My Wife Keep Waking up at Night!

[gumleafau]

She is mouth breather and getting large mouth leaks when using pillow mask!
I prefer her to use the full mask, so instead of the oxygen leaking from the mouth its should be going into her lung.
Hopefully in time that will help her low respiratory rate and reduce her symptom of breathless when she talk!
She had another great night after I set the CPAP to auto mode with pressure of 10-14cmH2O as you recommended.
I just received the new Resmed Aircurve 10 vauto, and which mode should I use and what are the pressure settings should I set the machine to?
Another AMAZING result last night with AHI of 2.4, the lowest she have ever been to, and her respiratory rate went up to 10.2.

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[Sleeprider]

You will have to have Mrs Gumleafau stop by and say hi. Looks like this is going very well for her, and I hope her comfort matches the improvement in results.

[gumleafau]

Where are you, I don't mind stop by and say hi to you!
My wife is trying her new Resmed Aircurve vauto last night and the result looked promising but obviously need fine tuning!
She is still feeling tired in the morning from full arousal at night!
I accidentally set the machine with a wrong date, so the correct date is 12 June 18.
But this is only a one day result, but seem to be in the right track!

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[Sleeprider]

It looks like the pressure support is helping with hypopnea, but I would allow maximum IPAP to go to 14 cm. Good start.

[gumleafau]

With this new bilevel machine, every time I adjust the IPAP do I also need to change the PS, so it is PS=IPAP-EPAP?

[Sleeprider]

PS is a constant. As long as the difference between IPAP and EPAP is greater than PS you are getting consistent pressure support in the prescribed range.

In fixed bilevel, IPAP-EPAP=PS.
In Auto bilevel, Max IPAP - EPAPmin must equal or be less than PS for the auto algorithm to work.

For example, 11 IPAP max - 6.0 EPAP min = 5.0 PS. this results in fixed bilevel at 11/6 PS 5. If the desired target is for auto bilevel at PS 5, the max IPAP must be increase or minimum EPAP decreased. At PS 4, 11/6 allows only 1-cm of EPAP increase from the minimum or a range of 10/6 to 11/7.

[gumleafau]

Thanks you for the insight into IPAP, EPAP and PS!
Last night I set the IPAP to 14 and the result is horrible!
At PS4 11/6 the AHI is 5.89 and my wife is woken up by the OA index 3.34  and Hypopnea index 1.39.
At PS4 14/6 the AHI is 10.31 and my wife is woken up by the OA index 8.00 and Hypopnea index 1.85.
What pressure should I set the machine tonight?

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[Sleeprider]

Interesting. I think sometimes centrals disguise as obstructive when pressure rises high enough the individual's lungs just can't deal with the pressure. I'd like to zoom into the flow rate during some of those events. We can perhaps improve on results by manipulating inspiration time and/or trigger/cycle.

[gumleafau]

Hi Sleeprider, 
Attached zoom images as requested!

[attachment=6762][attachment=6763][attachment=6764][attachment=6765]

[gumleafau]

I am anxiously waiting for your comments on the zoomed images attached previously!