Someone Please Answer

Okay, I have received feedback from many of you this week and I REALLY appreciate it. I have been reviewing my daily numbers and last night my leak rate was 0.00L/s. I had NO leaks. But, my AHI was 6.8. As some of you know I suspect I have some centrals since my diagnostics indicated that I had mixed apnea, but I do not see my doc until June 12. I am still considering raising my pressure from 13 cm to 14cm to see what happens. Would you try this for one night to see what happens??????????

You guys are probably getting tired of this question, but I am desparate to feel more rested.

skjansen wrote:Okay, I have received feedback from many of you this week and I REALLY appreciate it. I have been reviewing my daily numbers and last night my leak rate was 0.00L/s. I had NO leaks. But, my AHI was 6.8. As some of you know I suspect I have some centrals since my diagnostics indicated that I had mixed apnea, but I do not see my doc until June 12. I am still considering raising my pressure from 13 cm to 14cm to see what happens. Would you try this for one night to see what happens??????????

You guys are probably getting tired of this question, but I am desparate to feel more rested.

Go for it!
You'll know tomorrow if it helped or not. (or if you want to give it a couple of nights)
If it doesn't.....you can try going the other direction and see what happens there.

Best wishes,

Den

No leak???? I thought masks were designed to have some "leak"-isn't it how the exhaled CO2 is purged from the mask? All of the masks I've used come with a chart of the rate of "leakage" at different pressures. Or are you doing the arithmetic and have no leakage in excess of the masks designed rate?

How long have you been on CPAP-if it is May 14-give yourself a little time.

krousseau wrote:No leak???? I thought masks were designed to have some "leak"-isn't it how the exhaled CO2 is purged from the mask? All of the masks I've used come with a chart of the rate of "leakage" at different pressures. Or are you doing the arithmetic and have no leakage in excess of the masks designed rate?

How long have you been on CPAP-if it is May 14-give yourself a little time.

Kay,

She's got a ResMed S7. When you enter the proper mask setting in the machine, it's supposed to know how much "leakage" is normal for that mask and pressure......so, if it doesn't exceed that, then it reports it as "zero".

It's that GREAT mask she's using.....

Den

I'm not sure raising your pressure will necessarily help if you have centrals - might even increase them. It's something you need to talk to your MD about, and if he confirms them, then you might want to think about a Bipap machine - there's a new one like this:- https://www.cpap.com/productpage-advanced.php?PNum=2471.

Wulfman wrote:

krousseau wrote:No leak???? I thought masks were designed to have some "leak"-isn't it how the exhaled CO2 is purged from the mask? All of the masks I've used come with a chart of the rate of "leakage" at different pressures. Or are you doing the arithmetic and have no leakage in excess of the masks designed rate?

How long have you been on CPAP-if it is May 14-give yourself a little time.

Kay,

She's got a ResMed S7. When you enter the proper mask setting in the machine, it's supposed to know how much "leakage" is normal for that mask and pressure......so, if it doesn't exceed that, then it reports it as "zero".

It's that GREAT mask she's using.....

Den

The key is the guessing game on whether you guessed the mask and entered it correctly, and guessing if the machine got it right. If it guessed 0.00, I'm guessing the leak rate is wrong.

I'm glad my machine counts on me to do the math, if I'm wrong, I don't have to go far to pin the blame. Jim

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Goofproof wrote:If it guessed 0.00, I'm guessing the leak rate is wrong.

When I used an S7 Spirit and an S7 VPAP III, I got quite a few zero leak rates... of course that was when the tape held well.

However, doesn't really matter to me which way machines figure it -- taking the mask into consideration or not. As long as I know which way they do it, either way is fine with me.

I do like not having to bother with putting in a mask setting at all with my Respironics and PB machines.

I don't use Remed boxes, and probably shouldn't even comment, but for me, an AHI of 6.8 would be unacceptable, even though Resmed algorithms tend to report higher HI's than some other manufacturers. If it were me, I'd crank up the pressure by an increment (I think your device will allow less than 1.0 cm setting increases), try that a few nights, and see how it goes. Data recording and analysis is your friend.

I'm not a medical professional, or even very smart, etc., but that approach has worked for me (AHI about 0.6 over several months). If you seem to be getting centrals, you should consult a sleep-qualified physician, but I think that some experts like SAG will tell you that pressure-induced centrals are more rare than most people think.

If you are concerned that they may be central apneas, you could try to have a partner or friend listen while you sleep. There should be a snort or snore with obstructive events (OSA and OSH) on the return breath but central events will have no return breath sound because the airway is not compromised. Without additional monitoring parameters, it is difficult to determine OSA from CSA. Sometimes even with the additional parameters it can be difficult. Again, the question is how do you feel in the AM? If you feel good and refreshed, then I would leave the settings alone, if not you could tinker a little.

As far as using Bi level pressure, standard Bi level is not recommended for central apneas. For central apneas you must use a spontaneous timed Bi level and then only in severe cases. Although now the consensus is to use a machine like ResMed's VPAP.

Good Luck....Joe

Great feature-Thank you.

[quote="Joethespy"]If you are concerned that they may be central apneas, you could try to have a partner or friend listen while you sleep. There should be a snort or snore with obstructive events (OSA and OSH) on the return breath but central events will have no return breath sound because the airway is not compromised. Without additional monitoring parameters, it is difficult to determine OSA from CSA. Sometimes even with the additional parameters it can be difficult. Again, the question is how do you feel in the AM? If you feel good and refreshed, then I would leave the settings alone, if not you could tinker a little.

As far as using Bi level pressure, standard Bi level is not recommended for central apneas. For central apneas you must use a spontaneous timed Bi level and then only in severe cases. Although now the consensus is to use a machine like ResMed's VPAP.

Good Luck....Joe