Sierra

I have no experience with the TapPap, but I do use a nasal pillow mask and have issues with opening my mouth during sleep. My solution is to use mouth tape. I use 1" wide 3M Micropore tape. This is a good video on mouth taping by a dentist. According to the dentist it has some other benefits...

How to Mouth Tape for a Better Sleep

Our son got the Z1 Auto as part of an insurance bundle when he got his AirSense 10 Auto machine. He did not like it because of the noise, and gave it to us. My wife has used it a couple of times as a backup when she had trouble with her ResMed S9. I can't say I recall it as being that loud, but I wear hearing aids which I take out at night of course. It has no humidifier, and is not compatible with SleepyHead or OSCAR. But, it does use standard masks which is an advantage.

The ResMed AirMini I don't know much about other than if you jerry rig some kind of adaptor, it needs a special mask model made for the AirMini. It has an optional humidifier which I believe just captures the moisture in your exhale breath and recycles it to the inhale somehow. You don't fill it with water like a standard humidifier. It also I don't think is compatible with SleepyHead.

Even though we have the Z1 Auto neither of us use it when we travel other than as a backup machine when we RV with our trailer. We have the 12 Volt DC to 24 volt DC adaptor for both of our ResMed machines. It works well on my AirSense 10, but not quite so well with my wife's S9. The adaptor trips out if you turn the heated hose and humidifier on. Without them on it works OK. Seems to be a design fault as I tried three different ones before I gave up on it. We turn the heated hose and humidifier off anyway when we are running off the RV 12 volt to save power. It takes quite a bit extra.

Hope that helps some.

Franco, first off, I am not a medical professional, just a retired guy that has taken some interest in CPAP treatment. I was a reluctant member of the CPAP club. I am 71 and was diagnosed about 2 years ago or more with an AHI of 37. I suffer from a fair bit of central apnea which is not well treated by a CPAP. I am happy to average about 2-2.5 for AHI. As for your questions:

1. On the leak rate I do not go by the happy/sad faces on my AirSense 10. Leaks have to be really bad to get a red unhappy face. I go by the graph in the SleepyHead (OSCAR) Daily Report. If you right click on the scale of the Leak Rate chart and then on Dotted Lines, you can check off Leak Rate Upper Threshold, which draws a dotted line at 24 L/min.. While I like to see a graph that track right down near zero, my experience is that when it does, it usually means I was really not sleeping well, or that my mask straps are too tight. My goal is to go through the night under that dotted line, but do not lose any sleep over going up to it. I do go over and my long term average is 2-4% over the leak rate redline. If I am exceeding the redline too much I adjust the straps on my mask. What type of mask do you use? If it is a nasal, or nasal pillow, one leak issue can be simply opening your mouth during the night. I do that, but mouth tape to minimize the impact of it.

2. I don't worry about the large leak thing. It most often is caused by my mask hose coming off, or me sleeping in a position that displaces the mask on my face. I just try to keep the leak rate below the red line.

3. I never look at the respiration rate. I just did because of your question, and I see that I typically average about 20. I have no idea what it means!!

I worry more about the Minute Ventilation graph, and the frequency of CA or Central Apnea events. The Minute Ventilation looks like a bit of a garbage graph but if you zoom in on the time scale (repeated left click of the mouse, or the up down arrow key), in a ideal world, it should be quite flat. However if it cycles up and down in a periodic manner it indicates your breathing control system is not stable. That in turn can cause central apnea and in the extreme Cheyne-Stokes respiration (CSR). Not sure what the ratio is of the type of events you are seeing in your total AHI, but if CA events are significant this is something to look at. My long term stats show that I am under 0.1% CSR. If it goes up to become more significant I certainly will ask my doctor to investigate, as CSR can be indicative of more serious heart-lung issues.

Hope that helps some. If you F12 in the Daily Report screen as screen shot will be saved. Watch in the lower right of the screen to see where. With File Explorer, locate the file, left click on it, hold, and then you can drag the file into a post you are composing here. It will display the image in the post. Just don't go whole hog and post multiple images as that seems to trigger the spam filter. Just post a Daily Report, if you want some comments as to what it is like.

Hope that helps some,

It seems for example if you open the Daily Report, then go to File, Print, and select "Microsoft Print to PDF", it will "print" a report to a PDF file. You can attach that to an email. You can also "print" the Statistics and Overview screens as PDF's.

I spend some time on my back, but prefer side sleeping for most of the night. Have tried a few different pillows including foam, memory foam, and those orthopedic shaped ones. My current choice is a down alternative type. I don't like the foam or memory foam as they seem too hard and push back too much. I recall others have recommended a buckwheat pillow and the My Pillow which I believe is a shredded foam type.

I am afraid I can't help you in adding back time for a date that is passed. About all I can suggest going forward is that you may want to consider adjusting the time of the machine. I believe by default the ResMed starts a new day at 12 noon, and you can't adjust that to my knowledge. If that is not a good time for you due to shift work etc, then it may be a good idea to fudge the time so it rolls over to a new day at a different (real time) time of day.

I think if one has to look at one number, I would look at the Total Time in Apnea which you will find in the OSCAR Overview graphs. That basically is the time you may not have oxygen going to the brain. I have to laugh when all these reports are on the news today about Trump being at 98% oxygen saturation, or dipping to an awful 90%, etc. But, the reality is for those with apnea that is happening all the time when we are sleeping and having apnea events. Total time in apnea is a good measure of what the risk is. Some use an oximetry instrument in addition to the CPAP values, but I think if AHI and Total Time in Apnea is controlled that is not necessary.

On Cheyne-Stokes I do have it, and I don't like it. If you look at the Minute Ventilation graph and if it cycles in a periodic manner it shows you have potential to have it. However when I look at the long term statistics in OSCAR, I only have it 0.1% of the time. I think it is worth watching, but unless it becomes frequent, not a big concern.

There is a lot to look at and learn from the OSCAR data.

My understanding is that ResMed only allows sleep medical professionals to download their program. There is another program which is just as good called OSCAR. It is an open source software and is free to download.

OSCAR, the Open Source CPAP Analysis Reporter

If you can keep your AHI averaging 3 I would not worry too much. If you want to investigate what is happening during the night I would suggest downloading some free software called OSCAR. The SD card on your machine should have all the data for each night since you got it. This means you can go back and look at what was happening with the higher pressure, and now with the lower pressure. It may uncover some opportunities for further improvement. OSCAR requires a PC or Mac, and a SD card reader.

In general setting the pressure on a CPAP or BiPAP is a tradeoff. More pressure reduces the OA or Obstructive Apnea event. But, more pressure can cause more Clear Airway or Central Apnea events. So, the trick is to lower the pressure as much as you can without causing OA to increase.

I am not a sleep doctor, and only a CPAP user that suffers from central apnea also. You can post your OSCAR daily reports here for comments if you decide to go that way.

When you plug the heated climate hose into the machine there should be a message that flashes up and says climate control is set to Auto. That is where I leave mine, and let the machine control the humidity and temperature. On your machine menu is an option to turn it to Manual, but I just leave mine in the default Auto position. In the Clinical Menu there is a setting which may force it to run in Manual. I would change that back to Auto if that is set to Manual. See this technical manual for more details on how to set it.