I got a taste of heaven - now it's gone!

[FreeIndeed]

It took a long time to get my therapy figured out, but with the help of this forum I achieved success. Then I had sinus surgery, which has been good overall, but a nasty byproduct is that my CPAP therapy got blown to pieces. Let me explain:
After the surgery I had to be off of the machine for a week or so. Then, I started again BUT I set my Resmed APAP S9 to CPAP and reduced my top pressure to 13 (because I was healing.) I use a Resmed liberty mask and they had me plug off the nose prongs and just use the mouth for a week. That was the worst, but I survived (on very little decent sleep). Anyway, after that I tried to get everything back to normal; I reset the machine to APAP and reset all the settings to where I was before the changes. I tried to reset the straps on my mask and get everything back to normal.... and I've struggled ever since. I tried to apply what I learned here the first time, but nothing has worked. My mask leaks like a sieve no matter what I seem to do.

I thought maybe the nasal prongs were ruined when I clamped them off, so I replaced them. Then I replaced the mouth cushion. I've tried having the straps loose, but then it leaks. I've tightened the snot out of them, but I still leak. For the life of me, I can't figure out why it would be any different than when I got it to work before. I used to just throw the mask on and sleep great - no leaks, AHI under 3. Now I'm over 24ml on the leak every night. Heck, 24 if I'm lucky! I wanted to post my Sleepyhead stats to see if anyone can spot any machine changes that I may have inadvertently made or see if they could give me any advice. BUT, for some reason Sleepyhead only shows me summary data now (not the detailed graphs.) I have no idea why this is happening either. I'll post a screenshot to show what I'm getting.
Any ideas on the Sleepyhead data? Any ideas on getting my therapy back on track?

Also, one last questions. APAP is supposed to set the pressure that you need right? Sometimes I wake up in the morning and am awake and breathing normally (still on the machine.) Shouldn't it decrease the pressure? Even when I'm awake it stays high.





And an old one for comparison:

[Pugsy]

The lack of detailed data points to the SD card either not being in the machine during the night or if it was in the machine it wasn't fully inserted like maybe it bounced out slightly (I have had that happen to me).

The pressure when you wake up....it doesn't drop instantly...it goes down slowly over a period of time....a few minutes at least depending on how high it went to.

You are also using an older SleepyHead version it looks like...so maybe update to the latest version though I doubt the lack of data is from the older version.
You can always use ResScan to verify if the detailed data is available in ResScan or not. If ResScan doesn't/can't give you the detailed graphs then the data isn't on the SD card.

Remember that with these ResMed machines the SD card must remain in the machine all night for anything other than summary data to be written to the SD card.

[FreeIndeed]

Thanks Pugsy. I downloaded and tried the new version of Sleepyhead. It seems all my data is gone - even when I go back to where there should be data. I'm 0pretty sure I have the card in, but I'll make super sure tonight. Doest the machine store the data and then write it to the card the next time the card is in? Or is that only the summary data?

[robysue]

Doest the machine store the data and then write it to the card the next time the card is in? Or is that only the summary data?

S9's like you are using only store the summary data and usage data on board. That data is written back to the SD card when it is reinserted into the machine.

All the detailed data is written directly to the SD card each night. If the card is not in the machine, the data is lost.

The Resmed S9's also overwrite the detailed data on the SD card periodically: The wave form (flow rate) data is only kept for seven days. The rest of the detailed data is only kept for 30 days. So if you want to have all your detailed data, including the wave flow data, you have to download it into SleepyHead at least once a week.

[Pugsy]

No the S9 machine doesn't store anything except summary usage stuff...hours of use, AHI and maybe a 95% leak.
All the data on the graphs you see on SleepyHead on the right side...the machine doesn't store any of that at all.

Maybe the card wasn't fully inserted...or have you erased the card at some point and started fresh?

