HOSE IT GOING?

[máirtín]

Last night:
Usage: 8:23hrs
Leak: 17L/min
AHI: 0.8
AI: 0.0
Average pressure: 12.6
EEP: 11
Min PS: 3
Max PS: 10
VT: 281 - 510
Mask: Quattro.
Mask fit: Very good ****

Comments: "Appointment" with DME today.

[máirtín]

Last night:
Usage: 8.2hrs
AHI: 0.2
EEP: 11
Min PS: 3
Max PS: 14
Mask: Quattro.
Mask fit: Green Smiley Face

Comments: I got my new machine yesterday and used it last night. The machine is an S9 ASV. It has a smart card that I will be exploring as I learn. It is also fitted with a modem to send compliance data though they told me that I can see this data online at Resmed. I guess the deciding factor was the (unrequested) wipeout of all the data from the other machine.
I tried to use the Swift LT with the new machine. The RT thought I should try that for a few days with a chinstrap to see if I could get the nose sore to heal. I was only able to use it for about an hour before I had to switch back to the Quattro with bandaid.

[máirtín]

Last night:
Usage: 7.3hrs
AHI: 0.0 (Goose Eggs)
EEP: 11
Min PS: 3
Max PS: 14
Mask: Quattro.
Mask fit: Green Smiley Face

Comments: I got home late. I went to visit friends in Santa Cruz. They invited me to stay over but I didn't have the machine with me. I decided not to risk it. I drove home and didn't get to bed until after 1am.

[máirtín]

Last night:
Usage: 9.3hrs
AHI: 0.0 (Goose Eggs)
EEP: 11
Min PS: 3
Max PS: 14
Mask: Quattro.
Mask fit: Green Smiley Face

Comments: Third night with the new machine. I still have not worked out the problems with the mask. I tried the Liberty for about 10 minutes but couldn't keep the pillows in my nose. I tried the Swift LT with a new chinstrap but after an hour I woke up and couldn't get back to sleep. The Quattro works fine but I can't get the sensitive spot on my nose to heal.

[máirtín]

Last night:
Usage: 8.8hrs
AHI: 0.0
EEP: 11
Min PS: 3
Max PS: 14
Mask: Quattro.
Mask fit: Green Smiley Face

Comments: I looked at the waveform data for the past few days. Nothing shows up on the AHI but the leak line is all over the place.

[máirtín]

Last night:
Usage: 7.6hrs
AHI: 0.0
EEP: 11
Min PS: 3
Max PS: 14
Mask: Quattro.
Mask fit: Green Smiley Face

Comments: Early to bed to get ready for the first day of school. Woke up around 5:15am.

[máirtín]

Last night:
Usage: 6.5hrs
AHI: 0.0
EEP: 11
Min PS: 3
Max PS: 14
Mask: Quattro.
Mask fit: Green Smiley Face

Comments: Got up for about an hour at around midnight. Nose sore is becoming a bigger problem.

[máirtín]

Last night:
Usage: 7.6hrs
AHI: 0.3
EEP: 11
Min PS: 3
Max PS: 14
Mask: Quattro.
Mask fit: Green Smiley Face

Comments: Slept throughout the night. I tried the mask without any bandaid on my nose to let it air out. My nose feels a little sore this morning but not as bad as before.

[máirtín]

Last night:
Usage: 7.8hrs
AHI: 0.3
EEP: 11
Min PS: 3
Max PS: 14
Mask: Quattro.
Mask fit: Green Smiley Face

Comments: I'm feeling very tired this morning. My nose feels very sore.

[máirtín]

Last night:
Usage: 7.6hrs
AHI: 0.2
EEP: 11
Min PS: 3
Max PS: 14
Mask: Quattro.
Mask fit: Green Smiley Face

Comments: I put a little Vaseline on my nose and that seemed to help - not as sore this morning. I am very tired - woke up feeling like I'm not getting enough oxygen (or maybe I have too much carbon dioxide).

[Pugsy]

Mr Green Smiley Face isn't all he is cracked up to be. You would be better off to eyeball the leak line and see how close you come to that red line and how long you stay there. Especially since you mention a few days ago leak line is all over the place.

