Resmed 10 "Clear Airway" events (mouth breathing?)

[Ron AKA]

Have a look at the layout of my SleepyHead data from an A10. That is the view that I find most helpful in doing the first quick look at what is happening.

[finsko]

Thanks for the suggestions; I'll try them. But can anyone explain to me exactly *why* lowering EPR might reduce what the Resmed is reporting as a "CA"?  Detail would be great; I'm trying to understand this stuff.

I don't have DME  insurance that covers equipment, so I had to pay for the Airsense 10 upfront (after a free week tryout from Kaiser, which also included the Eson nasal mask, which I got to keep). Fortunately, I found  a new one on-line for about half price. But I basically control all my own machine settings, although the pressure range was titrated during the week trial.

Sleepyhead is a lifesaver (particularly as a Linux user :-) ). Even if I were to try using the Resmed as a fixed pressure device, the data collection capability would be worth it.

Thanks again!

[Ron AKA]

Thanks for the suggestions; I'll try them. But can anyone explain to me exactly *why* lowering EPR might reduce what the Resmed is reporting as a "CA"?  Detail would be great; I'm trying to understand this stuff.

I think there are two differing views on this aspect, and I am struggling to understand it too. Here is my current thinking but be warned, it changes daily!!

CA events are not created by lack of pressure in theory. They are the result of your body's control system not responding properly to the stimulus to increase or decrease breathing effort. CO2 in the blood is the main initiator of the body's action. When CO2 goes up, it signals to breath more, and the reverse when CO2 goes down. It it over reacts or reacts incorrectly, it can signal you to breath less, and at some point stop breathing totally and you have an OA event. 

It is thought that when you increase the therapy pressure you get more oxygen in the lungs on each breath. That causes CO2 to go down. If you body overreacts to that, it can cause the breathing effort to reduce to the point of causing a CA event. This has generated a rule of thumb that higher treatment pressure is bad for CA events.

Now to the question you asked about EPR. The theory is that when you increase the EPR the pressure is lower on exhale and that makes the complete breathing cycle more efficient. You have a high pressure in the lungs when the lungs are fully inflated, and a lower pressure when fully deflated. That means on a mass basis more air is moved in and out on each breathing cycle. This again like higher therapy pressure in theory should increase O2, decrease CO2, and potentially trigger an overreaction to cause a CA. However, there is one more factor at play. An OA event occurs when the body essentially stops breathing. You can see it on the air flow graph in SleepyHead. But, the EPR pressure fluctuation from inhale to exhale helps to keep you breathing. 3 cm pressure differential is not much but it is better than nothing. So, what it can do is assist the body to keep breathing and possibly break the reduction in breathing effort before a CA event actually occurs. This I believe is essentially how a basic BiPAP machine operates. It uses a higher than 3 cm differential though, and that is the advantage of them over a standard auto CPAP. There is a little more to it, in that they can differ in how they trigger the switch from IPAP pressure to EPAP pressure, and that is where the various BiPAP machines differ in sophistication. 

So, the EPR is a double edges sword. I am starting to think that in users that are susceptible to CA's it may do more good than harm...

[Sleep2Snore]

The problem with air leaking out of your mouth (mouth breathing they call it here) is that if it is leaking out of your mouth it is not keeping your airway clear. I see that by my reports every morning when I have leaks, the AHIs go up. It is always Obstructive events.
Invest in a very good chin strap, in fact most are made of a stretchy material and do just that, stretch!
The cheap ones just have one strap and are useless, they slip and stretch and even knock the head gear you have on.
I would buy one that has at least three straps that go around the head so it stays in place. If that works make one and use the one you have as a template to make one that does not stretch. It still will not stop air escaping out through your lips, but should stop you opening your mouth and letting air escape.
Not quite worked out how to stop air escaping out my lips yet, but I am working on it.
Last thing I want to do is tape them.