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Re: My first night and I have a problem – Can any one please help
Posted: Wed May 31, 2023 8:24 pm
by Zapper
Pugsy wrote: ↑Wed May 31, 2023 8:12 pm
Zapper wrote: ↑Wed May 31, 2023 8:03 pm
Is it possible that the increase in mask pressure could be some how related to a Resmed machine setting by any chance.
Not that I can see on the above report.
Auto ramp will do it but you have ramp OFF. Have you messed with that setting at all....at any time????
A dramatic increase in flow limitations or snores will do it but again I don't see it in the above report.
Did you ever really go to sleep during that short period of time last night?
The Resmed settings are still what the doctor advised me to use, and Ive not altered them in any way.
[ A dramatic increase in flow limitations or snores will do it but again I don't see it in the above report.] - not sure what you mean ?
During the last night period I never went to sleep , and I’m not sure if I slept after switching the machine off .
Zapper
Re: My first night and I have a problem – Can any one please help
Posted: Wed May 31, 2023 8:36 pm
by Pugsy
Zapper wrote: ↑Wed May 31, 2023 8:24 pm
[ A dramatic increase in flow limitations or snores will do it but again I don't see it in the above report.] - not sure what you mean ?
If you had experienced a big increase in the flow limitations or snores they would have shown up either in the statistics or the Flow Limitation graph. You didn't include the snore graph but I checked the statistics for snores...0.0 all the way across...so no snores. Your flow limitation graph isn't exciting at all. In fact it is rather boring.
Now if you weren't asleep then the machine sensed something in your awake breathing that it thought was airway related for some reason. These machines can't tell awake breathing from asleep breathing. They only measure air flow and sometimes our awake breathing (which is normal for awake breathing to be very irregular) fools the machine into responding like something is going on with the airway as in trying to collapse or something but if you weren't ever asleep...they aren't real and they don't count but the machine thinks they count and will respond but the response was to something that happened while awake...so it doesn't matter.
You have to be asleep for any of this to matter.
See what happens tonight.
Re: My first night and I have a problem – Can any one please help
Posted: Wed May 31, 2023 8:44 pm
by palerider
Pugsy wrote: ↑Wed May 31, 2023 8:14 pm
zonker wrote: ↑Wed May 31, 2023 8:09 pm
i THINK that pressure increase was due to the high mask leak. but i could be wrong.
Leaks don't cause increased pressure...they just don't.
Yup, it's an old urban legend that needs to die.
I've got a screenshot around here somewhere showing an Autoset *reducing* pressure because of terrible mask leaks, trying to get the mask to re-seal.
Re: My first night and I have a problem – Can any one please help
Posted: Wed May 31, 2023 8:47 pm
by Zapper
Pugsy wrote: ↑Wed May 31, 2023 8:36 pm
Zapper wrote: ↑Wed May 31, 2023 8:24 pm
[ A dramatic increase in flow limitations or snores will do it but again I don't see it in the above report.] - not sure what you mean ?
If you had experienced a big increase in the flow limitations or snores they would have shown up either in the statistics or the Flow Limitation graph. You didn't include the snore graph but I checked the statistics for snores...0.0 all the way across...so no snores. Your flow limitation graph isn't exciting at all. In fact it is rather boring.
Now if you weren't asleep then the machine sensed something in your awake breathing that it thought was airway related for some reason. These machines can't tell awake breathing from asleep breathing. They only measure air flow and sometimes our awake breathing (which is normal for awake breathing to be very irregular) fools the machine into responding like something is going on with the airway as in trying to collapse or something but if you weren't ever asleep...they aren't real and they don't count but the machine thinks they count and will respond but the response was to something that happened while awake...so it doesn't matter.
You have to be asleep for any of this to matter.
See what happens tonight.
Thanks for taking the time to post your thoughts and recommendations.
To night ( June 1 ) I will use the exact same settings on the Resmed machine and see how it develops . I will post the outcome back here .
Zapper
Re: My first night and I have a problem – Can any one please help
Posted: Wed May 31, 2023 8:54 pm
by ozij
The sudden increase in pressure is not surprising from the machine's point of view
Look at 23:48 :
There's some heavy erratic breathing just before that.
Then - according to the machine - a long period of non-breathing, identified as an obstructive apnea when it ended.
After that supposedly obstructive apnea, the pressure shoots up, and then the leak is huge.
Now, I don't think that "breathing stop" was an apnea - if you click on the "events" tab, you'll see when this supposed apnea started and how long it was really was. On the chart it looks like it was almost 2 minutes!
I think what happened is the following:
23:46 - you may have changed position, a leak started. The leak bothered you, you fiddled with the mask.
