Looking for comments on this data!

[img]http://i252.photobucket.com/albums ... .jpg[/img]

I am posting these 2 days of data for Ainsle14.

He never had a titration study, just a first sleep study to daignose. He has a MSeries Auto with A-Flex and is using a Hybrid full face mask.

He has only been on therapy about a week but having trouble.

I have been helping by email but want some input from others here.

Initially, his range was set a 8cm to 20 cm. Two night ago we lowered the upper pressure to 16 cm since he was jumping all over the place.

Then, last night, we set the pressure range 8.5 to 16. I am thinking we need to raise the minimum probaly quite a bit yet but mask leaks seem to be a major issue.

The first image is last night (Pressure 8.5 -16). The second image is a couple of night's ago (he forgot to put his card in the night between). In the second image his pressure setting was 8 to 16. The second image is quite typical of the previous nights on therapy.

He is using the mask 4-5 hours a night and then taking it off.

Any comments and ideas welcome!
Thanks.

Hawthorne wrote:I am posting these 2 days of data for Ainsle14.

Has he got untreated or undertreated GERD, by chance?

Hawthorne wrote:Initially, his range was set a 8cm to 20 cm. Two night ago we lowered the upper pressure to 16 cm since he was jumping all over the place.

Good thinking... that you lowered his max for the time being, given what all was happening in the first data results.

Hawthorne wrote:Then, last night, we set the pressure range 8.5 to 16. I am thinking we need to raise the minimum probaly quite a bit yet but mask leaks seem to be a major issue.

I think you're right. Get control of the leaks, and raise the minimum pressure. Probably to 10.

Just my layperson's opinion, of course, as I'm no doctor or anything in the health care field.

I've been on treatment all of 1 week (minus 1 day ), but here goes... looking at that graph and seeing where they were getting good rest I'd try setting them around 10 on CPAP and see what happens. APAP was kinda messing with me. Not to that extent, but I wasn't setting my range as high so it might have done so given the chance...

Same here... not a doctor... I don't play one on television...

Chicken/egg scenario -- are the leaks causing the pressure increase or is the increase in pressure causing the leaks? In a couple of cases where it went hay wire it looks like the latter...

Hawthorn...

I'd say....first.....get the leaks under control....that leak line needs to be as flat as possible.

Once the leak rate is pretty level (meaning fairly constant), start walking the low-end pressure up a half-point at a time.

FL - Flow limitations are "Baby Hypopneas"
Hi - Hypopneas are "Baby Apneas"
AI - Apneas are "Mature Hypopneas....that are busy trying to kill you"

Get'em before they "mature"....by bumping the pressure up....in a controlled....logical.....experimental way.

Lood at the first graph and compare what happened at about hour 2 (intensive breathing disruption with leaks) to what happened at about hour 4.

Hour 1-2 had many leaks, may many snores, many apneas, even at the highest pressure.

Hour 4 had crazy leaks at less pressure.

When the pressure is too low, apneas can casue restlessness which can casue leak - and you can't handle them as long as the casue persists.

Based on all that, my (lay person's) suggestion would be to raise the minimum pressure to 11.5 or 12.

O.

Hawthorne wrote:...is using a Hybrid full face mask.

I don't know enough to comment on the data, but one other question - is there a particular reason he needs to use a FF mask?

old64mb - he mouth breathes so a full face mask is his choice over taping.