Ok,,, very strange turn of events!

[Chivalry]

Ok.. this is a weird one...
Sine my cpap started 3 months ago i have struggled to get a mask that doesnt leak.. Most i have tried seem to leak, varying from quite bad to hurricane!

Most of my masks that have leaked.. although i get blasts of up to 20 pressure.. most of the time.. even with the leaks.. it sits around 10-15 qith the occasional spike up to 20..

Now the wierd bit... i finaly got a mask thats leak free! ... was a free sample the clinic had for a Apex wizard 200 full face.. and i cant get it to leak no matter how i try... great.. or so you would think..

Since getting my leak free mask,,,, my pressure has shot up to being near 19-20 for what seems the entire night! and i seem to be getting alot more events... not to mention that the graph thats shows if my airway if open/partialy closed/closed seems to have gone ballistic with spikes constantly up and down evey few minutes by the look of it...

Whats happening? i allways assumes once i got the leaks under control my pressure would drop and things would settle... but they seem to have gotten alot worse!

Also was given a resmed full face that also is leak free and im getting similer results with that too... ????

is it possible that my apnea is so bad it actualy needs a pressure up at 19 / 20 to keep it under control?? or is my machine knackerd??

[Fredxx]

You have actually got a hose between the machine and the mask, haven't you? ...

Only joking It does seem very odd! My advice would be to talk to the clinic, only they can really tell you what is going on. It sounds like there may be some odd effect, such as the exhaust being too great, or maybe even a leak somewhere in your hose (although I would guess you would find that) that is affecting the delivered pressure or upsetting the machines algorithm

[Tigers Fan]

Simple approach

Hi Chivalry

As my grandson would say, you've reached the next level! Congratulations! All is well and as it should be, I'd say.

You used to have leaks, thus poor sleep thus not deeply relaxed thus fewer apnoeas and a lower pressure.

Now you have no leaks thus good quality sleep thus deeply relaxed thus more apnoeas needing a higher pressure.

I reckon what you need is to get re-titrated. My guess is that if you increased your Pmin, you would reduce the number of leak-free-apnoeas and thus the need for 20 cm max blasts.

The hard work is finding the right mask or finding how to make most any mask right for you. After that, it's just engineering.

I reckon you be a proper hosehead now, boy!

TF

[Sparticus]

Sounds like you need to change your machine to an APAP for better coverage or get yourself back in for a re-test to see whats happening but I think TF is right about what he said

[Chivalry]

Well heres 2 detailed graphs from 2 nights... the first lot is with the mask that leaks... and you can clearly see where ive woken up with the leakage and turned the machine off/on to reset it.. but look at the very low events even though itas leaking like mad!

Then the second set... no leaks.. but the pressure is mad and loads more apneas..
Also i have already increased my min pressure to 8 as you can see..

Might take a day or 2 for the graphs to show up while there`moderated` so please be patient..

First leaky mask graphs!





Now the new non leaky mask,,




weird huh.....

[Chivalry]

Yup i have an apap,, the resmed s9 autoset....
I just posted a load of graphs showing 2 different nights... first with my old leaky mask... and the second set with the new non leaky masc..

Will have to wait a day or 2 though till its been `moderated` though before you can see it ;0(

[symmit]

Yup i have an apap,, the resmed s9 autoset....
I just posted a load of graphs showing 2 different nights... first with my old leaky mask... and the second set with the new non leaky masc..

Will have to wait a day or 2 though till its been `moderated` though before you can see it ;0(

lol - what's your pMin and pMax?

[symmit]

Looking at your graphs, if I were getting that I'd be stepping up the pmin until it calms down a bit - check with your clinic first if they're in control though...

[Chivalry]

Looking at your graphs, if I were getting that I'd be stepping up the pmin until it calms down a bit - check with your clinic first if they're in control though...

I assume that pmin is the minimum pressure?
I already increased from 5 to 8... What would you suggest I try?

Last night I set it to 9 and turned the pressure relief when I breathe out down to its minimum, it was on 3 and now on 1..

Didn't make any difference though... still up around 20 for the whole night...

[Tigers Fan]

Hi Chivalry

One could only guess what your Pmin should be. The way to find out is to increase it gradually until you get an effect.

