Can someone review for a noob?

Ok, so been about 3 weeks or so since I have been on my Auto pap.

As a refresher, I am listed as severe OSA, titrated and prescribed at 20cm.
Bought an Auto machine so I can do this on my own.

Encore pro did not show up for the 1st week, so here are my results from past 2 weeks or so.

Started at a min of 10 and max of 20.

Doing my own analysis, I determined 10 was probably too low.
Bumped to 15 a few days after I started early Oct.

Noticed some vibratory snore snore at 15 and 16cm so bumped up to 17 minimum a few days ago (not sure if this was necessary, but I did it)

I have printed out some stats from Encore Pro Analyzer.

Any thoughts would be greatly appreciated. My AHI during study was 66ish.
Let me know if you need to see any other stats from Encore Analyzer.

Much appreciated.

http://funkymunkys.com/Encore.pdf

I would like to add I am at 100% compliance since I received the Auto M.

mboy wrote:I would like to add I am at 100% compliance since I received the Auto M.

Excellent!!
Welcome to the board,

mboy wrote:Let me know if you need to see any other stats from Encore Analyzer.

Actually, what I prefer to look at are 3 or 4 nights of the Encore Pro "Daily Details" graphs. The graph that begins on page 4 of Encore Pro (or Encore Viewer.)

Won't need to see the "Events per hour table chart" on the same page below the graph. Just the Daily Details graph itself -- for several nights.

It will be the graph like this one:
http://www.tnlc.com/Lara/laura/osa/Enco ... detail.jpg

Is their a way to do it for the 3-4 days in 1 shot?

So far, I have been only able to figure out how to generate the reports based on the specific card download ans sometimes I do them every day and sometimes, skip a few days.

have not been able to view a report with multiple days not on same download from card other then using Analyzer.

You can set the days for the report from calendar example Oct 23 through Oct 26 then scroll through the report till it shows you the daily details in the individual report graphs. Take a screen shot or print to pdf that single report.
Then do the next day and so on. It will need to be individual for each night's report. Don't need the summary data. The graphs show the best information for what we look at.

You get the report by going here to the compliance thing and changing to "full" reports and set your dates.




Here is example of one of mine. I have mine as jpeg screen shot images at Photobucket so I don't have to worry about links. There are ways to do the whole pdf thingy but I don't know how.

Ok, what a PITA.

here is the PDF (it is long) with everything.

1st several pages are from night before last.
Then after that is date range from 16th or so until 2 nights ago.

http://funkymunkys.com/Encore.pdf

Leaks have been giving you (and your machine) fits at times. Any time you see those solid black blocks at the top of the "leak" part of the graph, those are Large Leak periods.

For example, on the Daily Details graph for 10/19 - 10/20, you were spending almost half the night in "Large Leak." When a Large Leak happens, the autopap goes down to the minimum pressure in the range and stays at that minimum pressure until the Large Leak is over. The machine does not even attempt to identify or record any flow limitations, snores, hypopneas, or apneas (nada) for the Large Leak duration. So, the AHI reported for a night that had a lot of Large Leak episodes is not very meaningful. Since the machine stops looking for, or counting, any of those events during "Large Leak", the AHI will appear lower than it probably really was.

You've been getting better control of leaks than you had on that dreadful "Large Leak" night, but it looks like you're still sporadically having some major leak problems. Not surprising, given the high pressure you seem to need, but I'd keep working on the leak situation. Even at high pressures you can probably eventually get the leak problems worked out better, as you're obviously trying to do.

Looks like your sleep study titration recommended pressure of 20 wasn't all that far off from what you need most of the night. Looks like you do need 17 or 18 most of the time. Those seemingly steady minimums when large leaks were happening are misleading. The steady pressure line sitting on your minimum at those times, no events appearing, and the low AHI, are not reflective of what really may have been going on. What looks like nice lulls in pressure and lack of events could have been full of apneas hitting you. Remember -- the machine is not going to record what's happening, nor is it going to raise pressure no matter what's happening, during "Large Leak."

mboy, What position(s) do you sleep in?

