First time APAP use

Hello,

Last night was my 1st time using the APAP, with a full mask on. I dont know if my numbers are good. I was diagnosed of having OSA 2 weeks ago.

Here's the result from my smartlink:

Operating Mode: AutoAdjust
Upper limit: 17 cmH2O
Lower Limit: 6.0 cmH2O
Delay Pressure:4.0 cmH2O
Delay Time: 5 minutes
Smartflex: 3
Smartflex mode: Full-time
Irnd: 3
ERnd: 3

Time Statistics:
Time - 7.5 hours
Pressure Statistics:
Average Pressure : 10 cmH2O
95th % Pressure: 11.5 cmH2O
Max Pressure: 11.8 cmH2O
Standard Deviation: +/- 1.3 cmH2O
90th% Pressure: 11.5 cmH2O

Leak Statistics:
Mask Leak: 0.0% of total
Average Leak: 34.3 L/Min
90th% Leakage: 36.0 L/min
Exhale Puff or EPI: 1.5 per hour
Standard Deviation: +/- 2.7 L/Min
95th% Leakage: 38.0 L/Min

AHI Statistics:
AHI: 7.2 per hour
HI: 3.7 per hour
Snores: 105.0 events
AI: 3.5 per hour
NRI: 16.5 per hour
% time in Apnea: 5.8%

Ventilation Statistics:
Ave. Est. Tidal volume: 472.9 mL
Ave. breath Rate: 13.1 bpm


I dont have any slight idea what these numbers mean. I slept for 7.5 hours but i still feel that im not rested enough. Are the numbers good? Any comments? Thanks

Congrats on sleeping so long on your first night! Most folks don't sleep near that long on the first night. That is a GREAT achievement! The numbers that reach out and slap me are your snores, AHI and your leak rate. In my humble opinion, you could lower the both the snore and AHI numbers by reducing your leak rate. Are you using the ramp feature? If so, you need to adjust the mask at full autoset pressure... then kick on the ramp feature when you are ready for sleep. Your mask may not leak at ramp adjustment, but will at set pressure. Adjusting the mask tightness is a trick and you will need to get used to. Know that the mask should "float" on your face. Overtighting is a common mistake for first time users. A mask will leak just as bad when it is overtightened as it would when it is not tightened enough. Also, make sure your pillow is not bumping your mask at night. The mask will leak if it does. You can try to "hang" your head over the edge of the pillow or consider getting a cpap pillow. The cpap pillow has cut-outs so the mask can hang over the side without obstruction, when you are side-sleeping.

These are my thoughts.... best of luck,

Sheriff

Hi Antok,

Great night for a newcomer.

Because the NRI index is high, which includes central apneas, you might want to keep an eye on that. Unless, you had a whole bunch of them during your sleep study, it is nothing to worry about for now.

Many centrals can also occur during sleep/wake transitions which may have happened in your situation. Also, many newcomers will start off with a central apnea index and eventually, it becomes miniscule.

Here is more information:

http://tinyurl.com/bfd4tw3

As an FYI, this is a PDF file so proceed carefully if your computer has trouble opening it.

Good luck to you.

49er

antok wrote:Hello,

Last night was my 1st time using the APAP, with a full mask on. I dont know if my numbers are good. I was diagnosed of having OSA 2 weeks ago.

Here's the result from my smartlink:

Operating Mode: AutoAdjust
Upper limit: 17 cmH2O
Lower Limit: 6.0 cmH2O
Delay Pressure:4.0 cmH2O
Delay Time: 5 minutes
Smartflex: 3
Smartflex mode: Full-time
Irnd: 3
ERnd: 3

Time Statistics:
Time - 7.5 hours
Pressure Statistics:
Average Pressure : 10 cmH2O
95th % Pressure: 11.5 cmH2O
Max Pressure: 11.8 cmH2O
Standard Deviation: +/- 1.3 cmH2O
90th% Pressure: 11.5 cmH2O

Leak Statistics:
Mask Leak: 0.0% of total
Average Leak: 34.3 L/Min
90th% Leakage: 36.0 L/min
Exhale Puff or EPI: 1.5 per hour
Standard Deviation: +/- 2.7 L/Min
95th% Leakage: 38.0 L/Min

AHI Statistics:
AHI: 7.2 per hour
HI: 3.7 per hour
Snores: 105.0 events
AI: 3.5 per hour
NRI: 16.5 per hour
% time in Apnea: 5.8%

Ventilation Statistics:
Ave. Est. Tidal volume: 472.9 mL
Ave. breath Rate: 13.1 bpm


I dont have any slight idea what these numbers mean. I slept for 7.5 hours but i still feel that im not rested enough. Are the numbers good? Any comments? Thanks

Glad to see you took the time to set up your machine properly (Smartflex, Irnd, Ernd, etc). But your snores indicate that you aren't there yet. With the Intellipap, snores are one of the triggers for pressure increase. If your mask is leaking, and it is, you're not getting the pressure you need, and you snore, which kicks the pressure higher, which makes the leaks worse, which causes you to continue snoring . . .

