First night, mixed feelings

[jhallas]

Hi Everyone,

Ok, so last night was my first night at home on my new S9 Autoset. I ended up getting it from a local mom and pop DME provider recommended by my doctor. They charged me the same price as what I would have got it for online except now I don't have to deal with reimbursement from insurance and exchanges are easier.

I have the pressure set at CPAP of 10 per the titration sleep study. I have the climateline tubing set at 80 degrees. I'm currently using the Swift II mask as the DME provider I went to didn't have the Swift FX I used in the sleep study in stock and they said they would send me one for free later this week. This morning the machine read an AHI of 3.6, while my titration sleep study had a AHI of 0.6 at 10cm H2O. I noticed throughout the night that my mouth would open a little and wake me up, which didn't happen during the sleep study as far as I know. I guess I'll just get a PAPcap and tape my mouth in the meantime.

Mouth was really dry, assuming because of the leaks. Does it mess up the data recording if I take the mask off to get a drink of water? When does the machine record on the SD card? After the night is done am I supposed to hold down the stop/start button until it turns off?

Thanks,
J

[jhallas]

So I just checked out the data from last night and my obstructive apnea index is 0.2, but my central apnea index was 3.0. Is that normal? 95th percentile of leak was 22.8 L/min, is that high?

Thanks,
J

[LinkC]

It appears you are having centrals now that you didn't have during your study. Pressure set too high can sometimes trigger centrals, but they titrated you at 10cm and you apparently weren't having them then. That is something to discuss with your Dr.

If you have the Swift II mask entered into your machine, then 22 is a pretty large leak rate. (Your machine accounts for the expected "vent rate" of whatever mask you tell it you are using. That 22 is leakage ABOVE the expected vent rate of 33 for your mask at 10cm.) BUT, taking your mask off without shutting down the machine WILL affect the leak rate, so you'll want to see what it is under normal circumstances, before worrying about it.

Good luck and keep at it!

[wil]

Your machine accounts for the expected "vent rate" of whatever mask you tell it you are using. That 22 is leakage ABOVE the expected vent rate of 33 for your mask at 10cm

Is the S9 the only machine that does this? I've been wondering myself about whether vents were taken into account when showing leak info.

Mouth was really dry, assuming because of the leaks.

This is definitely indicative of opening your mouth. I use a considerably higher pressure than you (15-19 cm) but I didn't find anything could keep my mouth closed other than tape, which I just can't see myself doing. Tried PapCap, chinstrap, exercises, you name it (but that tape!). I ended up going with the Liberty mask (nasal pillows and oral mask). I find that just equalizing the pressure outside my mouth is enough for me to be able to keep it closed without straps and such.

I would certainly try out other options first, but this is something to consider if it gets too bad.

Stick with it... Once you start feeling better again you'll wonder how you did without it!

[WindFlyer]

Pressure set too high can sometimes trigger centrals,

Is that true, Link? A couple years ago when I asked my doc (well, nurse practitioner) about that, she pointed at the PSG and said, "Well, you didn't have any centrals at your sleep study, so you probably don't need to be worried about those." Anybody know what the facts are on this?

[PST]

Your machine accounts for the expected "vent rate" of whatever mask you tell it you are using. That 22 is leakage ABOVE the expected vent rate of 33 for your mask at 10cm

Is the S9 the only machine that does this? I've been wondering myself about whether vents were taken into account when showing leak info.

The S8 does it too. I believe the ResMeds all substract and the Respironics don't, but I'm not sure about the newest Respironics.

[wil]

I believe the ResMeds all substract and the Respironics don't, but I'm not sure about the newest Respironics.

If the Remstar Auto does this, I haven't seen it anywhere, and I've been all through the programming modes. I didn't think it did, just thought I'd clarify. My leakage went from right around 40.0 liters/min to 50.0 when I went from the ComfortGel to the Liberty. If it's not counting vents, I should be a LOT closer to zero...

[LinkC]

It's my understanding that, in general, ResMed machines account for venting and Respironics report total leakage. I doubt either company would make a model that goes against their basic design. But there may be an oddball model out there...

Elevated pressures can trigger centrals in patients who are susceptible to centrals. I don't believe they will in those who have no predisposition to centrals (which would almost certainly show up in your PSG). If the OP did NOT have them in PSG but is getting them now...that's something the doc needs to figure out. That also mirrors what your NP said.