Newbie - what can you guys tell me?

[dzadecta]

My DreamStation Go says I have 100% mask fit but my leaks look out of control. My mask is on as tight as possible!

[Walla Walla]

You have almost no excess leaks. Your seeing the vent leaks which are suppose to be there. Check the line below that and that's your excess leaks. You could use a boost on your pressure though. I'd set the minimum to 11cm.

[dzadecta]

Awesome! Thanks for that. I think I will.

[OpalRose]

dzadecta,
Your leak rate is fine, but your pressure settings are not optimal.  

Keep in mind that Respironics machines react slower to Apnea events, so an optimal pressure should be set closer to your median or just under the 95% reading.  

As Walla Walla states, move minimum to 11cm, but
I suspect you will need to be a little higher. I would leave at that pressure for a few days before making more changes.

To keep the pressure from responding to snores and FL, lower the max pressure to 16. Once your minimum pressure is set a bit higher, you should see less snores and a lower AHI.

Also, your profile states you are using a DreamStation Go, which is a travel machine. Please change that to DreamStation Auto Cpap.

[Gideon]

You have no excessive leak problem and I suspect from your description that your mask is on too tight.  Please read the Mask Primer.

You do have an issue with snores driving your pressure up, BUT your numbers say that you are treated per common medical standards (AHI < 5).  I use this mark (<5 AHI) to initiate a conservative approach to pressure changes.  Normally I suggest a Max change of .5 cmw and monitor for several days, but since you had been on a CPAP of 9 cmw I'll suggest a change to 7 cmw and wait a few days and see now you respond.  We may very well get up to Walla Walla's 11 cmw it will just take a bit longer.  

Also, once you are under 5 AHI, therapy needs to really center on how you feel.  Don't chase numbers.



Fred

[dzadecta]

[chill]

One other point: the Simplus works better when it is just tight enough that you don't notice leaks on your face / in your eyes.  Yours is probably overly tight now.

[Sleeprider]

All Respironics machines graph leaks on two lines. The total leak is the design plus excess leak, and the bottom line is your excess leak. In your case it is so close to the bottom of the graph as to be unnoticeable. Your starting minimum pressure of 8 is not going to work. Your median pressure is 13.6, and that is much closer to your minimum needs. There may be a solid argument in favor of bilevel pressure in your case, because your pressure needs are pretty high. Good start here, but higher minimum pressure is needed.

[dzadecta]

Last night's data. Received a lot of different minimum pressure advice so decided to keep it the same.

What do you guys think? Still increase?

[Sleeprider]

Your minimum pressure is still 3-cm below your actual median. I recommend minimum pressure of 10. This should help reduce events. Note the location of many of your events is when the machine drops pressure below 10, and it does not recover until you have had several H or OAs. Increasing minimum pressure to 10 will probably reduce the maximum pressure you see, because with large pressure swings the machine will over-shoot your needs. The cluster at 00:30 looks positional to me. Those pressure swings are also disruptive to your sleep. Your leaks remain near zero and look very good.