My golden rule is 0.5 cm every four nights but you are so whacky at the moment I reckonn you could go 1.0cm every night until you notice a calming effect and then slow the rate of change so you can find the correct setting for you, for now.

I'd also suggest you could very reasonably consider dropping your Pmax. You are spending a lot of time at 20cm and that has to be disruptive. If your mask is tight enough not to leak at 20cm, it is way too tight at lower pressures - but I suspect it leaks at 20cm and disturbs your sleep. 18cm would give a much calmer night.

I used this 'narrow band' technique with my APAP to such an extent that I discovered that CPAP gave me a better result.

You could also consider staying in touch with your medics if you rate them.

TF

ps If you increase Pmin too mach/fast, you'll have difficulty with breathing - so slowlly, slowly is good.

[Chivalry]

Hi Chivalry

One could only guess what your Pmin should be. The way to find out is to increase it gradually until you get an effect.

My golden rule is 0.5 cm every four nights but you are so whacky at the moment I reckonn you could go 1.0cm every night until you notice a calming effect and then slow the rate of change so you can find the correct setting for you, for now.

I'd also suggest you could very reasonably consider dropping your Pmax. You are spending a lot of time at 20cm and that has to be disruptive. If your mask is tight enough not to leak at 20cm, it is way too tight at lower pressures - but I suspect it leaks at 20cm and disturbs your sleep. 18cm would give a much calmer night.

I used this 'narrow band' technique with my APAP to such an extent that I discovered that CPAP gave me a better result.

You could also consider staying in touch with your medics if you rate them.

TF

ps If you increase Pmin too mach/fast, you'll have difficulty with breathing - so slowlly, slowly is good.

Cheers.. will give that a go.

Unfortunatly the tecnitians at my sleep clinic dont seem to interested on the detailed graphs and stuff... they have never even once looked at them even with all the problems i have had ...
They only ever check the lcd on the machine and use the basic info that gives to learn what they need... even though i have explained its quite misleading compared to the full detailed graphs...

The thing i cant understand is my pressure hardly ever drops below 16 or 17... so is that where i am going to end up putting my pmin?? ;0(

[symmit]

I'd also suggest you could very reasonably consider dropping your Pmax. You are spending a lot of time at 20cm and that has to be disruptive. If your mask is tight enough not to leak at 20cm, it is way too tight at lower pressures - but I suspect it leaks at 20cm and disturbs your sleep. 18cm would give a much calmer night.

I used this 'narrow band' technique with my APAP to such an extent that I discovered that CPAP gave me a better result.

You could also consider staying in touch with your medics if you rate them.

TF

ps If you increase Pmin too mach/fast, you'll have difficulty with breathing - so slowlly, slowly is good.

"what he said"

Mine's set now at 8 min 14 max and I have a consistent <1 ahi. Raising the max allows it to freak out and wake me sometimes, not often though. Lowering the min makes it overcompensate. I also find that if using my other mask (full face forma) I'm better off with 10 min 14 max.

Whatever works for you is right for you - if the AHI comes down and you can sleep comfortably it can't be a bad thing - as TF says go up 1 at a time and try it for a few nights, if it goes bad drop it 0.5 and give it a few more nights.

Be patient! it takes time...

[Tigers Fan]

Good info

Hi Chivalry

As you hardly ever drop below 16 - 17 cm, I think you could consider increasing your Pmin as rapidly as you can tolerate to 14 - 15 cm - and then proceed more slowly from there.

Dropping Pmax to 18 cm as I suggested earlier might be a bit tight at this stage but I'd still give it a go - with higher Pmin you should not have so many events and so not need a high Pmax as muich. (Limiting Pmax of course limits your machine's ability to deal with 'bigger' apnoeas - but hopefully you don't get many of them. You can increase Pmax if you need to later.)

Your technicians seem to be typical of those who drive us to monitoring and adjusting our own therapy - out of necessity. And some of us just can't stay away from stats!

You're getting there!

TF

[drewsnoresnomore]

interesting

just a quick add to this thread.

please forgive me if i am being stupid but how wave u managed to print out all the graphs etc.
Is there a reader/software available to allow this.

sorry if i am seeming thick lol

[Chivalry]

Each manufacturer has its own software for reading the detailed information from the machine...
I have a resmed s9 autoset.... which uses the rescan software.
What make is your machine?