Need advice on setting BMC LunaG11

[Grumpytoo]

G'day am a new member here and very new to CPAP, I had a months trial with a resmed air sense 10 vauto and had a major improvement in energy and brain function as well as lots of aches disappeared so obviously needed it even though I was still a bit tired.

After the trial decided to go with the BMC luna which is according to the dealer very close to the resmed and superior in some cases, well it may be but as our insurance only covers $500 on a machine and the resmed is between $1900 and $2400, I decided to run with the BMC for $1200 with 3 masks etc etc so only paying $700 instead of $2000.

This machine appears to be noisy but many say they are quieter? the P95 is averaging about 8 where on the resmed it was about 12.5 and the mean is about 5.5 and on the resmed it was 9.5 these could be machine differences? the apneas with the nasal mask were less than 1 average over three nights and the last night was one for the whole night the night before had none but had 3 clear airway apneas?

These results should be good IMHO but I don't feel that good like I was on the resmed for some reason, last night I set the min pressure to 5.5 and max is set at 15 also the sensitivity at 4 rather than 5.

I do struggle to breathe at 5 on the ramp so may bump min up to 6.5 and see how that goes because have absolutely no problems  when I wake up and it's at 7-7.5 with this mask also the leak over the last three nights with this mask is under 6.

Last night I had headaches and a slight chest pain and although much better than at any time over the last 2 1/2 weeks trying different masks on this machine still not feeling that good so I suspect something could be wrong even though the readings to me seem perfect.

Any suggestions? anyone.

[ajack]

Chest pain should always be checked by a doctor, but it is probably you getting use to breathing out against pressure. If that's what it feels like, give it a while to the muscles to get use to it.

I haven't used the luna, you would be better to get some charts up. If depends on the scale, is leak 6 out of 10, 50 or 100?
I saw you had snoring on the other post. Again it depends on the scale, but that is normally resolved by more min pressure. The resmed uses a more aggressive algorithm then the BMC. Try min pressure 6.5-7 and see how the results go.

[Grumpytoo]

Thakn you very much Jack, I altered my minimum to 6.5 last night and the actual mean minimum went up to 7 and the P95 went up from 8 to 8.5 on the screen but it is still showing 8 on the SD card chart/record.

There is something I am not understanding with the SNI though as on the screen it shows <1 but on the SD card chart it shows 6.3 which is up .2 from the day before and that now shows .3 where it originally showed 6.1?

The higher min pressure obviously helped as there were no apnea events last night at all i.e no apea,hypopnea or clear airway apnea, zilch, nada, zip I woke up at 2.30am by the report from a deep sleep and felt like it was near time to get up (no clock) so removed the mask as there was some? problem which looking at the record was a substantial leak.

Went back to sleep and slept restlessly with no mask and then put it back on at 6am by the SD record and slept soundly till 8 am then woke much more refreshed than any time since the finish of the Resmed trial.

The reason for the high leak was that on one of the links you gave me was how to fold a bit of cloth under the mask and this caused some problems but it had the desired effect of removing red marks and not aggravating a pressure sore on my nose, I will improve on that cloth tonight but except for the high peaks of 27L the average leak stayed down to 11.8 which is only 6L above normal, I actually had no conscious memory of the mask leaking, while I was awake it felt perfect but woke with some idea of discomfort.

With most of the Resmed trial machine and the first 3.5hrs of last night I would go to sleep on my back and wake up on my back but the previous almost three weeks on this machine have been very restless causing me to try and sleep on my side then wake in pain from crook hips.

Thank you again for your advice, I now feel much more confident this machine can do the job and will probably boost the min to 7 as it feels very comfortable there, the only problem is the IMHO excessive noise from the machine itself at that level which I can hear above the air hose noise and my wife hears it on the opposite side of the bed.

[ajack]

My thought is the machine is using a different scale that the software, for the numbers to be different.

You keep raising the min pressure to around median and chasing the p95, the machine will settle as you go. You could put it in titration mode, that is more aggressive and will do it quicker. Leaving it it auto mode will get there in the end, so it isn't an issue. Or you could just go 1cm less than the p95, that will also do it quicker.

The mask is more important than the machine, If you can't get that one to work, try a resmed f20

tell her to go sleep on the lounge, you don't need her whining in your ear too

cut a hole in the back of your side drawers, enough for the hose and lead. You can also drill into the front of the drawer, if optics isn't an issue. Put the machine in the draw on a towel, it should muffle it a lot. I'd use the second drawer down.

[trish6hundred]

Hi Grumpytoo,
WELCOME! to the forum.!
Is the BMC Luna machine a Bi-Level machine, as is the Resmed AirCurve 10 V-Auto?
If the Luna is an Auto-CPAP machine, you aren't getting quite the same therapy as you would get from the AirCurve 10 VAuto.
Good luck on your CPAP journey and hang in there for more responses to your post.

[ajack]

I'm pretty sure it's an auto cpap resmed and BMC that was used. In sleepyhead, Med and 95% means the P median and P95. It is an aid to getting the right pressure in the auto. The 30 day average of P95 or 95% being the commonly used pressure for setting a cpap to fixed pressure. For auto putting the min 1-2cm below 95, another way is 1cm below or at the median pressure. Either will work with the low total pressures that G2 is using

did you get the clinical titration manual? google "manuals/resmart-auto-cpap-clinical-manual.pdf" using the " "

G2 When you can, get some BMC charts up

[Grumpytoo]

Thanks Trish no it's an auto machine but does Titration and manual

Jack the machine was set on Titration for the first week from the supplier but the Reslex and I think sensitivity was off, actually I think they said reslex was not available on titration mode but will check next time I set it, also the min was at 4 but pretty sure without checking the P95 wasn't much more than 8, that week was absolute torture, the apneas were below 2 except one night of 2.8 but almost went back to prior any treatment in what looks now to be just non apnea interrupted sleep.

The supplier was only interested in the apnea events but I was feeling terrible, re putting in a drawer, we travel up north during the winter and want to try and get a mask sorted as well as the noise but then I think it will be in a drawer under my bed in the van anyway, might just have to cut a neat exit hole for the hose.

The BMC micro nasal hose is great and the best of any of the 6 masks I have tried but it will be a lot hotter in the northern climate especially without aircond, after this week if I can get the pressures etc right with this mask will put a concerted effort in with the pillows as my mouth breathing is or doesn't seem to be much of a problem now although it wasn't much of a worry anyway.

Got the better of me and checked that yes Reslex and Sensitivity are available on titration mode but were definitely off, once I get sorted I will try some other settings and both the other masks, I particularly liked the phillips undernose one with the gash in it but the head straps kept pulling off and had a pressure problem on the bit of short hair there.

[ajack]

You can use the titration mode, but auto will do the same thing. By you taking charge and doing your own adjustments, you are fine tuning as you go and don't really need the titration mode. The titration mode is mainly for doing a rough setting in up and then averaging the P95 over the 30 days. As said, then setting the P95 as a fixed pressure or boxing the P95 in auto, with the min -2 below and the max +2 above the P95. Or setting the minimum on median.

I would use P95 -1 for my minimum pressure, it sorts out events before they start.

[Grumpytoo]

Where do you think the sensitivity should be set? it goes from off to 5, I have it at 4 for the present but probably should just leave it for now or I will get myself confused there is also a delay setting with on or off but not sure what it does, default is off and it is off now.

[ajack]

auto on, is the machine automatically starting when you breathe with the mask on.
sensitivity 4 should be fine
try reslex 1,2 and 3, see what you like.

did you get the clinical manual from googling "manuals/resmart-auto-cpap-clinical-manual.pdf" using the " "