While you were fiddling with the mask, you may have pulled it away from your face. During that period, the machine didn't recognize you were breathing - so once it saw you breathing again, it shot the pressure up.
Automatic machines don't try to "plow through" obstructive apneas, they will only raise the pressure after they recognize a resumption of breathing.
For the sake of troubleshooting, I'd put the machine on CPAP - to keep it from responding to misinterpreted breathing events.
And if it were me, I'd put the pressure at 7.2, not more for the first night of troubleshooting.
Putting the machine on CPAP will also help you learn to distinguish between a leak and a rise in pressure.
You can always switch the machine over the APAP if that turns out to be necessary.
Re: My first night and I have a problem – Can any one please help
Posted: Wed May 31, 2023 9:08 pm
by palerider
ozij wrote: ↑Wed May 31, 2023 8:54 pm
After that supposedly obstructive apnea, the pressure shoots up, and then the leak is huge.
Just a little context, (mainly for the OP), the pressure went up *a little*. like 2cm.. it just looks big on the graph.
Re: My first night and I have a problem – Can any one please help
Posted: Wed May 31, 2023 9:32 pm
by Zapper
ozij wrote: ↑Wed May 31, 2023 8:54 pm
The sudden increase in pressure is not surprising
from the machine's point of view
Look at 23:48 :
There's some heavy erratic breathing just before that.
Then - according to the machine - a
long period of non-breathing, identified as an obstructive apnea when it ended.
After that supposedly obstructive apnea, the pressure shoots up, and then the leak is huge.
Now, I don't think that "breathing stop" was an apnea - if you click on the "events" tab, you'll see when this supposed apnea started and how long it was really was. On the chart it looks like it was almost 2 minutes!
I think what happened is the following:
23:46 - you may have changed position, a leak started. The leak bothered you, you fiddled with the mask.
While you were fiddling with the mask, you may have pulled it away from your face. During that period, the machine didn't recognize you were breathing - so once it saw you breathing again, it shot the pressure up.
Automatic machines don't try to "plow through" obstructive apneas, they will only raise the pressure after they recognize a resumption of breathing.
For the sake of troubleshooting, I'd put the machine on CPAP - to keep it from responding to misinterpreted breathing events.
And if it were me, I'd put the pressure at 7.2, not more for the first night of troubleshooting.
Putting the machine on CPAP will also help you learn to distinguish between a leak and a rise in pressure.
You can always switch the machine over the APAP if that turns out to be necessary.
Many thanks.
Some interesting information there , your.....
[ I think what happened is the following
] ..... sounds very possible . For me its difficult to remember just what I did during the time I was laying in bed with my mask on . Now this may sound a bit strange , but what do you mean when you say .... I'd put the machine on CPAP ?
Zapper
Re: My first night and I have a problem – Can any one please help
Posted: Wed May 31, 2023 9:34 pm
by Zapper
palerider wrote: ↑Wed May 31, 2023 9:08 pm
ozij wrote: ↑Wed May 31, 2023 8:54 pm
After that supposedly obstructive apnea, the pressure shoots up, and then the leak is huge.
Just a little context, (mainly for the OP), the pressure went up *a little*. like 2cm.. it just looks big on the graph.
After seeing the graph and how high the spikes went I instantly thought , I have a BIG problem
Zapper
Re: My first night and I have a problem – Can any one please help
Posted: Wed May 31, 2023 9:50 pm
by Pugsy
Zapper wrote: ↑Wed May 31, 2023 9:32 pm
what do you mean when you say .... I'd put the machine on CPAP ?
CPAP mode...fixed pressure and not auto adjusting. That will stop the "sudden" pressure increases that seem to feed the leak monster.
The provider/clinician manual explains how to do it.
https://www.respshop.com/manuals/ResMed ... %20her.pdf
And I know the pressure increase looks but that's due to scale. The actual amount of increase was barely over 2 cm and 2 cm isn't much of an increase. I do know that any change in anything is going to seem massive with someone who is trying their first night with cpap. So I do understand how any of this can be unnerving.
Your main job right now....learning to fall asleep with the mask and machine on and keep it on.
Re: My first night and I have a problem – Can any one please help
Posted: Wed May 31, 2023 10:21 pm
by Zapper
Pugsy wrote: ↑Wed May 31, 2023 9:50 pm
Zapper wrote: ↑Wed May 31, 2023 9:32 pm
what do you mean when you say .... I'd put the machine on CPAP ?
CPAP mode...fixed pressure and not auto adjusting. That will stop the "sudden" pressure increases that seem to feed the leak monster.
The provider/clinician manual explains how to do it.
https://www.respshop.com/manuals/ResMed ... %20her.pdf
And I know the pressure increase looks but that's due to scale. The actual amount of increase was barely over 2 cm and 2 cm isn't much of an increase. I do know that any change in anything is going to seem massive with someone who is trying their first night with cpap. So I do understand how any of this can be unnerving.
