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Re: Large Leaks

Posted: Thu Apr 28, 2016 6:06 pm
by palerider
cathyf wrote:Right -- what I was trying to say is that the machines themselves appear to be storing some particular pieces of data in multiple places, and that there may be a bug in the machine's software or even the underlying algorithm where the different places that it's storing data are not consistent. What sleepyhead is reporting is 4 hypopneas, and when you look at the graphs, you can see 4 hypopneas, and can easily see the exact time stamp for each one. But encore says that there were 170 hypopneas, while giving no data as to what times those 170 hypopneas happened.
I'm much more inclinded to trust encore, and encore will show you when the hypos happen, you just have to look over the horrible multipage flow report that it only gives for the last day or two's data.

encore is much harder to get any kind of useful data out of, it's all targeted towards printouts (how very 20th century).

fact of the matter is, there's still bugs in sleepyhead... and while it works well for a lot of things, there's still bits that fall through the cracks, *especially* in betas... which, of course, is to be expected, that's why they're betas.

Re: Large Leaks

Posted: Thu Apr 28, 2016 6:38 pm
by AcedDublB
Thank you, I will stick with the Encore Pro 2.

I can send the PDF file for the 12 page detailed Encore report for last 7 days if anyone offers to review and comment.

My problem remains on trying to fix these Large Leaks that I am never aware of, either when I start the machine, during the night or when I wake up in the morning.

It is impossible for me to know what I need to fix if I never experience the leaks when I am awake.

Anyone else having this issue. My pressures are 22.5 and 17.5

Re: Large Leaks

Posted: Thu Apr 28, 2016 8:56 pm
by cathyf
Actually, are you sure you aren't having the leaks while awake? I notice that the amara has 3 distinct states. There's really loud leaks -- the trombone noise -- where you can feel a buzzing spot around the mask perimeter. Then there is this not loud at all diffuse hiss around the mask, which doesn't seem to be leaking anywhere in particular. If you grab the mask and pull it straight out from your face and settle it gently back, it becomes basically silent. I can get the same effect if I open my mouth and let my cheeks inflate -- it seals the mask. Sometimes I can get the chipmunk cheek thing with my lips sealed, with the air coming in through my nose. It's the only way that I can get a good seal with my mouth closed.

I didn't figure out the difference between state 2 and silence until reading the responses to my thread that was linked above. I really like this mask, but it's taken me some work to get the hang of it.

Re: Large Leaks

Posted: Fri Apr 29, 2016 7:59 am
by AcedDublB
Surprisingly last night the Sleepyhead matches the DreamStation/Encore Pro results.

Best Mask Fit ever at 94% and AHI 10.6

Image

Look forward to comments.

I can't get rid of Windows tiles on left side of screen.

Re: Large Leaks

Posted: Fri Apr 29, 2016 10:45 am
by lilly747
Well things do look better....but with your graphs....almost anything would look better...

Your leaks are the most important thing right now to tame and KEEP them tamed...With that said, at some point you need to look at that high AHI of yours.

This may sound picky, but when you post graphs could you get rid if the strip cutting off the left side of your chart. And get rid of the PIE Chart, it is preventing the ability to see the info below it..

Turn off the Pie Chart (so that we can see the statistical data for the leak rate and the pressure). .....TO TURN OFF the Pie Chart: Click on File- Preferences- Appearance then uncheck Show event breakdown pie chart.

Re: Large Leaks

Posted: Fri Apr 29, 2016 11:46 am
by Cannuck 1
I have read your posts and would go to CPAP supply and check for best review for full mask.
People seem to like the Simplex Full face (Fisher & Paykel) not sure if you have tried this one?
I do not use a full face mask and things can change and it interests me about this, A good mask should have a double seal like a Divers mask who are under great pressures when diving.
You might have to do a mock up while awake tossing and turning that occurs and see what is going on with those leaks.
All the best.

Re: Large Leaks

Posted: Fri Apr 29, 2016 2:01 pm
by palerider
AcedDublB wrote:I can't get rid of Windows tiles on left side of screen.
next time, upload the file that's mentioned in that box in the lower left corner of the screen...

Re: Large Leaks

Posted: Fri Apr 29, 2016 2:09 pm
by AcedDublB
Cannuck 1 wrote:I have read your posts and would go to CPAP supply and check for best review for full mask.
People seem to like the Simplex Full face (Fisher & Paykel) not sure if you have tried this one?
I do not use a full face mask and things can change and it interests me about this, A good mask should have a double seal like a Divers mask who are under great pressures when diving.
You might have to do a mock up while awake tossing and turning that occurs and see what is going on with those leaks.
All the best.
I have tried Simplex, Quattro FX, Quattro Air, Amara View, Blue Cushion, most of them for at least 3 nights.

The supplier was terrific letting me try different masks.

I thought I could make the Quattro Air work as it was so comfortable and light and I wasted $115 on that.

The Amara View is the on;y one where I don't detect leaks when I am awake, all the others did leak to some degree when I was trying to get to sleep or wike me up.

As you can see I am running high pressures in 20+ range.

Last night i tightened the Amara View a little tighter than normal and had the best Mask Fit % in months.

Re: Large Leaks

Posted: Fri Apr 29, 2016 2:13 pm
by AcedDublB
lilly747 wrote:Well things do look better....but with your graphs....almost anything would look better...

Your leaks are the most important thing right now to tame and KEEP them tamed...With that said, at some point you need to look at that high AHI of yours.

