Help for new-ish user.

[Sleeprider]

It might help you to understand "positional apnea" better. http://www.apneaboard.com/wiki/index.php...onal_Apnea In our wiki article are a number of Oscar examples that show the typical pattern of clustered apnea. Your friend's events are similarly clustered, so that is a consideration to discuss. I agree with the other opinion that therapy pressures look pretty good and the priority needs to be addressing leaks and chin-tucking. This is the soft cervical collar wiki http://www.apneaboard.com/wiki/index.php...cal_Collar

[solo]

Thanks so much, the links are helpful.

[solo]

I just noticed that my friend has had clear airway events all along. Is that something we should talk with the docs about? He was diagnosed with REM sleep disorder during his sleep test, but that has improved with cpap treatment.

[Sleeprider]

I wasn't planning on addressing central events until we first dealt with the obstructive issues. In conventional sleep therapy, central apnea is managed using bilevel pressure using a device that has a timed or adaptive backup rate. In other words, the positive air pressure inspiration pressure (IPAP) will trigger on a timed or algorithm basis to cause a person with an open airway to take a breath without spontaneous effort. This gets kind of complicated if you don't understand how bilevel pressure works. CPAP is constant positive air pressure, while BiPAP or bilevel has a lower expiratory pressure channel, and triggers to a higher inspiratory pressure. We can use bilevel to cause CA events to not occur by either triggering the IPAP pressure and forcing a breath with high IPAP, or stimulating a spontaneous breath with a smaller increase in IPAP pressure. I don't know how deep you want to dive into this rabbit hole, but changing to bilevel with a backup rate (non-invasive ventilator) or without a backup rate (respiratory assist device), requires a doctor's prescription, and I don't think we're ready to go there quite yet.

[solo]

Thanks for that info. His results have been up and down, but overall better, I think. He does sleep with the cervical collar most of the time and is trying to learn to sleep on his side. He used a full-face mask for a while because he was having allergies and doing a lot of mouth breathing. Both of us have at times wanted to throw the danged machine out of the window as we seem to have had every problem there is, but he does feel better when he gets good sleep so we are continuing to work on it. We would have quit long ago without such good help here, so thank you very much!

[solo]

I'm not sure if this is where to ask about this, so tell me if not. My friend is using a Resmed Airsense 11 and has had it for about a year. Recently he had several occasions where the machine displayed a warning about a large leak and then reverted to the home screen and quit operating. Mask settings seemed fine, but there was water in the water chamber area and also in the tube. It was dripping off the piece that connects the water chamber to the hose. I took the water chamber and connector in to the local medical supplier to get replacements after reading that a bad connection between those could cause such problems. The medical supplier kind of freaked out that we had taken the connector out of the machine. Apparently they had not read the instructions from the company to take that piece out and wash it when cleaning the other parts. Instead of new parts (which they did not have) we were told to reduce the humidity to 2. The next time we put the machine back together it worked fine. We did change the humidity to 2, but it was working at 4. After cleaning the machine yesterday it started giving the large leak warning again and not working. The part of the connector piece that joins with the water chamber does look a little distorted. So the questions are: 1/Do we need new connection piece and water chamber 2/If so, where do you suggest we get it?

[Sleepy Quixote]

@solo,

Both the water tank and that internal connector are on the replacement cycle recommended by Resmed and should be covered by insurance. The recommended replacement is every six months, so your friend should be good to go to request both from their DME. If your local parts supplier couldn't identify the outlet connector as needing regular removal and cleaning, I'd find a new supplier...  it may have just be lack of experience of the person on the desk that day, but it would be worth looking up reviews of the place and see how they score.

As far as the rain-out you are describing I've never experienced it with my As 11 so cant speak to it, but the issue with the Large Leak warning and shutting down has happened a couple of times, it was because the heated hose connection was ever so slightly misaligned at the machine, almost imperceptible, but pulling and re-seating fixed it both times. One time it was because I didn't seat it properly after cleaning, the other time was because apparently it got pulled sideways by my rolling around in bed.

If you look down at the top of the machine at the outlet connector and hose junction you'll see two white bars, one on the hose the other on the connector, if they aren't perfectly parallel with each other, the connection is misaligned and could cause the issue described. Just wiggle the hose side to side and you'll see it clear as day.

 

[solo]

Thanks, that helps a lot!

[Sleepy Quixote]

@solo

*minor correction, even though I think you got the idea - "you'll see two white bars, one on the hose the other on the connector" Correction should read * other on the top of the housing where the connector slides in.

[solo]

Thanks, I wondered about that. Did get the idea, though, and got it to work for the past couple of nights. Also in the process of finding a new DME.