Schleima's first night on CPAP!

Hello all-- and thanks again to everyone who helped me out with all those terrible problems I was having with my sleep doctor.

Last night I got a visit from the respiratory therapist who hooked me up with my S8 Elite II and heated Humidaire 3i.

As I am a stomach sleeper, I asked her to bring some over-the-head interfaces like the Breeze or the Aeiomed headgear. She strongly advised me against them, as the breeze had an uncomfortable hard plastic plate, and the company did not carry Aeiomed products. I wound up with what she had-- the Optilife and the Swift. (she raved about both, kept insisting that she had no financial incentive to push either one, and I think I believe her-- she just feels that that these are the best)

I tested both out on my bed, and realized that the Optilife's more compact and angled protrusion moved the least.

So... the big question... how do I feel?

Kind of the same as always. Sleepy pressure around my eyes.

This is in sharp contrast to when I had my titration study done with the supposedly inferior and leaky Comfort Classic mask... with only 6 hours of sleep, I woke up feeling incredible.

So... here are my questions

1. The therapist was very straightforward with me about having "locked me out" of all modes in the S8 Elite II other than ramp and humidification. She said "I know you'll just look up on the internet how to get the data yourself, but I'm not gonna do it." So... how do I go about viewing my data/apneas/etc from last night? (I do not have the software yet)

2. How do you feel about the breeze? Is the hard plastic plate really an issue?

3. My DME says they do not have a contract with Aeiomed.... do you have any suggestions as to how I could convince them to order the headset for me? The local distributor is not an in-network provider.

More questions to come, I'm sure. In the meantime, thanks for all your help xPAPpers!

The Optilife is Resprionics' the Swift is Resmed's...

The Breeze and Headrest are my favorites - I couldn't get along with Respironics nasal masks - haven't tried anything else.

I considered myself a stomach sleeper - but with cpap I have reverted back to being the side sleeper I was in childhood - stomach sleeping must have been an adatation to sleep apnea.

The Breeze's hard plastic plate (I take it she is referring to the frame) is padded. I can be an issue for back sleepers, it never bothered me - I did some stomach sleeping with the Breeze (hose hanging from above my head).

A third nasal pillows mask you may want to consider is Fisher & Paykel's Opus, which many here love.

And don't discount the possibility that you may sleep well in a nasal mask.

Good luck on cpap!
O.

To get to the Clinician's menu on your machine:

Press the down arrow and right arrow buttons at the same time. Wait a bit and the menu will come up.

Press enter.

Scroll down to Results and press enter.

Scroll down to Efficacy Data and press enter

Scroll through your results: Pressure, Leaks/second, AHI, AI, and HI.

Press exit several times to get back to the original display.

If you have any problems, let me know.

[quote="Claire"]To get to the Clinician's menu on your machine:

Press the down arrow and right arrow buttons at the same time. Wait a bit and the menu will come up.

Press enter.

Scroll down to Results and press enter.

Scroll down to Efficacy Data and press enter

Scroll through your results: Pressure, Leaks/second, AHI, AI, and HI.

Press exit several times to get back to the original display.

If you have any problems, let me know.

I have had no problems at all with the hardness or rigidity of the Breeze frame. Have used the same one for 6 years and all the padding has actually worn off, but still no problem with comfort. I intended to buy a new one when the padding started lifting after about four years, but just never got around to it.
KenD
Brisbane

Schleima,

The Clinicians menu allows you to make changes to the settings of your machine. Before you make any changes, please be sure to go through and write down all of your settings first. That way if you don't like what you have changed you will know how to change it back. Also, if you do change anything, only make one change at a time and wait to see how you respond to that.

If you just want to view your night's data without making any changes, you can access the "Advanced Patient" or Efficiency Menu by pressing and holding the left < and right > buttons. Then follow the directions Clair gave for your nightly info. But this data is rolled over into the weekly-monthly-yearly average at noon, so the night's data will no longer be accessible. You can check your weekly-monthly-six month-annual averages by pressing the left button under each screen.

alnhwrd wrote:Schleima,

The Clinicians menu allows you to make changes to the settings of your machine. Before you make any changes, please be sure to go through and write down all of your settings first. That way if you don't like what you have changed you will know how to change it back. Also, if you do change anything, only make one change at a time and wait to see how you respond to that.

If you just want to view your night's data without making any changes, you can access the "Advanced Patient" or Efficiency Menu by pressing and holding the left < and right > buttons. Then follow the directions Clair gave for your nightly info. But this data is rolled over into the weekly-monthly-yearly average at noon, so the night's data will no longer be accessible. You can check your weekly-monthly-six month-annual averages by pressing the left button under each screen.

Thanks to everyone for the replies.

I've accessed my data, and here are the results.

For some reason, the first night yielded "No Data"

The second night (last night) I got the following results:

Leak 0.4 L/s
AHI 5.3
AI 0.8
HI 4.5

Both nights I woke up feeling more to less like I always do. Maybe a little clearer. On the first night I used the optilife, and on the second I used the Swift.

I am a little confused as to how this compares to my sleep study results, which read as:

Non-titrated study:
RDI: 10
AHI: 5

CPAP titrated study:
RDI: 0.4
AHI: 0.4

What is AI and HI? These numbers do not appear on my study results.

Is my leakage rate normal?

Thanks!

Apnea Index (AI) and Hypopnea Index (HI) added together give AHI.

