New to apap, graphs ok? :)

[Chivalry]

Hi all.... a few weeks ago i was diagnosed with severe OSA and given the obligitory machine/mask to take home and try to get used to for the rest of my life ;0(
Luckily.. here in the UK we get it all given to us for free as you probably know.. so at least i didnt have the extra worry of finding cash on top of dealing with the apnea..
I was given some good equipment,,,, a resmed S9 autoset, the 5i humidifier and a mirage liberty hybrid mask (small) ...
Needless to say.. as most people, i expect.. things didnt go to well.. leaks , and the machine ramping up to 20 alot of the time and waking me.. which i mentioned on my next visit a week or so later.
Unfortunatly.. here in the UK the general idea is that auto machines are auto tritrating and so they tend to be left wide open... mine is set from 4 - 20.. and the hospitals (at least mine anyway) dont think fine tuning is needed.. and so... 3 masks later im still having problems,, ;0(
I managed through browsing this forum to find out its possible to get extremly detailed graphs of the nights sleep using the rescan software (not something i would be provided with here) and have made a couple of results for the last 2 nights since i got my newest mask,,,,, both nights quite different (although bot are still putting out huge pressure ) and hoped some of the more expert among you might take a look and give an opinion on what might be a good course of action for helping ,,
First 4 pics are from night 1... next 5 pics from second night












Many thanks for any help / advice that anyone can offer... im just trying so hard to make this work and am looking for any advice i might find

[dtsm]

First suggestion: edit your profile and list your equipement

Your second set of images is telling - pressure jumps when you leak. The first objective is to get the leaks under control. What type of mask are you using and is that model correctly inputted into your S9? Tell us more

Once you get your leaks within a reasonable range [ultimate objective is to eliminate but that might take longer time], then you can zero in on your effective pressure settings. If you choose to remain on apap, the lower [initial] range is usually the 95th percentile number, and the upper can be 3-5 units more. If you use EPR, an additional adjustment is needed.

PS - From the limited data, it appears your initial range is around 7[?]. You might want to reduce the range to 7-15 while trying to get your leaks under control?

[Chivalry]

oops... sorry.. updated now

The wierd thing i thought.. was on the first night around 3.30am i had a HUGE leak... and yet the machine kept the pressue very low around 8.... yet other times ive had leaks .. not as big... my pressure had gone nuts up to 20!

Its the constant ramping to 20 and waking me up thats causing me the biggest headaches ;0(

[dtsm]

Great! Hopefully others more familiar with your mask can offer suggestions on how to reduce the leaks....

[cflame1]

try some of these to fix your leaks

wiki/index.php/Hybrid_Mask_Modifications

[Chivalry]

am trying.. but short of messing with the strap tightness,,, theres not much else i can do (

[cflame1]

have you tried any of the modifications listed in the link?

[Chivalry]

tbh alot of the info there seems to relate to problems with the nasal pillows,,, which is the 1 area i dont seem to have any problems.. my leaks are allways from around the mouth area..
I have tried most of the things on there... (bar the ladies tights over my head!) ,,,,,, (welll..... not since ive had the mask anyway,, lol) that are obvious... and am just trying fine tuning and tweaking atm i spose

[GumbyCT]

tbh alot of the info there seems to relate to problems with the nasal pillows,,, which is the 1 area i dont seem to have any problems.. my leaks are allways from around the mouth area..
I have tried most of the things on there... (bar the ladies tights over my head!) ,,,,,, (welll..... not since ive had the mask anyway,, lol) that are obvious... and am just trying fine tuning and tweaking atm i spose

The ladies tights will likely fix your problem.... Your call

[Muse-Inc]

I have the Liberty and cannot stop the huge leaks I get with it. I wear the original hybrid-style mask, the RespCare Hybrid Universal which seals great on my face; could be you have the same problem, the LIberty just doesn't fit your facial anatomy. Seems from posters here that if one of the hybrid-style masks seals well, the other one won't. The Hybrid comes with 3 sizes of oral cushion and 3 sizes of pillows that can be set at 2 heights. Plus, the headgear has an over the head strap and a chin flap that helps stabilize the mask on the face.

[dtsm]

tbh alot of the info there seems to relate to problems with the nasal pillows,,, which is the 1 area i dont seem to have any problems.. my leaks are allways from around the mouth area..
I have tried most of the things on there... (bar the ladies tights over my head!) ,,,,,, (welll..... not since ive had the mask anyway,, lol) that are obvious... and am just trying fine tuning and tweaking atm i spose

The ladies tights will likely fix your problem.... Your call

I tried it with my Headrest a few times but found later did not need it

On a more serious note, you might want to try a nasal pillow with chin strap and/or tape?

[rested gal]

I'd set the machine for CPAP mode and a straight pressure of 10 until you get leaks under control.

Or, if I were going to use it in autotitrating mode with a range, I'd set the range at 7 - 11....until I got leaks under control.

But straight CPAP (trying 10 for awhile) would probably be the better way to go while you sort out the leak problems.

I'm not a doctor or anything in the health care field. That's just what I'd try.

[Chivalry]

Woohoo.. Woke up this morning... Slept the while night through for the first time since getting my machine..
After a quick check on the lcd screen.. I also had another first.. 0 leakage !!
Main thing I changed was I upped the minimum pressure from 4 up to 7..... And a slight adjustment of the straps..

Looking forward to getting home from work and getting a decent look at the detailed graphs, with 0 leaks..
Will post em up in a bit..

Wooo result!

[dtsm]

Woohoo.. Woke up this morning... Slept the while night through for the first time since getting my machine..
After a quick check on the lcd screen.. I also had another first.. 0 leakage !!
Main thing I changed was I upped the minimum pressure from 4 up to 7..... And a slight adjustment of the straps..

Looking forward to getting home from work and getting a decent look at the detailed graphs, with 0 leaks..
Will post em up in a bit..

Wooo result!

What was your 95th percentile pressure with the 0 leak line? Keep it up....

[Chivalry]

ok,, here it is,,, my results from my first `perfect night`






check that leakage flatline! lol i bet i dont get so lucky 2 nights in a row... hehe