Sierra

Some of the ResMed masks have a pattern or fairly large holes where the air vents out. They have made no attempt to diffuse the air from it. I had a Swift FX mask that was very good, except for the high velocity air vent problem. I tried various things to try and diffuse the air without success. ResMed have come out with a QuietAir version of their F20 mask with a better diffuser, but I don't think it has been moved to the N20 mask.

The best mask I have found for being quiet and controlling air velocity is the ResMed P10 mask. It has a mesh of quite fine holes that seem to diffuse the air and keep the noise down to a real minimum. The other mask to consider is the F&P Brevida. It has a small clip on diffuser that helps control the air velocity. Not sure it is quite as quiet though. My wife uses it. The Brevida has better headgear than the P10.

What model of ResMed machine do you have. Depending on the model you can download a software program called OSCAR to view detailed data on what is happening during the night. You need a PC or Mac and a SD card reader.

A CPAP is not always a silver bullet to cure insomnia. I have found the tips at this site below helpful in getting a reliable sleep.

MySleepWell

Sure, I will look at it. It is best to start a new thread. If you have a PC just do a F12 to save a screen shot, and take note in the bottom right where it is saved. Then use File Explorer to find the file. Left click on it and drag it to the body of the message. It should upload. But since you are a new user it may get delayed before it is posted, so you will have to be patient. Just post one image and that seems to speed things up a bit. The daily report is the one of most use.

Do you appreciate that the way you have your machine is set up it is functioning essentially the same as a fixed pressure CPAP machine set at 14 cm, with the EPR set at 3 cm?

Here is a screenshot of my ResMed machine on a night when leaks were hitting the redline limit of 24 L/min. ResMed displays mask pressure (the blue trace), and as you can see, the mask pressure is unaffected. See the area where the green cursor line is. Also note that there are no events when the leak rate is high. The pressure does fluctuate a little up and down with each breath and that is the reason for the ragged look of the trace. However it is that way whether or not there is a larger leak or not. While DreamStation does not show the mask pressure, I suspect it is highly likely to be just the same as a ResMed machine. They are both doing the same thing.

While it may be worthwhile to reduce leaks for other reasons, such as comfort, I would suggest it is a rabbit hole non-solution to the issue of higher AHI. There are other reasons for the high AHI. They probably can be solved with a higher minimum pressure unless the hypopnea are central in nature. You will notice that my hypopnea is not that good either, and I believe at least some are central in nature. It is very unusual for me to get under 1 for AHI.

The net real leak rate is hitting about 18 at most. The top trace in the leak graph on DreamStation machines is misleading and I don't know why they even display it. It is the total leak rate including the necessary purge rate. ResMed subtracts out the purge leak rate and only shows you the true leak rate. Yes, leakage from a full face mask especially when it blows into your eyes is very annoying, and can keep you awake. However, at this low leakage rate shown it should not impact the treatment pressure at all. Unfortunately the DreamStation machines do not show you the actual mask pressure like the ResMed machines do. However, I would be very confident that this leakage is not significant enough to impact mask pressure.

OSCAR should work for both ResMed and DreamStation (Respironics) machines. However, some of the most basic fixed pressure CPAP machines may not capture any useful data on the SD card. The Auto machines should all work, and some of the fixed CPAP should too.

Hi Mike,

Your post must have gotten delayed as a new user and when posting a graphic.

Yes, I think you should be able to do better than an AHI of 5 or so. OSCAR is showing a CA or central apnea of 0.56, which is a little concerning. Central apneas are more difficult to control because they tend to increase as the CPAP pressure increases instead of decreasing. The airway is already open so more pressure does not reduce them. Your main component of the AHI is Hypopnea. It can be obstructive in nature or sometimes central. I agree that your minimum pressure setting is low. I also see you are using FLEX which can have a negative effect. My initial suggestion would be to increase your minimum pressure to about 7.5 cm and turn the FLEX off, and then see if that improves your AHI. Later on if CA events become a problem, then you may want to limit maximum pressure to try and prevent them. You should be able to see if they are happening at random or mainly at a higher pressure. Once you sort things out with what is enough pressure but not too much there may be some advantage in switching your machine to a fixed pressure mode set at that ideal pressure. Hope that helps some.

Your leakage rate is not that bad. Ignore the higher curve on the graph. That is the total leakage including the intentional purge flow out the vent of the mask. If you right click on the leak rate vertical scale you should be able to set a leak rate red line at 24 or so. That gives you a good idea if your leak rate is too high or not.

I don't use one but I subscribe to Consumer Reports. I see they have one at a fairly reasonable price ($250) that is rated quite highly (#3) - Honeywell HPA300 Air Purifier. The top rated one is the Blueair Classic 605 at $830, followed by the Blueair Blue Pure 211+ Air Purifier at $300. Those are the top 3.

If you have a particular one in mind I could look it up.

If you use OSCAR to view your results from the machine you can get a lot more detail on what is going on through the night. It requires a PC or Mac and a SD card reader. If you still have your old machine SD card you can load the data from that first, and then add the data from the new machine. That is a way you can compare results with the old machine to the new one.