AHI & Leaks

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Muffy
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Re: AHI & Leaks

Post by Muffy » Wed Oct 21, 2009 6:22 pm

SuperGeeky wrote:Air dumps out into leak port as it should, so no blowfish Muffy, please correct me if I'm wrong... Throat flattens, air has less space too travel, pressure rises, Leak Port diameter remains static, leaks around mask would increase. Though, I would think it would slight....
There wouldn't necessarily be any leak around the mask as some of the pressure increase would vent out according to the Leak Rate Characteristics of the mask (more pressure = greater leak rate), but mostly the rapid response of the flow generator simply drops the flow rate.
SuperGeeky wrote:Next question, would the Leak Graph above distort the 'Auto Setting'? My opinion, no!!
Me neither.

Muffy
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Muffy
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Re: AHI & Leaks

Post by Muffy » Thu Oct 22, 2009 4:15 am

jules wrote:
Muffy wrote: Right! Like in Paul's download...
Yes, like Pauls. Paul was using a nasal pillow mask and wouldn't use a FFM. He has this alternation pattern. I have seen it in a couple others.
I believe Paul's issues are related to sleep quality.

It's Only An AHI If You're Asleep

Muffy
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rested gal
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Re: AHI & Leaks

Post by rested gal » Thu Oct 22, 2009 8:05 am

Thanks, Pugsy, for posting the Daily Details chart for one of qjosea's nights. It was most helpful to see that the EPAP is set awfully low, imho.
GumbyCT wrote:qjosea -
3. You do know on a bipap it is the EPAP that keeps most of your events suppressed?
4. Just a WAG and w/o knowing more maybe you need to set epap at 9.5 and ipap at 12 or 13?
I agree with Gumby.

If it were me, I'd raise the EPAP pressure to 10, and the IPAP pressure to 13 or 14.

EPAP isn't just a setting to provide comfort when breathing out. EPAP has a very important therapeutic purpose.

It's my understanding that EPAP usually needs to be set high enough to prevent most apneas from the get-go. That present EPAP setting of 5 doesn't seem to be anywhere near high enough to do that for you, qjosea.

Here are some links to a few topics with my thoughts about EPAP setting on a bilevel machine (and min EPAP on the BiPAP Auto):

November 2007 - EPAP is for more than just comfort exhaling.
viewtopic.php?p=227068#p227068

December 2007 - my understanding of how a bipap titration is done.
viewtopic.php?p=231786#p231786

May 2008 - discussion with RonS about importance of EPAP setting.
viewtopic.php?p=265020#p265020
ResMed S9 VPAP Auto (ASV)
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ALL LINKS by rested gal:
viewtopic.php?t=17435

jnk
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Re: AHI & Leaks

Post by jnk » Thu Oct 22, 2009 9:36 am

Sure would be nice to know something about the titration and Rx, though, with all the talk from the OP about centrals and SV and stuff.
qjosea wrote:"The tech indicated that based on my symptoms it seems that I have central sleep apnea and that he would write it up and forward it to my Dr. and Insurance company. He said they would have to approve the machine I need since the need a Rx to request a bipap w/st feature." -- viewtopic.php?f=1&t=45688&p=409483#p409483
Last edited by jnk on Thu Oct 22, 2009 9:42 am, edited 1 time in total.

jules
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Re: AHI & Leaks

Post by jules » Thu Oct 22, 2009 9:41 am

jnk wrote:Sure would be nice to know something about the titration and Rx, though, with all the talk from the OP about centrals and SV and stuff.
Yes as I said on page 1
jules wrote:what does your sleep study indicate for AHI and how is that divided between Obstructive and Centrals?

what is the recommendation of your titration? is this a bipap trial before a fancier machine?
jules wrote:it could be that OP has lots of centrals and they are not being addressed or they are being caused by pressure on machine

many unanswered questions -------------

need that titration report for a start ---- maybe all of them including ones from the past -

jnk
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Re: AHI & Leaks

Post by jnk » Thu Oct 22, 2009 11:09 am

qjosea,

Here is my wild guess:

Your earlier post in another thread as a guest stated:
qjosea157, guest wrote: "I called and saw the tech for apria and explained what was happening with the bipap. He rand a check on the machine and said it was working correctly based on the prescription the doctor requested."
You also said:
"I've seen my doctor twice. The first time in Nov 07, that's when I was diagnosed w/mild to moderate sleep apnea. The tech said I had stopped breathing about 57 times in one hour. My doctor prescribed a cpap then. I tried to get used to it for about a year and gave up. Then in august of this year I thought I was going to die."
If the person from Apria you spoke to spoke truth with knowledge, that may mean the doc considers you to have "failed CPAP" and has given you bilevel at a low pressure to get you compliant first in order to then go from there. In other words, they may think they are going easy on you by having you start out with your machine set up that way and are now trying to test whether or not you are willing to continue using a machine at night, since you stopped before.

IF that is what has happened, I might call my doc, tell him AHI is at 15.5, and ask about the possibility of higher pressures in order to actually treat the obstructions, if that's what they are. I would also ask my doc straight out if I might have central apnea, if I was worried about that. But I would go by what the doc said, not the "tech." And I might hesitate to make the change myself, in this case, in view of my history of what the doc might consider "uncooperative" from before, since cooperation might earn you the privilege of keeping that machine. But I would make the call today and not wait around with my AHI that high.

But, hey, that's just me.

jeff