See what happens tonight..put the SD card in the S9 and watch the LCD screen to make sure the machine says something about
"reading the SD Card" and leave it in all night and see what happens tomorrow.

[Sleeprider]

Thanks Pugsy. I downloaded and tried the new version of Sleepyhead. It seems all my data is gone - even when I go back to where there should be data. I'm 0pretty sure I have the card in, but I'll make super sure tonight. Doest the machine store the data and then write it to the card the next time the card is in? Or is that only the summary data?

Just a thought on the data. If you're using a Windows 8.1 machine, without locking the SD card it may write an index file to the SD card. The Resmed machine doesn't like that. The problem doesn't seem occur with Windows 7.

If this is the problem you need to get rid of the index file put there by Windows or get a clean SD card. Let me know what computer you used the card in, and if needed, we can discuss how to fix.

[FreeIndeed]

Thanks all! I made sure the card was in all the way - which it almost always is because I check for the "don't power down writing to card" message. This time I locked the card before putting it into my Win7 machine. Anyway, I got data for last night, so I'm not sure what the cause was, but I'll definitely download the card once a week now with it locked.

Below is the data for last night. I'm still stumped on why I can't get my leak down, but maybe the graphs will tell you guys something:

[FreeIndeed]

Can I trust the AHI if the leak was like it was in the above chart?

[palerider]

Can I trust the AHI if the leak was like it was in the above chart?

probably, your leak is bad, but not horrible, if there were apneas when your leaks were in the 30's, it's likely they would have been unclassified, instead of oa or ca.

the scales are so far off on some of the charts, like the flow chart, it's impossible to even get a hint. right click on it and fix the scale.

also drag one or the other of the pressure charts down below, so that snores and flow limitations can show up.

[FreeIndeed]

I can drag the charts so the right ones are visible, but how do I know what's a good scale to use for them?
Thanks!

[palerider]

how do I know what's a good scale to use for them?

a good scale is one where the datapoints use up most of the chart, without going off the top or bottom,

you'll note that your flow line is nothing but a little line, and the max flow rate is something inhuman in size.

[Pugsy]

The AHI is only potentially questionable during the time of the large leaks and how questionable during the large leak time depends on just how far it goes into large leak territory. So your overall AHI is still probably accurate except for maybe the time in large leak and that's why we try to avoid prolonged amount of time in large leak. I found through personal experience that when I went above 35 L/min the machine pretty much couldn't sense anything well enough to report any events that might occur due to compromised therapy. The problem with leaks over 35 L/min is we don't know if the lack of events being flagged was simply due to none happening or the machine missing them. You may or may not have had apnea events during that time frame...but the rest of the night when leaks weren't so big the data can be trusted.

The scale on the large leak graph is going to be skewed a bit due to the extremely large leak where it looks like the mask was maybe briefly removed from the face possibly during a refitting of the mask.....that 135 L/min spike. If the maximum leak wasn't so big then the scale wouldn't need to be so small to get it all in the graph and then you could better evaluate just how far above 24 L/min you actually went to. With the 135 L/min spike your leak graph is going to need to be huge to see that big leak in better detail but it can be done.

[Mabutu]

be fascinating to know just what they did during the sinus surgery

[FreeIndeed]

Boy this is sooo frustrating. I can't figure out why I keep having leaks. I've proved that the Mirage Liberty will work for me, but since the sinus surgery I can't get it to not leak. I did try adjusting the mask multiple nights and I tried switching to a different size nasal pillow set. I THINK the leaks are either from the prongs popping out of my nose or the times when I roll over and the hose comes undone for a sec. I experience both of those frequently. My surgery was just to get rid of polyps and get my nasal passages open again.
I'm going to post a few of my recent charts and maybe you experts can see something in the data that night help explain. I changed the graphs and which ones display per your suggestions, but let me know if I should change anything else. (There are some large spikes in the charts, but I cut them off so the range would be smaller). I really appreciate any questions or comments that night help.
Last night:

[FreeIndeed]

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