Critique Requested

[grokJim]

I've been a CPAP user since 2009 but since December 23 I went through a torturous 9 week period with first no CPAP then CPAP with wrong masks and then since March 1 CPAP with the right mask.

I've been using this forum for advice on getting optimum performance and my situation has improved by a vast amount and I am very happy.  I'm posting my SleepyHead stats today and asking for the many experienced and talented folks on this forum to offer any ideas they might have on how to get my situation to perfection.

[attachment=4749]

[Walla Walla]

I'd say you need to work on the leaks according to your chart.

[Hojo]

And I'd be very happy with an AHI of 0.78!

[Walla Walla]

I wouldn't trust a AHI of 0.78 with Large Leaks 47% of the night.

[Sleeprider]

I'm seeing pressure of 8.0 to 11.0 with EPR 1 resulting in less than 1 AHI. The flow limitations are pushing pressure to the maximum setting, and would likely force higher pressure than would be effective or comfortable without the upper limit of 11.0. It will go as high as you allow. This appears to be an effective solution for you, and the leaks , while above the desirable level, are acceptable.

I'd like to see leaks improve, but I don't see that significantly affecting the reported results. The honest truth is, you can use autoset mode, or just go to a fixed pressure of 11 with 1 EPR and get the same or better results. Whatever mask you're using, I'd suggest you change it or find a solution to the leaks.

[fitmart]

You really seem to be getting the hang of this judging by your numbers.  Good to see you taking matters into your own hands.  A couple things jumped out at me.

1. Your events occur most in the final hours of sleep.  That means your apnea is probably REM sensitive.  The majority of the REM sleep occurs in the last hours of the night. There is not much you can do about that, but just letting you know in case you stress about what is different about that time.
   
2. You have more RERAs than apneas.  This is common with people diagnosed UARS.  (Fancy acronym for saying you have more RERAs than apneas). If your sleep study was primarily OSA, than you don't have UARS.  If RERAs were the bigger problem, than you do.  Most people with UARS have a narrow throat.  This is important to know when treating apnea.  Long story short, purchase a firm soft cervical collar from Walmart.  3" minimum.  Wear it at night and see if your RDI gets better.  (RDI is AHI+RERAs)  By holding your head steady and slightly elevating your chin, the c-collar opens the throat wider.  
   

Good Luck

[grokJim]

I wouldn't trust a AHI of 0.78 with Large Leaks 47% of the night.

Where do you see the 47% number?

The leak rate soared from previous and the only thing changed was that Min Pressure was increased from 4 to 8.  Does it make sense that that would explain it?

[Walla Walla]

Look to the left of your flow charts, under statistics you'll see time over redline 47.070%. Anything over 24ml/min is considered a large leak on the ResMed machines. If you go to the bottom of your charts and turn the flag on for LL you'll get a grayed out area on your event chart showing large leaks.

[grokJim]

I'm seeing pressure of 8.0 to 11.0 with EPR 1 resulting in less than 1 AHI.  The flow limitations are pushing pressure to the maximum setting, and would likely force higher pressure than would be effective or comfortable without the upper limit of 11.0.  It will go as high as you allow. This appears to be an effective solution for you, and the leaks , while above the desirable level, are acceptable.

I'd like to see leaks improve, but I don't see that significantly affecting the reported results.  The honest truth is, you can use autoset mode, or just go to a fixed pressure of 11 with 1 EPR and get the same or better results.  Whatever mask you're using, I'd suggest you change it or find a solution to the leaks.

The mask I'm using now is by far the best of the 4 masks I've used over the last 6 weeks.  The improvement has been dramatic.

But the leak rate was much, much lower when Pmin was at 4.  Like 4-5 rather than 10 to nearly 60.  So tonight I will set Pmin to 6 and see what happens.

[grokJim]

Look to the left of your flow charts, under statistics you'll see time over redline 47.070%. Anything over 24ml/min is considered a large leak on the ResMed machines. If you go to the bottom of your charts and turn the flag on for LL you'll get a grayed out area on your event chart showing large leaks.

Thanks, Walla.  I see the 47% now.  And I've turned on the LL flag.  Thanks for the pointers.