Aircurve 10 VAuto and Large Leak Problems

[GeorgeGus]

Set up Resmed Aircurve 10 VAuto for first use last night. Kept all the default settings except minor changes to TiMax and TiMin based on the chart in the Clinic manual. Took a 10 minute nap at 5PM and the results were essentially perfect. Last night's results were far from perfect but a general improvement over my previous Resmed Airsense CPAP.

One of the main problems seems to be my Large Leak. It was high in both versions of the Resmed, which seems to indicate it is a mask fitting problem. Right now I am using a Fisher & Paykel Solo. It is the most comfortable mask I have yet to use and would hate to lose it. I tested it out using the Mask Leak Test on the Resmed. I laid on my back, on my side, got out of bed, went back into bed, move my head a lot, but I could not cause a leak. I mostly a side sleeper, so I can only think I am turning my head into my pillow and displacing the mask. I had the same leak problems with two other nasal masks I tried with the Airsense. 

Note that the LL is quite frequent during my first half with few occurrences in the second half and at a lower rate. It seems the leak fixed itself. I did not consciously fix it or wake up until much later. Median rate was 1.20. Oximeter ODI was 3.1 compared to 11.56 AHI. I had to get up at 7:30 because I was breathing so poorly. I got out of bed for 5 minutes, went back without mask, and slept normally for the next 1.5 hours.

Any thoughts on what is causing the Large Leak?

Also any recommendations for Aircurve settings?

   
   
   

[SarcasticDave94]

I found the ResMed machine leak test to be too vague to be helpful in any way. Red frowny or green grinning ghouls cannot compare to the OSCAR chart.

think the spikey leak pattern will be the mask itself, while the wider rounded somewhat flattened areas will be mouth leaks.

Examples of spikey leak pattern from the beginning of the session to about 01:45, and others that look similar.

Example of the wider mouth leak, about 1:50-2:05, 2:25-3:35 etc.

With the elevated Central Apnea, consider changing the Trigger to High.

[GeorgeGus]

Thanks for the help.

I will change trigger to High.

What do you think of MinEPAP, MaxIPAP and PS settings?

[SarcasticDave94]

The only one you may have want to try to edit may be PS from 4 to 3. I would try trigger edit first.

[GeorgeGus]

Thanks. Much appreciated.

One important point I totally forgot to mention is that when I begin sleeping I say a short three word mantra. On both inspiration and expiration, I can say the whole mantra.

Six hours later when I am experiencing difficulty breathing, I can say the whole mantra on inspiration but only two words of it on expiration. Is there something I can change to help my expiration and breathing?