When you used the Swift, did you inform the machine it was the Swift you were using?
O.

[quote="ozij"]Apnea Index (AI) and Hypopnea Index (HI) added together give AHI.

When you used the Swift, did you inform the machine it was the Swift you were using?
O.

You'll find all the terms and acronyms defined and explained in the blue links at the bottom of your post.

Those results would bother me too - but before you do any tweaking of the machine's pressure, check all you hose and mask connections.

That leak rate, when the machine knows it has a Swift is way too high. Could the main hose be loose? Have a hole?

Your results look like you're not getting therapy.
You feel like you're not getting therapy,
There was no data on the first night
There is a large leak on the second night.

I'd say something is wrong with the physical setup; it could be a machine malfunction but check all connections thoroughly - including - I assume = the humidifier connection.

If you're absolutely sure everything is connected properly, check your mask leaks. I think you can use the machine to test your mask fit (it has a speical menu).

O.

O.

[quote="ozij"]You'll find all the terms and acronyms defined and explained in the blue links at the bottom of your post.

Those results would bother me too - but before you do any tweaking of the machine's pressure, check all you hose and mask connections.

That leak rate, when the machine knows it has a Swift is way too high. Could the main hose be loose? Have a hole?

Your results look like you're not getting therapy.
You feel like you're not getting therapy,
There was no data on the first night
There is a large leak on the second night.

I'd say something is wrong with the physical setup; it could be a machine malfunction but check all connections thoroughly - including - I assume = the humidifier connection.

If you're absolutely sure everything is connected properly, check your mask leaks. I think you can use the machine to test your mask fit (it has a speical menu).

O.

O.

My take is that you can't go by one night's worth of data. If you had a split-night PSG where you were diagnosed during the first part and titrated during the second part, your titration may not represent your actual AHI either. If you did not get to REM sleep during titration period, your AHI may be low even without treatment.

Take it slow, ease your stress, collect a week or more of data then determine what needs fixing if any. You begin by focusing on leak data first. A 0.4 L/s leak number on a ResMed is the same as a 24 L/m leak rate above the normal vent rate of the mask. That is a bit on the high side IMO. I think your RT knows not what she says.

Once your leak is is good, you can focus on pressure settings to lower AHI values. What is good leak rate? That is why software and card reader is needed. In general, you want a steady leak rate ... one that does not flucuate up and down during the night. The LED will only give you an average for the night, not the details you need to conquere your leak issues.

[quote="DreamStalker"]My take is that you can't go by one night's worth of data. If you had a split-night PSG where you were diagnosed during the first part and titrated during the second part, your titration may not represent your actual AHI either. If you did not get to REM sleep during titration period, your AHI may be low even without treatment.

Take it slow, ease your stress, collect a week or more of data then determine what needs fixing if any. You begin by focusing on leak data first. A 0.4 L/s leak number on a ResMed is the same as a 24 L/m leak rate above the normal vent rate of the mask. That is a bit on the high side IMO. I think your RT knows not what she says.

Once your leak is is good, you can focus on pressure settings to lower AHI values. What is good leak rate? That is why software and card reader is needed. In general, you want a steady leak rate ... one that does not flucuate up and down during the night. The LED will only give you an average for the night, not the details you need to conquere your leak issues.

What bothers me even more is that I just now shared this info with my respiratory therapist on the phone. Her response to the 0.4 L/s leak... "if it's 0.4 or below, that's normal. All masks have some leakage because they are supposed to vent air." What is an acceptable leak rate?

She's right, in principle. But with your mask defined as a Swift, your 0.4 is 0.4 above the expected leak rate. Look in your documentation, page 6. The Swift's intentional leak leak rate at a pressure of 8 is 29 LPM, which is more that .4 LPS to start with. Add that to what the machine reports, and you're at more than 0.8; too high. You will see that number if you inform the Elite that you're using a "standard" mask. Maybe the RT doesn't know about Resmed's way of reporting leak for Resmed masks.

At 0.8, my apnea index was actually pretty low (right?)

Right.

As for my much higher hypopnea index (HI 4.5), my right nostril was congested last night, so I wonder if that had something do do with it? I guess if this is a chronic problem, I'd need a hybrid or full face mask?
Also, my throat was a little dry when I woke up, so she suggested that I likely need a chin strap to keep my jaw from dropping and keep the air in. (my humidification is set at 3). She said that jaw dropping often lead to leakage problems.

Well, she really has to figure out whether she thinks you have a leakage problem or not. At any rate, she right about needing to avoid leaks from your mouth.

O.

No harm recreating good results ... in fact it is encouraged.

ResMed displays LED leak data in liters per second. You must multiply by 60 to convert liters per second to liters per minute.

In addition, ResMed leak data represents the leak rate in excess of the mask's designed CO2 vent rate. ResMed has a mask setting which it uses to subtract the CO2 vent rate from the total leak rate. The residual (what is left over) is what you see in the LED. Ideally, the leak rate on a ResMed should read as zero ... anything greater than zero means you have a leak somewhere in the system (hose connections or more likely leaks from your mouth if using a nasal type mask or where the mask interfaces with your face/nares).

On other machine brands, the leak rate vlaue is always the "total" leak rate given in L/m and one must subract their own CO2 vent rate for their given mask and pressure settings (CO2 vent rates increase with increasing pressure settings).