This may sound picky, but when you post graphs could you get rid if the strip cutting off the left side of your chart. And get rid of the PIE Chart, it is preventing the ability to see the info below it..

Turn off the Pie Chart (so that we can see the statistical data for the leak rate and the pressure). .....TO TURN OFF the Pie Chart: Click on File- Preferences- Appearance then uncheck Show event breakdown pie chart.

I have tried everything to turn off those Window tiles with no success, did a Google search and the F11 key doesn't do anything. Windows 10.

Do you recommend any revisions to my pressure settings?

Normally what is the recommended difference between IPAP & EPAP, mine is set at 22.5 and 17.5 but last night the EPAP ran high for a period of time.

Thank you for your advice, much appreciated.

Re: Large Leaks

Posted: Fri Apr 29, 2016 3:06 pm
by Sonnyboy
To hide the taskbar try:
Open Taskbar and Start Menu Properties by clicking the Start button , clicking Control Panel, clicking Appearance and Personalization, and then clicking Taskbar and Start Menu.
Clear the Lock the taskbar check box.
Select the Auto-hide the taskbar check box. The taskbar is hidden from view.

Re: Large Leaks

Posted: Fri Apr 29, 2016 5:22 pm
by lilly747
AcedDublB wrote:I have tried everything to turn off those Window tiles with no success, did a Google search and the F11 key doesn't do anything. Windows 10.

Do you recommend any revisions to my pressure settings?

Normally what is the recommended difference between IPAP & EPAP, mine is set at 22.5 and 17.5 but last night the EPAP ran high for a period of time.
Well Sonnyboy gave you info on how to turn off the tiles........

OK first the leaks have to go so we know what the data really is....so if you get a night with good leak control, could you post a shot showing your data without the pie chart so we can see all the info below the chart which in your other shots have been cut off.

Also is this your Rx settings? And why were you given a bilevel? Medical problems or because your pressures are high?? In your sleep study titration did they eliminate all the hypo's?

Your OAS and CAs seem great, if I can see around the leaks.. I am wondering if any amount of pressure will eliminate the FL you seem to be having...I don't know at this point ..we will see...

Also I am a VPAP person not a Bipap person. So maybe palerider and Wolfman will chime (hopefully they won't kill each other if you get some good graphs up

Re: Large Leaks

Posted: Fri Apr 29, 2016 5:43 pm
by AcedDublB
Okay I will check back in a few days. Thank you everyone.

I originally started out on CPAP but after my second sleepover the Doctor moved me to Auto BiPAP.

I thought I was doing well before on SPAP as AHI was below 5 but the switch to auto BiPAP has been problematic for sure although I am quite satisfied with therapy and varying pressures but leaks are a problem except for last night.

Re: Large Leaks

Posted: Fri Apr 29, 2016 5:56 pm
by palerider
lilly747 wrote:Also I am a VPAP person not a Bipap person. So maybe palerider ...
vpap, bipap, same basic thing, just different names...

I'm a resmed fanboy(person?) too

as to the latest chart, a higher max pressure might have done something with that long string of hypopneas.

Re: Large Leaks

Posted: Sat Apr 30, 2016 6:55 am
by AcedDublB
palerider wrote:
lilly747 wrote:Also I am a VPAP person not a Bipap person. So maybe palerider ...
vpap, bipap, same basic thing, just different names...

I'm a resmed fanboy(person?) too

as to the latest chart, a higher max pressure might have done something with that long string of hypopneas.
Pale rider

Amazing results last night after taking your advice on increasing pressure.

I bumped IPAP up 1.0 cm to 23.5 and IPAP up 1.0 cm

My AHI was the lowest ever, an amazing 2.8 and my Periodic Breathing was 0.0

The 90% IPAP was 21.5

I will post chart when I get some time later today.

On the downside, Mask Fit was only 51%, probably due to a Velcro strap that loosened and I didn't notice until waking.

I am tightening the mask more than normal and I used a new RemZzzs liner last night too.

Hopefully you and others will be kind enough to review my chart when I post it as instructed later today.

This is a huge improvement and I am excited about finally making some progress.

Re: Large Leaks

Posted: Sat Apr 30, 2016 8:03 am
by Pugsy
AcedDublB wrote: I bumped IPAP up 1.0 cm to 23.5 and IPAP up 1.0 cm
I think you meant that you also bumped the EPAP up 1.0 cm so both EPAP min and IPAP max went up 1.0 cm....is that correct?
AcedDublB wrote:I will post chart when I get some time later today.
Please post that new report with the graphs. Let's see what the pressure was doing during the time of the 51% big leak.

Here's the big problem with large prolonged times spent in large leak....the machine can't respond like it should in the face of really big leaks and its ability to respond greatly diminishes proportionally as the large leak worsens. In other words the machine can maybe respond like it should at say just barely into large leak territory but essentially becomes clueless when you are 20 L/min deep into large leak territory.

I looked at the EncorePro daily reports that you sent....in pretty much all of them when you are in large leaks and having truckloads of hyponeas the pressure line was stagnant and doing nothing when it should have been doing something and that tells me you were so deep into large leak territory the machine couldn't decide to do anything. When this happens it essentially becomes a fixed pressure machine and the fixed pressures are too low to get the job done.

What I want to see with the new 1.0 cm baseline increase and lower AHI is if the leaks were still causing the machine to work like a fixed pressure machine with minimal variation which means you were deep in large leak territory but the increase in fixed pressure enabled the machine to do a better job to start with
or see if the pressure varies a lot as we would expect but maybe you were just barely into large leak territory and thus the machine responds as expected.