Your main job right now....learning to fall asleep with the mask and machine on and keep it on.
Thanks, just wondering , should I just have one more night with the same pervious un touched Resmed setting to see what happens , or now change to the new '' CPAP mode '' and see if there's any difference .
Zapper
Re: My first night and I have a problem – Can any one please help
Posted: Wed May 31, 2023 10:47 pm
by ozij
Zapper wrote: ↑Wed May 31, 2023 10:21 pm
Pugsy wrote: ↑Wed May 31, 2023 9:50 pm
Zapper wrote: ↑Wed May 31, 2023 9:32 pm
what do you mean when you say .... I'd put the machine on CPAP ?
CPAP mode...fixed pressure and not auto adjusting. That will stop the "sudden" pressure increases that seem to feed the leak monster.
The provider/clinician manual explains how to do it.
https://www.respshop.com/manuals/ResMed ... %20her.pdf
And I know the pressure increase looks but that's due to scale. The actual amount of increase was barely over 2 cm and 2 cm isn't much of an increase. I do know that any change in anything is going to seem massive with someone who is trying their first night with cpap. So I do understand how any of this can be unnerving.
Your main job right now....learning to fall asleep with the mask and machine on and keep it on.
Thanks, just wondering , should I just have one more night with the same pervious un touched Resmed setting to see what happens , or now change to the new '' CPAP mode '' and see if there's any difference .
Zapper
Let's put the question differently:
Which of the two options will better help you achieve your main task:
Pugsy wrote:...learning to fall asleep with the mask and machine on and keep it on.
Re: My first night and I have a problem – Can any one please help
Posted: Wed May 31, 2023 11:02 pm
by Zapper
ozij wrote: ↑Wed May 31, 2023 10:47 pm
Zapper wrote: ↑Wed May 31, 2023 10:21 pm
Pugsy wrote: ↑Wed May 31, 2023 9:50 pm
Zapper wrote: ↑Wed May 31, 2023 9:32 pm
what do you mean when you say .... I'd put the machine on CPAP ?
CPAP mode...fixed pressure and not auto adjusting. That will stop the "sudden" pressure increases that seem to feed the leak monster.
The provider/clinician manual explains how to do it.
https://www.respshop.com/manuals/ResMed ... %20her.pdf
And I know the pressure increase looks but that's due to scale. The actual amount of increase was barely over 2 cm and 2 cm isn't much of an increase. I do know that any change in anything is going to seem massive with someone who is trying their first night with cpap. So I do understand how any of this can be unnerving.
Your main job right now....learning to fall asleep with the mask and machine on and keep it on.
Thanks, just wondering , should I just have one more night with the same pervious un touched Resmed setting to see what happens , or now change to the new '' CPAP mode '' and see if there's any difference .
Zapper
Let's put the question differently:
Which of the two options will better help you achieve your main task:
Pugsy wrote:...learning to fall asleep with the mask and machine on and keep it on.
Thanks, I think trying the CPAP mode may reveal more useful information , I think
Zapper
Re: My first night and I have a problem – Can any one please help
Posted: Thu Jun 01, 2023 2:39 am
by Respirator99
palerider wrote: ↑Wed May 31, 2023 9:08 pm
Just a little context, (mainly for the OP), the pressure went up *a little*. like 2cm.. it just looks big on the graph.
Palerider is quite correct - this is a small increase in pressure, from a very low base.
As an exercise to see how much pressure you're really dealing with, you need a tall glass of water and a straw. Insert the straw 7cm and blow bubbles - this is the inhale pressure the machine is supplying you. While blowing, push the straw down a further 2cm - that is the change in pressure you've experienced - I'll bet you can hardly feel the difference. And because you have EPR set to 3, your exhale pressure is way lower. It feels like a lot through the mask at first, but really the pressures are quite low. Once you get used to it you won't feel any pressure at all.
Re: My first night and I have a problem – Can any one please help
Posted: Thu Jun 01, 2023 12:31 pm
by palerider
tl;dr, it wasn't the pressure change that caused the problem, the problem caused the pressure change.
Re: My first night and I have a problem – Can any one please help
Posted: Thu Jun 01, 2023 5:31 pm
by zonker
Respirator99 wrote: ↑Thu Jun 01, 2023 2:39 am
It feels like a lot through the mask at first, but really the pressures are quite low. Once you get used to it you won't feel any pressure at all.
i'm repeating this for emphasis for the new folk. it's very true. i remember after my first few months, i woke up and had to feel for my mask because i swore i hadn't put it in.
it feels like a hurricane at first but the body adjusts.