app1nag - Therapy Assistance Thread

[app1nag]

I know I should be concerned about leaks but I am still getting <2 AHI each night. Is the AHI index still accurate despite a high rate of leakage? I've been on therapy less than a week and will be making adjustments as I progress with the device. I believe leaks are coming from opening my mouth and not a poorly fitted mask. As a hypothetical, if my mouth stays open all night yet my AHI is still <2, does that mean therapy is still working, or is the AHI a false reading because of the high leakage?

thanks !

forgot to mention, my Airsense gives me a smiley face in the morning even though I am seeing high leakage #s in Sleepyhead.

[DeepBreathing]

Resmed machines can nominally compensate for a leak up to 24 L/min. Above that you can't place any reliance on the AHI reading.

[vsheline]

As stated Aircurve is a BiLevel machine, but a setting of 10-20 would suggest an Auto CPAP machine. There is confusion in the prescription.
I would want to look at all the details of the sleep study used to determine the prescription. Then I would insist the doc correct the prescription to support the sleep study diagnosis.

From ResMed: The AirCurve 10 VAuto is an auto-adjusting bilevel device that uses the comfort of both the AutoSet™ algorithm and Easy-Breathe waveform in its VAuto algorithm to treat obstructive sleep apnea patients who can benefit from greater pressure support.

Hi app1nag,

Perhaps bwexler's point was that an AirCurve 10 VAuto prescription would normally state the Min EPAP, Max IPAP and Pressure Support. (True)

Maybe the DME will assume the doctor meant Min EPAP 10, Max IPAP 20, and default value for PS (4, I think). (Good luck with that.)

[Gabby]

This is where I am confused because I get 2 and below for my AHI's my leaks are always from 6 to mid teens, I have never had a red face and I would say most of my leaks are from my mouth, note, I do wear a chinstrap.
But and its a big but, I am still extremely tired every day and this has been going on for nearly two years now.
So even though I have leaks all night long because they don't get to 24, no red face?
AHI is good so I just continue as I am and being exhausted every day.
Sleep Dr. said everything was fine. Said he couldn't do anymore for me.

Sorry app1nag for butting in here, you're a newbie and I'm an oldie but im still confused.
Good luck on your Cpap journey.

[cate1898]

Hi Gabby, have you ever tried a FFM? Just wondering if that is what you really need or would help your leak rate?

[app1nag]

...so I used the airsense auto for 10 days and got the DME to swap it our for the aircurve auto. I slept with the aircurve auto for 2 days and they were the worst 2 days since I started therapy 12 days ago. The machine seemed noisier, I was more restless, and my mask seemed to leak more. I actually got up one morning at 4am, took the mask off, then put it back on and slept another hour. I never did that with the airsense. Can this even be possible? I thought the aircurve was the Rolls Royce of the RESMED line. I am thinking of getting the airsense machine back and enjoying a restful night of sleep.

---

A10 AutoSet deliver ONE pressure, if EPR enabled, pressure drop at exhale by whatever level is selected (1, 2, 3)

Bilevel deliver TWO pressures, IPAP and EPAP
Pressure support is the difference between IPAP and EPAP can be set 4 or higher

EPR is not exactly like pressure support, it can be suspended when an apnea is detected

I would do a trail and see if helps ... set the Autoset on CPAP mode, so pressure remain constant all night (except Ramp time) and not fluctuate during the night as on AutoSet mode

are you saying that EPR might be a better technology for preventing apneas?

[notsleep]

Something is set wrong with your settings i have an aircurve 10 asv and it is as quiet as mouse .
What are the settings set at ?
What mode is the machine in?
I think if you give us this info others that or more experienced with this particular problem will help you get this figured out.

[PoolQ]

The AirCurve is the higher end machine with many more choices to tune it to your liking, but it does need to be tuned. Only the therapy pressure is "Auto" on these machines (and set by prescription), everything else is tunable and was left at default.

Do you have sleepyhead installed? read up on how to get screenshots and post them. Many people here can help you tune up you machine.

[app1nag]

The bottom line is that I did not really need a bi-level machine and all the customization that goes with it. I was doing really well (AHI-wise) on the Airsense auto and should have stuck with it instead of pushing for the Aircurve. I will be back on the Airsense tonight and will see how it goes.

Part of the confusion was how the script was written, Aircurve Auto Elite 10-20. After speaking with the doc, all he really wanted was an APAP machine and the Airsense fits the bill.

Apnea Hypopnea Index (events/hour) since Dec 2.

1.5
5
1.1
0.5
1.1
0.5
0.6
0.6
1.5
0.3
0.7


Thanks for all the feedback!

[app1nag]

[attachment=1970]I've been on therapy for half a month and am starting to dig deeper into the data provided by Sleepyhead. I was looking for some assistance from more experienced users of this software. I posted last night's results and was wondering how they looked compared to others you may have seen. Disregard the large leak at the very beginning as that was caused by me.

Thanks !!!