Aussie Paul needs some help...

[Aussie Paul]

Ok, compared to 3 days ago I have reduced flex to 2, then the next night 13th increased pressure to 11.0, and last night increased pressure to 11.5. I do have trouble with nasal pillows creeping up over my nose.

I have another mast to try a Phillips respironics Optilife that I will try tonight.







Aussie Paul.

[retired_guy]

Whoa up tiger! That's enough changing for awhile. Let your cute little body get used to the new stuff for a few days at least before you do anything else. Your numbers actually look great! Good job with that.

[DeepBreathing]

Whoa up tiger! That's enough changing for awhile. Let your cute little body get used to the new stuff for a few days at least before you do anything else. Your numbers actually look great! Good job with that.

Agreed - the last set of numbers is a big improvement. But you need to make adjustments slowly, only one parameter at a time and wait at least a few days (better to wait a week) before changing anything else. Too many changes too quickly and your won't know what really worked and your body won't have time to get used to the different pressure (or whatever).

[Aussie Paul]

Ok People, thanks for the help. I will stick with these settings and the chinstrap mask and see how the next week or two go.

Aussie Paul.

[Sleeprider]

I think you've found a sweet spot for the pressure. Let that settle in before making any changes. At this point, just focus on comfort and leak control. I think you've made great progress in a few days. Let's see if it holds.

[Aussie Paul]

Hi Everyone, we have had 5 days away in our caravan. Unfortunately I am just so exhausted, BUT enjoyed the few days away with Eril (wife). Learning more about the van with the mods I have done so that we can camp away from all amenities.
These are the results from last night. I spent time yesterday adjusting and making the nasal pillow mask as comfortable as possible.





Aussie Paul.

[retired_guy]

Those stats are looking good Paul, good job...

You only had one spike in your leak graph which is totally meaningless. Overall on the leaks, you can keep working to smooth them out a little, but you're really doing fine. Look at your "snore" graph. For goodness sakes your neighbors are going to think you moved. Your events are low so that's a good thing too. I think what you should do next is to put a happy face on that guy in the pics above.... Yeah, that would be good.

[Aussie Paul]

Hi Peeps, I am having difficulty working out what all the graphs mean. Can you tell from the Sleepy Head info if I am breathing through my mouth at all?

Aussie Paul.

[Sleeprider]

This is discussed in a very understandable and comprehensive way by "Pugsy" on another forum site in a thread called Pugy's Pointers. You can probably search that. Hope this helps:

A leak is a leak no matter where it is coming from and the machine doesn't know where it is coming from so how do we determine if the leak you see is mouth breathing leak or just typical mask leaks? Well, it's kind of difficult but in general we look at the leak line on the graph. Short brief spiky leaks are very likely mask movement leaks...brief refitting or minor movement. Mouth breathing leaks tend to have a longer period of leak and often tend to sort of create a plateau effect.

In this ResMed example below there are actually 3 periods of probable mouth leak but only the middle one went above 24 L/min. I think you can see the pattern easily enough. Do we know with absolute certainty that this is mouth breathing leak? Of course not but we can make an educated guess.



Not all mouth breathing episodes will show up on the leak line because the amount of air escaping through the mouth doesn't always mean that there is enough air escaping the mouth to greatly alter therapy pressure. I have awakened often in the middle of the night...mouth slightly open and I am mouth breathing and mouth is horribly dry but when I go back and look at the leak line for that time frame...well I just can't spot anything of great excitement and certainly nothing that points to anything anywhere near large leak territory. Sometimes the leak line is totally flat at 0.0 (using the S9). So either I wasn't doing it for very long or the mouth leak was tiny that it just didn't register on the software. So this means that not all dry mouth equals massive leaks. It doesn't take much mouth breathing to dry the mouth out.

So if you are using a nasal interface mask and you have dry mouth...it may or may not be a significant problem requiring extra measures to limit it from happening. I can tell you right now that I am not going to wear a chin strap or tape my mouth or switch to a full face mask to fix 30 minutes (out of 6 to 8 hours sleep time) of mouth breathing leak even it if is above large leak territory dividing line. I pretty much know that adding a chin strap or tape or FFM is going to disturb my sleep a whole lot more than that 30 minutes may have impacted my entire night. The cure would be worse than the disease.
Remember...quality of sleep is very important. For me it is my number one goal. Now if I woke up often during the night from the dry mouth then that is a different story but I sleep right through leaks even way past large leak dividing line.
I rarely wake up during the night from dry mouth and I rarely wake up with any leak...large or small.
I have tried taping...tried chin straps...even tried a FFM once. I had more awakenings from those additions than I have ever had from a leak.

Now some people aren't so lucky and they have to decide if the leaks they are seeing are a real concern either from the amount of time spent in large leak territory or frequency of the leaks disturbing their sleep. This is a personal call and has to be made on an individual level. If you are already super sensitive to every little thing then you may elect to take some extra measures to limit the leaks (big or small). Gotta get the sleep first and fragmented sleep for any reason will totally mess up sleep architecture and the normal sleep cycles and the time spent in each sleep stage. If you wake up 20 times a night fiddling with leaks (whatever the cause) you are going to feel like crap the next day. Heck, if you wake up 20 times a night for any reason (even reasons you can't point a finger at) you are going to feel it the next day because if you remember a truck load of awakening I am betting you also very likely had a sizable number of awakenings that you don't remember also.
Fragmented sleep in general just kills the body's ability to make use of the normal restorative powers of sleep.

So use some common sense when evaluating leaks. How big of a problem is it really? Is the cure more of a problem than the leak? Dry mouth may or may not mean that you are seriously impacting your therapy with mouth breathing.
Look at the whole picture first to see if there is really a significant problem or not.
Don't panic if you have a bad leaky night.

[Aussie Paul]

Steadily getting to understand the lingo, those links were great sleeprider.

This is how I have the machine set up.

Aussie Paul.