Newbie's Encore Viewer reports

Hi, I've been on APAP for a couple of months, first with an AutoSet Vantage (loaner), now with my M series Auto w/ A-flex. I started out with a Mirage Quattro small mask, which was cutting into the bridge of my nose so badly that my DME decided to swap it out for a medium a couple of weeks ago. The medium mask wasn't brand new though, like the small was, and although it's more comfortable, I can't seem to get the leaks under control.

I got the medium mask and the M series machine at the same time, and ever since then, I don't feel like my therapy is working as it should. I'm less refreshed in the morning and get tired earlier in the afternoon. Been trying different pressure ranges, different mask positions, loosening the straps, tightening them, etc ad nauseum and I'm tired and really frustrated at this point. Finally got the Encore Viewer software a couple of days ago and uploaded the reports to Photobucket. Would someone more experienced at this stuff take a look at them? Could my mask be THAT worn out, or what would you try next?

http://photobucket.com/crs_album

Thanks in advance...

-CRS

you just need more time in the saddle, leaks have become a problem at times, but you will eventually learn to control those. If you keep your leaks under control the machine takes care of your apnea pretty good.

I would move the Maximum pressure back up to 15 cm, don't limit the machine so much. Until you get used to therapy and consistent with sleeping every night keep your Minimum low where it is comfortable. I would use Aflex=2 settings. If you increase the Minimum pressure you only increase the amount of leaks you have to deal with.

You want to avoid those Large Leak "bars" at the top of your leak charts. Try to hang the mask off your pillow if side sleeping, don't overtighten the mask straps to the point where it crushes the cushion. The cushion seals better with a freshly washed face with no creams or anything. The cushion seals with pressure.

if the cushion on the mask lands in your open mouth when your jaw drops it is too small, check into getting SleepGuys's PapCap, that will stop that then the mask will leak less. You show snores, that is probably from the Full Face mask and mouth breathing, if you go with the PapCap you may even be able to go back to a nasal mask for better therapy.

Yep, everything Snoredog said. When you clean the mask(you DO clean it daily, right?) Try a 1 part vinegar to 2 parts water mix and soak the cushion for a few minutes. It will help remove any soap residue and facial oils that may cause leaking. See if you can figure out exactly where the mask is leaking from. Those leaks need to be fixed for you to get proper treatment.

Brenda

Terrible leaks are what are wrecking your therapy.

The pressure range you were using on the Oct 5 data looks fine -- IF you can keep leaks under control. You had one period of massive leaks that night which sent the pressure soaring as the machine tried to compensate for the leaks. Otherwise, that night looked very good. The next nights were a mess...because of the leaks.

WOW, thank you for all the great information and suggestions.

Snoredog wrote:You show snores, that is probably from the Full Face mask and mouth breathing, if you go with the PapCap you may even be able to go back to a nasal mask for better therapy.

I wondered why I'd be snoring so much with the CPAP running; I guess that was mouth breathing that was showing up? Haven't tried a nasal mask yet, my sinuses are very obstructed (according to my ENT surgeon) so when I had the titration study I told them I would probably need a FF mask.

bdp522 wrote:When you clean the mask(you DO clean it daily, right?) Try a 1 part vinegar to 2 parts water mix and soak the cushion for a few minutes. It will help remove any soap residue and facial oils that may cause leaking...

I do clean the mask religiously each day, albeit with baby shampoo.

rested gal wrote:Terrible leaks are what are wrecking your therapy.

Yes. Once I got the software and saw the leaks I was shocked. I just can't figure out WHY I am not keeping a good seal with the Quattro. It seems snug when I go to bed, but then I wake up in the middle of the night with the pressure at 14 or something and the cushion making an awful noise. Even holding the mask firmly in place with my hand, the higher pressures blow the cushion outward and it won't keep a seal.

On that note, SOMEHOW (I'm going to try to replicate it again tonight) I managed to avoid most of the leaking last night and got some good data. Of course, all evaluations and suggestions are welcome

http://s362.photobucket.com/albums/oo65 ... 010_13_08/

Which brings me to another question: The sleep lab told me I had no apneas, just a LOT of hypopneas, and titrated me at 9cm. The AutoSet Vantage I had as a loaner gave me pretty much the same information: no apneas, some hypopneas, and 90% pressure (or whatever % it is on the Resmed) of 9.2. The M series A-Flex says my 90% is more like 12cm, and that I do have apneas. If leaks aren't the cause of the differences, is there something wrong with my machine?

The M series A-Flex says my 90% is more like 12cm

This only means that you spend 90% of the time at or below 12cm. Your average was 7.2cm.
Your leaks do look a bit better, but still need work. Keep tweaking that mask, or try a different one. The mask is the hardest part to get right.

Brenda