First night results from Encore Pro: Assistance appreciated

RosemaryB · Post by **RosemaryB** » Sat Apr 28, 2007 11:55 am

I finally got my equipment yesterday. It was a very successful first night, due to having good advice and quality equipment due to advice from the very fine people on this forum.

Because it took so long to get my equipment I was able to order everything to capture the data . My Remstar classic Auto w/CFlex pressure range is 4-10. C-Flex is enabled, set by the DME but I don't know what it is yet. Ramp is on, but set by the DME and I don't know what it is yet. Mask is Mirage Swift Nasal Pillow System, which I'm loving!

Using the Encore Pro software t looks to me like I maxed out toward the end of the night at 10 and had some OAs after that. The titration study tech maxed out at a pressure of 5 and recommended a CPAP set at 5, so I didn't expect it to go so much above that, perhaps 7. But maybe this is due to leaks or something.

I did wake up at about 3:30 a.m. and couldn't go back to sleep with the machine on, but I thought it was due to rainout. I also remember the pressure seeming much higher. It looks like there was one bad leak. I did find myself waking a few times because I was "exhale puffing" toward the end, too. Given the hour, this is when the greatest amount of REM is expected to occur.

I'd appreciate any and all opinions about anything you see. Here are the printouts

(It says two nights, but that's because after I got it, I turned it on for the day in order to reduce the plastic smell)

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): C-FLEX, rainout, Titration, Encore Pro, CPAP, DME, Ramp, auto

cpapernewbie · Post by **cpapernewbie** » Sat Apr 28, 2007 12:16 pm

Rosemary

you did much better than many of us on your first night

My first night is 100% failure - after 30 minutes I throw away my mask and that's it...!

On your first night chart

Probably it is too early to tell, not enough data.

But the very large leak btw 5-6 is to be noted - what mask are you using?

Before that large leak, your leak is very well under control, practically perfetct. My own stats are very erratic since I cannot sleep still and the leak chart is like a NOISE chart

I think you may want to ask your DME to narrow your range of 4-10 later on after 2-3 weeks

I was set at 4-20 and then 6-15 and at that range my AHI was 1.5-2.0

Now I change the range to 7-11 and my AHI range is 0 - 0.9

Your AHI last night is a bit on the high side

cflame1 · Post by **cflame1** » Sat Apr 28, 2007 2:17 pm

Looks like you had a large leak last night about the time that the pressure started to get high.

RosemaryB · Post by **RosemaryB** » Sat Apr 28, 2007 2:58 pm

[quote="cpapernewbie"]

I think you may want to ask your DME to narrow your range of 4-10 later on after 2-3 weeks

I was set at 4-20 and then 6-15 and at that range my AHI was 1.5-2.0

Now I change the range to 7-11 and my AHI range is 0 - 0.9

Your AHI last night is a bit on the high side

cpapernewbie · Post by **cpapernewbie** » Sat Apr 28, 2007 3:05 pm

Rosemary

the narrower the range I think is best. In my case, when i reduce my range, MY AHI is so much better

It is too early to tell what your range should be. One night is definitely not enough to decide on your range - better wait another 2-3 weeks

Your sudden leak which cause the sudden jum in pressure or is it the other way around is probably something that is only a one time event or ???

SleepySandy · Post by **SleepySandy** » Sat Apr 28, 2007 6:44 pm

Congratulations on making it through the night!!! Lots of people only make it an hour or two before taking the mask off.

That long straight leak line in the middle of the night is great.

I find it interesting that you were titrated at 5 but the pressure had to go higher a whole bunch of times. You were at a pressure above 5 for 39.1% of the night.

Give it a couple of more nights so we can see more data. I wouldn't make changes based on this one night.

I am absolutely not an expert. My non-expert thoughts are:

It's possible your bottom pressure needs to be higher because you were at that pressure for only 37.8% of the night. I'm at my bottom pressure for at least 70% of the night. I could be wrong, but I think the goal is to have your bottom pressure be high enough that the machine doesn't have to move you up and down all night.

