CPAP user for 5 years, switched to BIPAP

[Sleeprider]

Your event rate looks just fine. Hypopnea may be related to flow limitation created by positional obstruction. You can zoom into the events and if you see big flat tops or downward sloping inspiratory peaks, then that's likely the problem. The Wiki on flow limitation provides a pretty good idea of what this looks like.

Large leaks are excessive, and if the only way you can shut them down is by cranking down on the mask straps, then your mask does not fit properly. Consider looking for a different make, model or size.

[cbombzzz]

Checking back in with you guys...
Having much more success with the ASV machine than I ever thought. AHI has reached a maximum of 2.1 but most nights around 1. I even had a night with a 0. Amazing!

Quite often I do wake up with an extremely dry mouth and can barely get my lips apart. What is the cause and remedy for that?

Again, your help is much appreciated and I hope others that have followed this thread are also benefiting.

C

[Sleeprider]

It's good to hear the BiPAP Auto SV is working well and life is easier. Check your leak rate, you might be opening our mouth.

[cbombzzz]

Yep, looks like the leak rate is the problem. The second attachment is a good example of the leak and what happens to the pressure. Very interesting. I want more nights like this.
As a reminder, I'm using a nasal pillow. Does that mean I should be using a mask with a chin strap? If so, any recommendations?
Are there other issues with a high leak rate other than dry mouth? In other words, should I just go not worry about it?

Thank you.

C

[Sleeprider]

Chombzzz, this request has nothing to do with therapy but to better understand the Philips DS SV. Could you please post a chart with a zoomed view of the flow rate and mask pressure? No more than 2-minutes so we can see how the pressure is delivered, and what the respiratory flow looks like. If you are ambitious, post two charts, one with spontaneous breathing, and one with triggered breaths as indicated by those black hash marks on the top of the chart.

Thanks,

Tom

[cbombzzz]

Is this what you are looking for Tom?

Could you tell me what you are looking for and what your thoughts are? My respiratory rate has dropped from using the BIPAP AVAPS where the average rate was upper 40's to low 50's. On the current AutoSV, it is now in the mid-teens consistently. I'm very happy with the AutoSV and every bit of credit goes to Sleeprider and Bonjour. 

I'm currently researching other masks. I'm wondering if my current mask is not sufficient. 

Thanks,

C

[Sleeprider]

That's great. The Philips provides a square sine-wave pressure support that is very unlike the Resmed. In most of the segments you showed above there is moderate to severe flow-limitation, or the machine is creating a breath during what would otherwise be central apnea. I'm going to point Bonjour (Fred) to this post so we can consider how it might be helpful in a Wiki comparing Resmed and Respironics ASV. The pressure support delivered by the respironics is not only delivered as a brief square wave pulse, it is often inadequate to fully resolve the flow limit or hypopnea. In most of these cases Resmed would have delivered higher pressure support.

[cbombzzz]

I thought about posting my findings in a new thread, but I think it still relates to this topic.

As you know, I've been using a GoLife nasal pillow mask throughout last year until two days ago when I switched to the WISP nasal mask. See the attached for the results. Feb 15 was GoLife, Feb 16 was Wisp. The Large Leaks have stopped. Although last light on Feb 17 (did not include that data) I had some large leaks when I had to shake the moisture out of the mask from massive condensation build up. We sleep with the window open and it was 4 degrees outside last night. Our room was 48 degrees.

I love the WISP mask so far and I think with the ASV machine it was a good decision to move away from the nasal pillows.

C