Thanks Rested gal.

Leaks are now the single most difficult thing for me. Having a lot of trouble eliminating at that high pressure.
Still don't really know how to fully get rid of them.


Rooster, I start on my side/stomach, but I do know sometimes I wind up on my back (which I know is the worst position to be in for OSA).

mboy wrote:Thanks Rested gal.

Leaks are now the single most difficult thing for me. Having a lot of trouble eliminating at that high pressure.
Still don't really know how to fully get rid of them.

I notice in your equipment Profile, you listed the FullLife mask by Respironics. Perhaps in previous posts you might have mentioned trying other masks. I'm too lazy to go looking right now. If you've not tried other FF masks, I'd be trying some others.
The Full Life didn't do very well in the recent cpap.com Product Challenge:
http://mask-full-face-life-quattro.cpaptalk.com/

I've never had a very high opinion of Respironics masks, except the Comfort Lite II (which is not a FF mask.) I personally think ResMed makes probably the best FF masks, especially their old Ultra Mirage FF, predecessor to the Quattro.

I'd be figuring out a way to put an extra homemade strap around whatever mask I used, if I were going to have to use very high pressure. A homemade strap can work wonders stabilizing many masks, imho.

Got the main air hose hanging up out of your way, so that the main air hose doesn't tug at the mask when you turn over?
LINKS to Hose hangers and methods of managing the air hose
viewtopic.php?t=10640

Incidentally, I very much disliked every Full Face mask I tried -- have tried almost all of them, including the "hybrid" types. Since I can breathe through my nostrils fine and do so all day, but have the misfortune of a habit of breathing through my mouth all night during the full relaxation of sleep, I would have to wear a FF mask, if I hadn't started using tape over my mouth.

I don't know if you have to wear a FF mask because of nasal breathing problems. But if you can breathe through your nose ok, you might want to think about a different type of mask completely -- plus tape over the mouth. I know..sounds crazy, doesn't it?

LINKS to: Mouth leaks - Air Leaks - Tape - DIY Guard
viewtopic.php?t=8011

Just don't let any DME try to tell you that nasal pillows masks can't be used at high pressures. They can be. Remember -- there's always a good old homemade strap to steady things.

Probably the best sealing "regular" nasal mask (covers just the nose) is the old Activa...the one before the Activa LT. The Activa LT may be as good about not leaking, but I've not tried the LT version of it. The older Activa is definitely a "tried and true" good sealer, imho. A marvelous thing about the Activa is how loosely the straps can (and should be) worn to achieve that great seal.

Thanks again. I have been contemplating different masks. I have allergies, so FF is kind of a must for me.

I actually ordered a hose hanger this am and am looking into a quattro and or a resmed ultra.

Gots to get rid of those leaks

My setting is 17 and I sometimes use a ResMed Mirage Liberty and sleep on my side with virtually no leaks. Last night my leak rate was 0.04. Some people have problems at high pressures with the pillows blowing out but I believe that is caused by improper fitting. I toss and turn all night from one side to the other and am contemplating switching full time to this mask as it stays in place better than anything I have worn in 21 years of Cpap therapy.

Good to see you again, Taz.

I'm still in awe:

Sleepy Taz wrote:21 years of Cpap therapy

no need to be in awe, Cpap is easy now that we use electricity!!

mboy wrote:.........

Rooster, I start on my side/stomach, but I do know sometimes I wind up on my back (which I know is the worst position to be in for OSA).

Since you have such a high pressure, I will just throw this out for thought. I need a pressure of 19 cm on my back. I trained myself to sleep on my sides and then later on my tummy. On sides or tummy, 7.5 cm is sufficient. I determined this using software and self-titrating.

You might have a lower pressure requirement on your sides or tummy, or you might see no difference.