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+--- Thread: Large leak rate, what am I doing wrong? (/Thread-Large-leak-rate-what-am-I-doing-wrong)
Large leak rate, what am I doing wrong? - Jspiv - 07-02-2024
Hey everyone! Thanks again for such an amazing source of information. I've been utilizing the heck out of this forum since beginning the process of being diagnosed with severe central SA, AHI 67.
I received my Apap (resmed 11) a week ago after trying to get the more appropriate ASV device to no avail.
I'm a nurse and trying to dial in my numbers to as best I can using the OSCAR date, but they're all over the place.
Can you help give me suggestions on what I can adjust to help these number?
June 29th, no taping.
June 30th, first night of taping
July 1st, still taping
RE: Large leak rate, what am I doing wrong? - nh00 - 07-02-2024
Hey Jspiv, it might help if you post which mask you're using, but here's the Holy Book for mask fitting: https://www.apneaboard.com/wiki/index.php/Mask_Primer
RE: Large leak rate, what am I doing wrong? - G. Szabo - 07-02-2024
(07-02-2024, 11:48 AM)Jspiv Wrote: Can you help give me suggestions on what I can adjust to help these number?I trust July 1st is just a temporary discrepancy.
Your June 30th was quite good. I suggest increasing the minimum pressure to 8 cm to reduce OAs and setting EPR=1 to reduce CAs (mainly because you have a severe CA diagnosis). It would be best to consider purchasing a soft cervical collar and CPAP pillow. Also, and sleeping on your side. Keep taping.
Regarding leaks, you should experiment with different sleep positions and mask types/settings. It takes quite a while to find the optimal mask.
RE: Large leak rate, what am I doing wrong? - Deborah K. - 07-02-2024
Did your sleep study show lots of CAs? If you have it, it would be good if you would post a redacted copy of it here.
RE: Large leak rate, what am I doing wrong? - SarcasticDave94 - 07-02-2024
You'll either want to post your sleep study results here in a post, redacted of personal info. Make certain you have your personal copy of the sleep study detailed results.
Since you're at higher elevation, Central Apnea may be an issue. So this leads us back to the test results. Request this from the ordering physician, if you've not already. They must fulfill the result request as soon as it's made available. If they then refuse, remind them HIPAA states your rights to this test exist. Still refusing, report the doctor to the local or regional medical board. You need this ASAP to know what you're dealing with. I think it's headed to a different machine.
RE: Large leak rate, what am I doing wrong? - Jspiv - 07-02-2024
Thanks all,
I'm currently using a p10 size medium. the small said it had a good seal, but I felt like it wasn't giving me enough air.
Attached are the sleep study results
RE: Large leak rate, what am I doing wrong? - SarcasticDave94 - 07-02-2024
My opinion you'll need the ASV to treat properly. Reasoning is 353 events total, 32 Obstructive, 321 Central and Mixed. I don't believe it's possible to avoid that many CA with the AutoSet or even bilevel VAuto. Old school treating with ST wouldn't help either. ASV is really the right thing. I'd say get any doctor that's working on your healthcare to script it, even default. Titration isn't required unless they stipulate to get the ASV. Regardless we can get it tuned here.
ResMed AirCurve 10 ASV is best bet. With ASV you treat CA, others you attempt to edit settings to avoid CA but compromise the treatment for the rest.
The only reason, also debatable, for ASV being under contraindication is for low LVEF at or below 45%. Echocardiogram gets you this data. I've used ASV, my echo gave a 55%, after 2 years use was up to 63%. I have heart PVCs.