AirSense 10 Elite pressure loss

[Da93]

I have an AirSense 10 Elite (just CPAP mode, no AutoSet) which I have been using for a few months with a full face mask and humidifier.

It has been fine until the past couple of weeks when the pressure has not felt as high as it should. Also when I drift off to sleep, often the pressure will dip so low that I have apneas and wake up.

I’m pretty confident I can rule out leaks (I’ve checked everything). I have messed about with the settings a bit, EPR is off completely so it’s not that either.

Any help or suggestions would be much appreciated!

[OpalRose]

Hi Da93,
Leaks can be ruled out by looking at your data.  Are you using software?

Download the OSCAR software.  Be sure you have a SD card in your Cpap while sleeping.

We would like to see a Screenshot of the daily page in OSCAR as outlined here:
http://www.apneaboard.com/wiki/index.php...ganization

Once your chart is organized, please use the Attachment Feature to post your screenshot here.

Thanks

[mesenteria]

Fill a large tumbler with water, insert the cushion hose connector end down below the surface the same depth, in cm, as your fixed high, or low. Let it run, and check after 30 mins to see if the air still bubbles freely out the hose end.

[Dog Slobber]

After becoming acclimated to CPAP, many feel the pressure isn't as high. It's the same as it was, you may be just used to it.

Leaks (within reason), don't cause reduced pressure. The CPAP compensates by increasing flow.

With OSCAR compare your Pressure graph to Mask Pressure graph, the two should be similar. The Pressure is what the machine should be blowing, the Mask Pressure is the actual measured pressure.

[Da93]

Hi, thanks for the replies. Sorry I haven't checked this in a while.

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Just having to post a couple more messages before I'm allowed to attach an image.

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One more....

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Hi Da93,
Leaks can be ruled out by looking at your data.  Are you using software?

Hi, sorry for the late reply. Here is my screenshot from Oscar. Thanks.     

[OpalRose]

I don't see a leak issue. You said you've messed with the pressure a bit... what else have you tried and did it feel any different?

You do have some flow limitation, but it's not too bad. Normally, we advise using EPR to help with FL.

Being your machine is a Cpap, the pressure doesn't change, even though you feel it is.

Your profile states a pressure of 12. What did you experience when using 12? How did it feel? Any increase in events?

Also, the flow rate graph looks a little grassy. You could open up the graph a little and post a couple 2-3 minute segments.

[mesenteria]

I use the same machine, AS10 Elite.  My setting is quite a bit lower than yours, a steady 8 over 5.6, EPR of 2.  I have gotten used to it after five years, and sometimes it does feel as if it isn't delivering enough.  However, a quick placement of my palm in front of the mask's vent soon reassures me that all is well.  Additionally, the bulk of my nightly report is of centrals, although my stats suggest that my rate of centrals is just under half of yours.  So far, they are innocuous. 

You have quite a few 'central apneas', at least in relation to whatever else the machine detects.  These often come up soon after commencing treatment, and may persist unless you make judicious adjustments to your pressure range.  Counter-intuitively, adding more pressure defeats the purpose insofar as controlling or minimizing centrals (called 'clear airway' by the Resmed folks). You would be better off reducing your max pressure back to what was prescribed (if ....IF...you have raised it since then), and also reducing your pressure support setting.

If you elect to continue to fiddle with pressures, make only one change at a time.  If you make two, even for a single night, you won't know which of the two changes has resulted in any changes to what your machine reports, and which you take as a veridical measure of your 'success'.  Also, try for at least three consecutive nights, not just a single night.  You want a decent sample, and to encompass the normal variation in results which all of us see from night-to-night.

I would also counsel you to make bolder changes rather than incremental changes.  Instead of reducing pressure by a single cm of H2O, try two, or even three cm.  If, after three nights, you can see clearly that you are headed the wrong way, then you can halve the change and try another two or three nights at the mid-way setting.