[CPAP] Desperate - Please Help

[TMac]

Thank you Dormeo for the encouragement. I did try Micropore tape over my mouth and it hurt so badly when I removed it. I did get better results that night, so I'll try your recommendation of Somnifix. I really appreciate your help!

[RayBee]

Did I read that right?  Your Ramp Time is set to 45 minutes?  That sounds awfully long to me.  I set mine to 5 minutes then turned it off after I got used to the pressures.  Most advice here is to target your Ramp Time to being off.  And if you must use Ramp Time to get to sleep, then go with the minimum time that still works.

Ref: Post #1, Image #1

[TMac]

Thanks, RayBee,

I have no idea why it's so high. That's how it was set. I'll decrease it tonight with the goal of eventually getting it turned off. Thanks for your help! 


Tmac

[mjphyi]

At around 3:00, you have a 20 minute large leak.  It is hard to imagine having a mask leak for that long and not waking up.  Your snoring and flow limitations also seem to coincide with your leaks.  Sleeprider asked about mouth breathing.  I'm wondering the same thing.  If you open your mouth or air is leaking out of your mouth, you might still avert an apnea, but there will be a reduced amount of air therapy.  The machine will compensate for a lot of this, by ramping up the pressure, but it may not eliminate flow limitations which are "almost" an apnea since air flow is restricted.

John

I'm not one of the experts around here, and so I'm hesitant to step in here at all, but I've been looking at my own charts quite a lot over the past year, and I disagree with your conclusion about the mask leaks. You use a full face and I used to as well, but the OP is using a nasal mask. It's my belief that large leaks DO cause therapy "issues" and pressure changes when a full face is being used, but they have much much less effect when a nasal is being used.

I can't explain why this is, although I have a few ideas. I think it's more that the area and perimeter of the full face is much larger, and once a leak opens up, it can rapidly get much larger. I think this is a bigger effect than the nasal's smaller air volume within the mask or hose.

We could learn more about these issues if the posted chart contained the Mask Pressure chart. This is slightly more informative than the Pressure chart. Pressure is really Machine Desired Pressure, sampled every 2 seconds and the Pressure Oscar displays is the actual machine/hose/mask pressure sampled 25 times a second.

So when a leak happens, the pressure will drop, the machine senses it, and turns up the fan speed  to maintain the pressure. If the pressure is kept at what is desired (and in my experience it usually is) then the therapy should be unaffected. And in my experience, with a nasal mask it IS unaffected, and with a full face, it is initially unaffected, but the leak detection's side effects are not compensated for sufficiently in the automatic desired pressure algorithms, and possibly also in the Flow Limitation traces.

In summary leaks affect therapy with a full face mask, with a nasal, they have way less effect.

Michael