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RE: New & confused - Sleeprider - 11-08-2019

It sounds like your pressures are similar to my own (see profile at left) with settings at 18/9.0 PS 4.0.  As Fred says, to take advantage of the Vauto function, you need to make your settings such that pressure can rise or fall a bit.  With 12/8 and PS 4, that will be fixed pressure.  I think you will like the Vauto much more than the Philips.  I came from the Philips System One DS760 auto BiPAP and the Resmed is more comfortable with a lower AHI event rate.  Instead of BiFlex, the Resmed uses EasyBreathe™ that shapes the pressure changes much like a cresting wave. You can see the shaping of the pressure support by looking at the mask pressure chart in OSCAR.  Mask pressure is a chart function your Philips does not have and shows the precise delivery of pressure in response to your breathing flow rate. I will attach a chart to show an example.  In addition, the Resmed allows a number of fine-tuning adjustments you have not had previously like setting the minimum and maximum time of inspiration at which IPAP pressure is provided, and changing the sensitivity of the machine to trigger IPAP or cycle to EPAP.  For now, just use the default settings.  The only feature the Resmed Vauto does not have is a variable pressure support.  The pressure support is fixed, while with the Philips BiPAP you could have set a range.

Here is a closeup of the Vauto breathing flow rate compared to mask pressure in OSCAR.

[Image: attachment.php?aid=16846]


RE: New & confused - hamiltonrrwatch - 11-08-2019

Thanks Sleeprider.

I've attached my most current and complete telemetry from OSCAR. So far, I do like the AirSense more. Feeling rested upon waking, but was initially having some fitment issues with my P30i mask. For the most part, I've resolved these by increasing the humidity, and swapping out the Medium for Small pillows.

Feel free to comment on the report; is there anything there that I should be concerned about, or settings that could be tweaked? Thinking-about

[attachment=16848]


RE: New & confused - Gideon - 11-08-2019

Your numbers look ok. You are experiencing some mouth breathing and large leaks that are only marginally high. These are related.


RE: New & confused - Sleeprider - 11-08-2019

Adding to Fred's comments, your AHI is in good shape here with OA events being less than 1.5 per hour and not clustered. Your minimum EPAP pressure of 8.0 looks to be pretty good and pressure is only moving to 10.0 max. A pressure variation of only 2-cm should be minimally disruptive to your sleep. I don't think the leaks are large enough to interfere with therapy, but it's something to work on to avoid sleep arousals. These appear to be leaks through your mouth rather than mask leaks, and it's not uncommon when you are deeply relaxed to see this.


RE: New & confused - hamiltonrrwatch - 11-08-2019

(11-08-2019, 01:55 PM)bonjour Wrote: You are experiencing some mouth breathing and large leaks that are only marginally high.  These are related.

(11-08-2019, 03:00 PM)Sleeprider Wrote: These appear to be leaks through your mouth rather than mask leaks, and it's not uncommon when you are deeply relaxed to see this.

First of all, thank you both for your assistance. Please excuse my ignorance, but what markers does OSCAR report that would indicate mouth breathing?

This does clear up another mystery; why I sometimes wake up with a dry mouth. Tonight, I will increase my humidity and see where that takes me.

Also, I ordered a nasal cushion for my P30i. I'm hoping maybe the combo might lessen the mouth breathing and leakage.


RE: New & confused - Gideon - 11-08-2019

See the flat tops on the leak chart? That indicates "mouth breathing". Changing the mask is unlikely to fix this unless it is to a full face mask.
Wiki covering Mouth breathing. http://www.apneaboard.com/wiki/index.php/Mask_Primer#Mouth_Breathing


RE: New & confused - Sleeprider - 11-08-2019

The leaks on that chart were based on using the nasal pillows (Airfit P10?). When you switch to a full face mask, the mouth leaks usually go away unless your mouth slips from the mask seal, but the downside is a larger, heavier mask that has much more surface area to seal, and that is more likely to leak around the mask. Lots of members have the mouth leaks with nasal masks, and eventually get it under control. It will be interesting to hear your experience with a full face mask and your comfort. Don't forget to change the mask type setting.


RE: New & confused - hamiltonrrwatch - 11-08-2019

(11-08-2019, 08:35 PM)Sleeprider Wrote: The leaks on that chart were based on using the nasal pillows (Airfit P10?)

I'm using a P30i with pillows and waking up feeling rested. The dry mouth, while somewhat annoying, is infrequent. Before going with a full face mask, I would explore other options, beginning with a soft cervical collar, then working my way through the Wiki List Fred posted a link to Wink


RE: New & confused - Sleeprider - 11-08-2019

Good plan.

My confusion on the mask, I'm still not used to seeing the Airfit P30i nasal pillows and thought you were moving the F30 full face. Please disregard.