It's possible your top pressure needs to be higher because it clearly didn't stop that big cluster of apneas. I really don't know, though. More experienced people will be able to help.

That huge leak is interesting. I wonder what caused it.

Goofproof · Post by **Goofproof** » Sat Apr 28, 2007 7:51 pm

Your leak could be due to mouthbreathing, do you tape or glue, it looks like your pressure got away, and made the AHI bad. Jim

That said, you stuck with it, that's worth points. But no mouth leaks allowed.

RosemaryB · Post by **RosemaryB** » Sat Apr 28, 2007 8:01 pm

SleepySandy wrote:That huge leak is interesting. I wonder what caused it.

I have a vague memory of waking up very briefly and there was water coming out of the mask. I think I pulled it away from my nose and shook the water out. It's very vague, but I'm wondering if that could have been it.

SleepySandy · Post by **SleepySandy** » Sat Apr 28, 2007 8:09 pm

RosemaryB wrote:I have a vague memory of waking up very briefly and there was water coming out of the mask. I think I pulled it away from my nose and shook the water out. It's very vague, but I'm wondering if that could have been it.

Could be. It can be hard to know what registers as a leak and what doesn't. For example, when I pull mask away from my face to readjust it I'm pretty sure it doesn't register as a leak. And if it did you would think it would register as a large leak - can't get leakier than the mask off your face

I swear one of these days I'm just going to sit down with my machine and try to simulate leaks and see what happens...

You really don't want water to build up in your mask - that's called rain out. What's your humidifier set at? And, do you have your hose wrapped up? I'm going to make myself a hose cover eventually, but I have it wrapped in two scarves right now. It's very effective and reduces rain out considerably.

RosemaryB · Post by **RosemaryB** » Sat Apr 28, 2007 8:10 pm

[quote="Goofproof"]Your leak could be due to mouthbreathing, do you tape or glue, it looks like your pressure got away, and made the AHI bad. Jim

That said, you stuck with it, that's worth points. But no mouth leaks allowed.

RosemaryB · Post by **RosemaryB** » Sun Apr 29, 2007 11:57 am

[quote="SleepySandy"][quote="RosemaryB"]
You really don't want water to build up in your mask - that's called rain out. What's your humidifier set at? And, do you have your hose wrapped up? I'm going to make myself a hose cover eventually, but I have it wrapped in two scarves right now. It's very effective and reduces rain out considerably.

Goofproof · Post by **Goofproof** » Sun Apr 29, 2007 12:13 pm

Puffs count too. If I were you I would try 6 cm to 10 cm for a while, really if it were me I'd use 6 cm to 9 cm. I thing your AHI will come down with a narrower range, and a 9 cm top might help the leak problem. If you can get the lips to stay sealed, things tend to settle down, anyway you have started out with a good attitude and that's important. Congrats. Jim

RosemaryB · Post by **RosemaryB** » Sun Apr 29, 2007 12:50 pm

[quote="Goofproof"]Puffs count too. If I were you I would try 6 cm to 10 cm for a while, really if it were me I'd use 6 cm to 9 cm. I thing your AHI will come down with a narrower range, and a 9 cm top might help the leak problem. If you can get the lips to stay sealed, things tend to settle down, anyway you have started out with a good attitude and that's important. Congrats. Jim

SleepySandy · Post by **SleepySandy** » Sun Apr 29, 2007 1:09 pm

RosemaryB wrote:No rainout whatsoever! I slept nearly 7 hours straight.

Excellent. I'm so impressed you've adjusted so fast to the mask.

RosemaryB wrote:The leak rate was much better, with no big spikes due to rainout mask dumping

Can you post your Daily Details Report from last night (just the one page - you don't need to post the summary pages)? I think it would be good if lots of people saw them to consider your pressures (and I admit, I'm really curious )

Goofproof · Post by **Goofproof** » Sun Apr 29, 2007 2:18 pm

I don't think dumping the water out of the mask added much to your leaks, unless your a slow dumper. Water in the hose and maybe that mask can make noises that the machine sees as snores, even though it waves. Glad you got the water problem under control. Jim