Somehow you've got to get a handle on the leaks.

Just wondering what the recommended pressure was from your titration study. Your machine is running a pretty wide range, and your 95% value is way above your low setting; usually it shouldn't be much above about 2" difference. With such a wide range any auto-machine will tend to "hunt" and overcorrect, resulting in wide pressure variations. I'd recommend setting your low at 8 and see if the leaks come down somewhat.

But aside from that, your first time use is better than most.

I'd first go with the Sheriff's advice, the sheriff is always right ( except for his choice in cats)

Thanks for all the replies.

I noticed in my mask, there are tiny holes (i think thats for CO2 vent). Are these count for leaks? Thanks.

antok wrote:Thanks for all the replies.

I noticed in my mask, there are tiny holes (i think thats for CO2 vent). Are these count for leaks? Thanks.

They are for venting and must be there. They are counted in the leak rates but even so yours are too high. If you look up the documentation for your mask it will tell you what the acceptable rate is exactly for that mask.

Here is something you can get a baseline to compare to.

antok wrote:Thanks for all the replies.

I noticed in my mask, there are tiny holes (i think thats for CO2 vent). Are these count for leaks? Thanks.

You are right... the mask vent is accounted for by the machine and removes the co2 from your breath (exhale). Be sure not to try to cover the vents... it can get you into real trouble fast. Sheriff

Hey guys,

Here's the numbers on my 2nd night:


Time Statistics:
Time - 6.4 hours
Pressure Statistics:
Average Pressure : 12.2 cmH2O
95th % Pressure: 16.0 cmH2O
Max Pressure: 15.9 cmH2O
Standard Deviation: +/- 2.6 cmH2O
90th% Pressure: 16.0 cmH2O

Leak Statistics:
Mask Leak: 0.0% of total
Average Leak: 39.4 L/Min
90th% Leakage: 50.0 L/min
Exhale Puff or EPI: 2.3 per hour
Standard Deviation: +/- 7.3 L/Min
95th% Leakage: 56.0 L/Min

AHI Statistics:
AHI: 10.3 per hour
HI: 7.0 per hour
Snores: 25.0 events
AI: 3.3 per hour
NRI: 7.2 per hour
% time in Apnea: 5.5%

Ventilation Statistics:
Ave. Est. Tidal volume: 431.7 mL
Ave. breath Rate: 13.7 bpm


I guess i still have to resolve my leaks. Last night, even if i wore a full face mask, i covered my mouth with a tape (because i dont know if im a mouth breather or not, and secondly, i thought its one of the factors that causes leaks). Anyway, ill try another size for the mask tonight. Currently, i use a medium size. Hopefully, i can nail this soon. Thanks a lot guys!

If you are using a full face mask, it's ok to breath thru your mouth and you don't need to tape your mouth. The only type of mask that you can't breath thru your mouth are nasal masks. You lose therapy (air) if you mouth-breath with a nasal mask. I am convinced that if your leak rate drops, your AHI and snore rates will also drop.

Sheriff

Hello Sheriff,

Here's my data from last night:

AHI: 9.3
HI: 5.9
Snores: 23.0
AI: 3.4
NRI: 9.3

However, my leaks are:
Ave leak: 31.2
90th: 34
95th: 36

According to the manual i got from my mask (flexifit hc431), with the pressure of 11.5, the leak rate in around 42. Are my leak rates acceptable? But im not getting the optimum AHI, etc rate. Is there something i need to adjust? thanks a lot

Hello 49er,

Thanks for the link you provided. I appreciate it.

Based on my last nights' results:

1. AHI: 9.3 per hour. However, the pdf or the link you provided says that: "AHI is the number of apneas and hypopneas per hour. This number should be less than 10 per hour while on an autotitrating PAP, according to Dr Berry’s group.".
Question: Is my number any good?

2. Average Leak: 31.2 L/min. The pdf says: "(Normal mask vent leaks are expected to be in the 30-40 LPM range.)"
Question: Is my leak rate acceptable?

I did not expect cpap to be this complicated (frustrating sometimes).....

Am still sleepy....no headaches for the past 3 days (very good)....but with the results, im getting confused....no quick fix for cpap and apnea, i think.....

Thanks to all the people in this forum. I still have hope....