CPAPtalk.com

Although I prefer PhotoBucket, getting to detailed graphs on Flickr is quite easy, at least in Windowas.
1. Click on the image.
2. Right click on the Flickr image.
3. Select Full size (way on the right)
There you are.

Could be a blockage of the flow sensor. However my first thought on this is that your tubing or mask blocked off. It happened suddenly and corrected suddenly. Is it possible that the tubing kinked somewhere? The machine reactions and Sleepyhead do look to be working correctly. I presume you would have ended up breathing through your mouth whilst the blockage occurred. Does this seem to fit?
Ian

Cowboy Casey wrote:...well I feel the same so maybe not dead yet...

When you are, can I have your boat?

TIA.

Ian, I thought about that and I am just not positive that did not happen... it could have, but what if it did not?? crazzy to think that but maybe...

igdoc wrote:Could be a blockage of the flow sensor. However my first thought on this is that your tubing or mask blocked off. It happened suddenly and corrected suddenly. Is it possible that the tubing kinked somewhere? The machine reactions and Sleepyhead do look to be working correctly. I presume you would have ended up breathing through your mouth whilst the blockage occurred. Does this seem to fit?
Ian

TIA, LOL, its for sale You get about 20K in free stereo and equipment..

Sludge wrote:

Cowboy Casey wrote:...well I feel the same so maybe not dead yet...

When you are, can I have your boat?

TIA.

Cowboy Casey wrote:Ian, I thought about that and I am just not positive that did not happen... it could have, but what if it did not?? crazzy to think that but maybe...

If it did not, sorry to say but you would not be here. The tidal volumes reported during those two hours are less than the physiological dead space of around 175 mls. So you would have been getting zero oxygen to your lungs from your machine and mask during that time. Is the extra tubing or some part of your Pilairo mask susceptible to getting kinked or squashed if you lie with your face down on your pillow for example?
Ian

I have it hooked above my head on the wall so it is suspended down to me, there is just enough slack so the mask does not pull off my face... I tried to kink/smash the hose last night and could not recreat the same as that night...

I wonder if the machine just got lost for awhile?? Anything can happen...

It nice to now that it did react and do what it was suppose to do and I am still here, thats a great thing... I sent the data to my nurse and doctor and they are looking at it... we will see what they come up with...

Thanks to every one for looking over this, I will let everyone know what and if they come up with anything...

Agree with the above, if that was real, you'd be dead. Either machine malfunction or data corruption, take your pick.

igdoc wrote:Could be a blockage of the flow sensor. However my first thought on this is that your tubing or mask blocked off. It happened suddenly and corrected suddenly. Is it possible that the tubing kinked somewhere? The machine reactions and Sleepyhead do look to be working correctly. I presume you would have ended up breathing through your mouth whilst the blockage occurred. Does this seem to fit?
Ian

Look at the leak rate. It stays pretty much the same throughout the event. That strongly suggests:

The flow rate sensor is not plugged and is functioning normally.
The average pressure in the mask was the same before and during the event.
The hose is not plugged or kinked, unless it's plugged or kinked between the exhaust port and your lungs.
There's not some sort of leak event causing the problem.
The exhaust vent isn't blocked.

The only possible mechanical blockage explanation is that the pillows are somehow kinked between the elbow and your nose, or your nose is mostly clogged or blocked. I fooled around with my Swift FX, and couldn't find a reasonable way to mostly block off the airflow at the pillows. Casey, play around with your Pilario Q and see if you can get it to collapse or fold somehow such that airflow is blocked right at the pillows.


BTW, this is a good example of why it's so stupid to throw away the total leak data the way ResMed does. Not only does it verify the flow sensor is working, it verifies the hose isn't kinked, the exhale vent isn't plugged or blocked, etc.

I like the "occluded pillows/nasal passages" argument.

A closer examination shows this was not necessarily a sudden event. Inspiratory flow is reduced and pressures have been climbing prior to the onset of machine breaths:



That last disrupted inspiration could be the completion of the occlusion and conversion to mouth breathing (which, of course, the machine would be unable to recognize).

Of course, the question that begs to be asked is:

"If CC was totally mouth-breathing, that is essentially untreated OSA. Why is there no evidence of that?"

Well, I would submit that CC's OSA is not that severe and/or easily treatable, as witnessed by only sporadic events on low-level therapy:





So if the above scenario was registered during lateral sleeping or SWS, there may not have been any events.

BTW can you post an image of the return to normal flow in a ~5 minute window? Looks like the situation corrected during a SWJ.

Also the center area.

TIA.

Sludge wrote:BTW can you post an image of the return to normal flow in a ~5 minute window? Looks like the situation corrected during a SWJ.

Also the center area.

TIA.

I will tonight, Sorry I have not been on as much... working 14 hour days and when I get home I eat and go to sleep...

Casey

Sludge wrote:I like the "occluded pillows/nasal passages" argument.

Sludge, do you think the reported tidal volume/minute vent numbers are below the possible levels? i.e. would he be dead if all the data was really correct? Can we assume that there's either a data glitch or he's somehow breathing "around" the mask? His tidal volume appears to be below 170 for quite some time and minute vent is around 1 for a while?

Casey, can you zoom in on about 2:05 to 2:25 for this graph below?

Archangle, excellent point about the constant leak rates putting any mechanical blockage beyond the vent ports. Not familiar with the Pilairo but I wonder if the pillows could displace and impact into the skin. It is pretty extreme and sudden for nasal blockage. Thank goodness for mouth breathing!
Ian