't understand what could be wrong and don't know what else to try at this juncture.

[cinco777]

BleepingBeauty wrote

If you want to see your daily (or nightly) data on an M Series machine, you need to reset it every day. To do so, unplug the power supply from the back of the machine. Hold down the right and left arrow keys while you plug the power back in and wait to hear two quick beeps; then release. Now push the > button to get to the Therapy data screen. Hold down the minus key for a few seconds, until the data resets to 0. Push the On/Off button to exit the menu.

Please note that the LCD displayed #s that you will see for your last night of sleep (you will see them only after Noon your machine's time, which is for West Coasters, after 5AM local time) are based on the machine's internal clock which only matches the local time clock for users that live near London, England. Here in the West Coast time zone, the Respironics' day/night ends at 5AM local time. If you get up before 5AM, you will see (after 5AM local time) #s on the LCD display that match your last night's sleep period. If you sleep past 5AM here on the West Coast, the hours after 5AM local time will be included in calculations for the next day's LCD display. I've discussed the LCD Displayed Averages and the machine's internal clock in some of my recent threads/postings. Do a read of them if you want more information on the LCD displayed Avg #s including their accuracy. By the way, it is important to know WHEN to do the reset operation described by BleepingBeauty. For the West Coasters, don't do it until after you have looked at / copied down the LCD #s from the previous day/night. Your last night's #s will be there for the looking from (for West Coasters) 5:01AM local time today until 4:59AM local time tomorrow (give or take a few minutes for the clocks being "off" as the machine's clock is not an atomic clock).

[cinco777]

jeff123816 wrote

I don't understand what could be wrong and don't know what else to try at this juncture.

I have four suggestions for what else you can DO:
1) Continue reading this forum for tips and suggestions, what worked and what didn't for the members (may work for one and not for another), etc. and start trying things that look promising - this approach worked wonders for me (I failed my first attempt at CPAP 3 years ago - I didn't know about this Forum then).
2) Get the Software for your machine and monitor your sleep #s daily until you are getting restful sleep. Without the software you are driving in the dark, playing sports blindfolded, etc. You get the idea!
3) Take daily notes (and save and refer back to them on your sleep therapy journey) on what you are experiencing, feeling (Ok, Zombie-like, etc), trying, what is working, what didn't, sleep positions, etc. My list of things that I considered/tried numbered close to 100 before I reached my goal (I still have a list of a few things to try just so I don't get complacent).
4) Follow Muffy's (one of the very knowledgeable members who runs a Sleep Clinic) list of good sleep hygiene (his are the BEST). Do a Forum search to find them. I believe he posted them in one of BleepingBeauty's threads. I have the printed copy on the back of my bathroom mirror and refer to it weekly (used to be daily).

Success is there for the taking - it isn't easy for most but it will happen if you keep on "truckin".

[BleepingBeauty]

Thanks very much to both of you. So I looked at the manual for the mask and it says that the "flow" for a pressure of 8cm is 32 l/m (+ or - 6.0 l/m). So all in all, it sounds that the mask is doing quite well in terms of leaks.

Yes, it does.

Any idea then what is going on? My numbers are not fluctuating as much as they were before. The AHI average has greatly improved since I switched to APAP. I have had a few days of really good sleep. On Saturday night, I slept better than I have in years. And was only in bed for eight hours. Sunday night, I used the same machine, same settings, same mask, went to bed at the same time and woke up today feeling like crap. I even allowed myself to spend an extra two hours in bed, based on how lousy I felt after eight hours of sleep. Still feel like a zombie after ten hours of sleep. I don't understand what could be wrong and don't know what else to try at this juncture.

Without detailed data to go by, it's really anyone's guess. Some people have more events in REM sleep; so even if they sleep more deeply, they don't feel as good. Some have positional apnea, where what position you're sleeping in will affect your AHI (more events happen when supine, or on your back). Also, how much sleep you're getting is a factor. (Too much sleep is no better than not enough.)

Make only one change in your therapy at a time. And any change you make should be continued for at least a few nights to see how things work out.

You're doing well so far. Hang in there, keep asking questions and reading here, and you'll get there. In the meantime, get the software and a reader.