Sierra

If you look at the manual for each of your masks there should be a purge rate graph and/or value. In general the larger the mask the larger the purge flow to keep CO2 in the mask low. Full face have the most flow, and I believe nasal will have more than pillows, but it may depend on the specific mask. I believe when you set the mask type in the ResMed it then compensates for the expected purge flow. If you use a F&P mask then you need to match the mask purge flow to one of the ResMed ones, to get the correct setting.

Yes, the CA and H events went up more than OA went down. Like I say you could go back to 10 cm fixed and then try FLEX. Or, you could try the extra pressure for a while to see if this one night is reflective of the pressure. In my opinion the CA and OA events count for the same impact. I believe the H events are less severe as air flow is just restricted, not cut off.

I unfortunately cannot read most of the screenshot, but it appears CA went up and OA went down, and possibly Hypopnea went up too? When you post a screen shot here it is best to use the orange Reply button in the bottom left of the screen. That lets you start a new full width post and in turn allows the screenshot to be displayed bigger.

Unfortunately in some people, myself included, when pressure goes up then CA events go up. 10 cm may be as much pressure as you can use, and 10.5 is too much. I think you have a couple of choices. First would be to leave it at 10.5 for a few more nights and see if there is any improvement. Or the other option would be to put it back to 10, and at the same time put it back to fixed pressure CPAP mode. The more I think of it the more I recall that DreamStation reports flow limitations as events, so that is why you can't find a graph. If you put it back to 10 cm then you could try the FLEX to see what it does.

But, if you repost that screenshot using the orange Reply button I will be able to have a better look at it.

Yes, the Pressure graph is of limited use but with FLEX turned on you should get a red trace showing inhale pressure, and green trace showing exhale. It kind of confirms that it is working, but that is about it.

First I would suggest you make the pressure change, or add the FLEX but not both at the same time. I think I would try the pressure increase only first to see if it has any impact on the number of OA events, and if it has any negative impacts on the number of CA events. If you change both at the same time you will not know what to attribute any changes to.

On layout, you seem to have no snore, and now that I think about it I believe the DreamStation machines may count the Flow Limitations as events rather than as a graph value. Your Minute Ventilation can be of some value. A variation in Minute Ventilation can be an indicator of CA events starting. I would move the Snore down and bring back pressure though. It will show you what the FLEX is doing when you try that.

On which FLEX to use, I think once you have the pressure settled out, then try the basic C-FLEX to see if it helps or hurts. the RERA. If it doesn't help or makes the OA events worse, then I would just turn it off again. If it does help, then you may want to try the FLEX+ to see if it is more comfortable. Here is a little information on the FLEX feature. It is mainly reducing pressure on exhale. That makes breathing easier, but it also drops the pressure which may cause more OA events. It is kind of a try it and see if you like it, but I would turn it off it is causes more OA's. EPR is a similar feature on ResMed machines.

On the Leak rate, if I right click on the vertical scale numbers a menu pops up. One item is "Dotted Lines". When you go into it, then there is a box to check off called "Leak Rate Upper Threshold". It just draws a horizontal red line at 24 L/m. Not a big deal if it is not available on the DreamStation. It is a nice to have so you can get a visual on how the leaks are during the night.

Hi Jason,

You have a fairly simple setup with a fixed pressure at 10 cm. Your overall AHI is pretty good at less than 1. Of that the largest component is obstructive events at 0.64. You could try a pressure increase of 0.5 cm to see if that helps or hurts overall results. More pressure can reduce OA events, but it may increase CA (central events). It is a bit of a trial and error exercise to see what is best.

I use a ResMed, but compared to my results you seem to have a higher number of RERA events. I see that FLEX is turned off, and that usually gives the best results, but you could try turning it on at 3 and see if that helps or hurts the RERA frequency.

Your format is pretty good. If you click on the graph divider grey line and drag you may be able to reduce the height of each graph enough to display one more. It might be useful to see the Flow Limitation, unless it never reports anything. Then possibly snore or Minute Ventilation.

The Leak Rate graph on a DreamStation is a bit confusing as it reports the total leak in the top trace, and the actual unintended leak in the lower trace. The top one is meaningless, but the bottom one is important. If you right click on the vertical scale there should be an option to display the leak rate redline. I find that helpful to determine if the leaks are of concern. This graph shows nothing of concern though for this night.

Hope that helps some. If you have any questions, just ask.

My wife has trouble from time to time with this issue on her ResMed S9 machine. Then it just goes away and starts working again. I suspect the flow setting that shuts it off is marginal and sometimes it just does not see enough flow to make it work. ResMed should put an adjustment on the flow needed to make it work.

The MyAir app is pretty basic, and it is mainly intended to track "compliance", or in other works how regularly do you use your CPAP. Here is a link that explains how the "points" are awarded. It is quite bias towards hours used and keeping the mask on all night.

Understanding your MyAir Points

If you have a PC or Mac and a SD card reader there is a freeware program called OSCAR that you can download. It does a much more detailed job of displaying the data than MyAir. All the ResMed machines except the most basic one captures the data on the SD card on the machine, and it all should be there.

Here is a link to a recent thread that contains a few examples of what reports are available from OSCAR.

I use vinegar to clean my mask and headgear about once a week. I follow that with Dawn soap and water to rinse all the vinegar off. I get some marks on my face from the straps which go away in an hour or so, but no acne.

Franco, your good results using EPR motivated me to try it again for myself. I went through a very long trial and error process to end up with what I have been using for a couple of years now -- 11 cm fixed pressure in manual CPAP mode with EPR on Ramp Only. For last night I changed that to 13 cm (to compensate some for the EPR reduction) and turned EPR back to full time. I had intended to try this a long time ago but had never gotten around to it after I settled on the fixed pressure mode. Your results prompted me to try it.

In any case I got about the best results I have ever had with this change -- API of 0.4. 95% Flow Limitation was 0.01. Almost zero. This is one night only and may have been a fluke, but I will leave it there to see. My biggest issue has been hypopnea events and not so much OA events. For the night I got zero hypopnea events and one each of the CA and OA. Kind of amazing. Will have to see if it is repeatable. I did not notice the extra pressure during sleep and my leak rate was quite acceptable, although not zero.