new to apnea

[dilbert]

I was diagnosed with apnea a few weeks ago. I did some reading here and bought the Resmed s9 machine. So far (5 nights) I feel like I can sleep better for parts of the night but I either have leaks or I have the head straps so tight they are annoying me. Last night I taped my lips for the first time seems to help. If I sleep on my back the mask is fine but if I roll on my side then I get leaks.

Also I have the software how do I read the leak info?

[TooGroggy]

The blue line shows the leak recorded by the machine. You want to keep the blue line well below the red line at 24 liters per minute. What do you see on your graph?

[dilbert]

I will check when I get home.

I exchanged my mask yesterday as I am getting a sore on the bridge of my nose and it leaked alot when I turn over while sleeping.

My new mask is Swift FX Nasal Pillow Mask. That was a tough night hard to breath out against an incoming flow. My machine has EPL or EPR that is supposed to lower the flow when exhaling. Doesn't seem to do it with my new mask.

[Suetois]

Are you adjusting your mask at max pressure while you're lying down and changing position? That worked for me after somebody here suggested it. My only reason for not thinking of it myself was undoubtedly that I was oxygen deprived due to OSA. viewtopic/t61587/posting.php?mode=reply&f=1&t=61587#

[dilbert]

I do adjust it laying down when I feel a leak. I always lay down first then connect my mask to the hose.

[Pugsy]

What is your pressure set at?
What is the EPR set at?

[dilbert]

My pressure if I understand it correctly is set at 8 and the EPR (ramping) is at 4

I am going for another sleep study this weekend to find out what the pressure should be. The settings above were on the prescription from the doc. I was told it was based on my height weight and neck size.

[Pugsy]

My pressure if I understand it correctly is set at 8 and the EPR (ramping) is at 4

I am going for another sleep study this weekend to find out what the pressure should be. The settings above were on the prescription from the doc. I was told it was based on my height weight and neck size.

Ramp may start at 4 and gradually increase up to your 8 cm of pressure, won't take long to get there. Not far to go.
EPR is a set exhale relief and top number is 3 meaning it reduces the pressure 3 cm when you exhale. If you are having trouble exhaling against the pressure I would suspect EPR is off.
They are 2 different things. I don't have ResMed machine so I don't know if both can be on at the same time.

If it were me I would turn off ramp and make sure EPR was on if you had trouble exhaling at 8 cm. EPR setting is comfort feature. 3 is the greatest amount of pressure relief, then 2 then down to 1 which is 1 cm decrease in pressure. Your choice which feels best for you.

Pressure needs based on neck size? Might as well use a ouija board. They are using the apap to get an idea where the pressure needs to be but if your leak is not controlled it will mess with that number. Sleep study done after you have got used to using the machine is better way to know what you really need. The will also be able to see immediately if leak is a problem.
Good that you are getting the sleep study.

[dilbert]

Leak results from last night new mask

median 6 95th percentile 22.8 maximum 34.8

old mask median 0 95th percentile 1.2 maximum 33.6 (old mask was uncomfortable and leaked when I roll over

[Pugsy]

Leak results from last night new mask

median 6 95th percentile 22.8 maximum 34.8

This tell us that you had a large leak of 34.8 L/min and for 95% of the time the leak was 22.8 L/min OR less and the median is 6 L/min. It would be more helpful to see the actual graph of the detail data report showing the leak line itself. Then you could really see if the leak is possibly impacting the therapy over the night as a whole. You could have had a huge leak for an hour and it will mess up the numbers for a really good leak for the other part of the night.

ResMed says that leak over 24 L/min can and will impact therapy and data.

[dilbert]

http://i1180.photobucket.com/albums/x40 ... tstats.jpg

This is from last night, Felt I had a better sleep and I noticed it did leak some.

[Pugsy]

This is from last night, Felt I had a better sleep and I noticed it did leak some

Did you tape last night? That leak line looks pretty ragged and at times pretty bad but for the most part "acceptable" in terms of what ResMed says the machine can handle. I use that term loosely, a good bit of the time you are pushing the limits.

If you did tape and the tape stayed on, then maybe some mask adjustment is in order. I use the Swift FX also. The back strap tends to come up the back of my head when I toss and turn. Do you toss and turn a lot? I have short, short hair and the velcro idea doesn't have much to stick to and I don't have huge problems with mask movement so I just deal with it but my leak line doesn't look anything like yours... I have found that adding Padacheeks fleece side straps and the barrel cozy seem to help stabilize things and I get less mask movement. It is also pretty darn comfortable. One other thought is have you tried the next size larger in the nasal pillows or even the size smaller? It may be that a different size would seal easier and better for you...

[dilbert]

I did tape my lips last night. I found the breathing easier and I went down a size to the small pillows from medium. They seemed to fit okay but I noticed they were loose at times and I would adjust them. I do toss and turn but I am usually woken up by it with the hose and all.

I have the strap that goes across the top of my head shifting sometimes I notice (damn round head) lol and the strap in the back is loose. Should I tighten it up?

[Pugsy]

I would tighten the back strap a little more. It allows the pillows to displace easily with toss and turn, especially if it slides up a bit, sort of gets the pillows out of place. If it is a bit more snug maybe it will help the top strap from moving. I understand the round head. Mine is round and small...

Consider the fleece side coverings and barrel cozy. I found they really did help snug things up and I actually could loosen the straps a bit and still get a good seal all night and I toss and turn quite a bit due to back pain. It is rare that I start in one position and stay there. The Swift LT might be a little more stable for you but there is a bit more "stuff" on the face. I used it for over a year before I got the Swift FX.

This is one of my better leak nights so I will show you it can be done. Bear in mind I have been doing this for much longer and I also had to tape in the beginning but I haven't taped since about 2 months into therapy. I wouldn't expect your leak line to be near this one but I would like to yours more straight wherever it is. Though you report feeling better and that is the most important thing. Leaks themselves will disrupt sleep and anything that disrupts sleep will affect how we feel overall. You are really doing pretty good for being new at this stuff. Sometimes takes a lot of fiddling to get things "just right". You are on the right track though.
Here is one of my reports.. See how straight the leak line is? Doesn't jump around.

[dilbert]

Thanks for your help. I will tighten up the straps and look at the coverings you mentioned.