BTW, I just now got caught up with your posts as I have been behind. Congrats on the new machine.

[máirtín]

Last night:
Usage: 9.3hrs
AHI: 0.0
EEP: 11
Min PS: 3
Max PS: 14
Mask: Quattro.
Mask fit: Green Smiley Face

Comments:

[máirtín]

Last night:
Usage: 9.4hrs
AHI: 0.0
EEP: 11
Min PS: 3
Max PS: 14
Mask: Quattro.
Mask fit: Green Smiley Face

Comments:

[moresleep]

I have looked over your postings and have a few suggestions:

1) Change the Subject to something like "VPAP Adapt SV - Low AHI but feel terrible." That should attract the attention of more people with an ASV machine, perhaps with problems like yours, who may be able to shed light on your issues. Your AHI figures are generally very low (if reliable), but as I know from personal experience, AHI does not tell the entire story.

2) Post leak numbers again--you've stopped doing that lately. As others have pointed out, you really have to keep leaks under control, for any CPAP therapy to work. Many nights, your leaks (back when you were reporting them) were so high that the AHI and other numbers are not reliable.

3) Try other masks--even if you have to buy them yourself from Cpap.com or another online retailer. Keep trying masks until you find one that works better than your Quattro. You should not have to live with leaks or sores. Have you looked at a hybrid mask (nasal pillows plus mouth mask)? I haven't used one, myself, but might be one solution for mouth breathing and pressure leaks. If you go to Cpap.com and look at their masks, you'll also see the ratings by users, which can be helpful in identifying quality masks.

4) A few times, it appears you may have had alcohol in the evening. That most likely made your problems worse those nights in spite of your subjective feeling--definitely does mine. On the other hand, if you can drink a little black tea near bedtime and still get to sleep, that might stimulate your sleeping breathing reflexes--helps for me.

Good luck, and keep trying!

[máirtín]

Thanks moresleep for looking over my thread. Your suggestions are quite helpful.

Change the Subject

The thread is called "HOSE IT GOING" because it is my personal sleep journal. When I have questions or problems specific to the ASV I start a different thread. This thread is more general though it is specific to my therapy. My AHI is low (and reliable) but I agree that AHI doesn't tell the whole story: I may have problems that are not in any way related to sleep apnea and that won't be helped by knowing the experience of others with regard to their therapy.

Post leak numbers again

I stopped posting leak numbers because my new machine (S9 ASV) doesn't report leaking in the way the old machine did. Every morning since I started with the S9 I have been greeted by Mr Green Smiley Face, which indicates that for 95% of the night the leaking was well within the tolerances set by Resmed as not compromisiing therapy. I can tell from the detailed reports that there is considerable spiking of pressure and leaking at various times during the night. This is to be expected - the whole purpose of the machine is to provide jolts of pressure when the software determines that a central apnea is about to take place or when the Cheyne-Stokes pattern of breathing is detected.

Try other masks

I have tried the Quattro, the Liberty and the Swift. In my experience, only a full face mask provides the therapy that I need. When more, differently designed masks are available I will try them but I can't see anything but a full face mask ever working with an ASV.

it appears you may have had alcohol in the evening

Yep, I have. My consumption of alcohol would barely register on a dipso-meter. The whole time I was in Ireland (about a month) I drank about 10 units of alcohol. (When I was in France I certainly drank more than that but I learned to do most of my drinking in the afternoon or early evening - long before I went to bed.) Since I have been back I have averaged a glass of wine every 3 or 4 days. And I don't see much change in how I feel in the morning.

a little black tea

I am very sensitive to caffeine. I drank tea several times in Ireland (hard to avoid) and had very restless nights even when I drank the tea early in the morning. I know from experience that tea (other than naturally uncaffeinated herbal teas) is not something I can drink and hope to get good sleep after. Ditto for coffee.

@Pugsy:
Thank you for reviewing my posts and making suggestions. I am still trying to figure out how to get detailed reports to you for your perusal.