Sierra

I see that you have posted about similar issues before with your AirCurve 10 CPAP and F20 mask. I would suggest you have two choices. One would be to download SleepyHead and view your results with that software. The other option would be to take the SD card from your machine to your sleep clinic and have them look at the data to tell you what is going on.

My informal tracking of the issue suggests that the US DME are the ones mainly doing it. I suspect there is not a huge market for 4 GB SD cards, so there must be another reason...

What you don't make on the item you can always make up with more volume!

There are some things to do to optimize the layout on the Daily Detail screen before you post it so you can get the critical data to show.

• Under File, Preferences, Appearance, uncheck the box that shows the event breakdown pie chart. It covers up more important information.
• F10 (on a PC) gets rid of the redundant tool bar on the right
• Click on the triangle beside the current date to hide the full month calendar display

When you have it set up just press F12 (PC) to capture the screen. A box will pop up in the bottom right showing where the image file is saved. With Windows Explorer left click on the file and drag it into the body of a message you are composing here. Use the Write a Reply button near the bottom so you get a full width window here to display it.

You can use the date functions to go back to what you think looks like a typical day (for AHI) at both elevation levels. Just remember to hide the calendar again. You can use the Overview tab to look back for what you think are typical days. But, just do the daily detail screen shots. It has the critical stuff.

Any questions, just ask...

The AirSense 10 CPAP is a basic machine that does not save any detailed data and is fixed pressure only. If you have options to change machines without cost or at minimal cost, I would recommend upgrading to at very minimum the AirSense 10 Elite. It is still a fixed pressure machine, but it captures detailed data and can distinguish between central and obstructive events. The basic CPAP cannot. Ideally again if it is without cost I would recommend go to the automatic machine which is the AirSense 10 AutoSet or AutoSet For Her. I has much more capability.

Which mask is best is a very personal decision. I think there are advantages to a nasal pillow mask like the Swift FX, but not everyone can use it. Getting the proper size is best done by trying the mask. Alternately if you google the mask name and fitting guide, some have printable fitting scales that you can use to determine size. The nasal pillow types typically are sold as a "Fit Pack" which means they come with two or three insert sizes. You try each one and see which one works best.

On the humidifier setting, I believe the starting point is a setting of 4. You adjust it up or down based on how it feels. If you get water in the hose, then you have to turn it down.

Your pressure will not change on this machine. The standard way to get the pressure changed is to go back to the sleep clinic and have another titration test done. You could manually adjust pressure up and down, but with almost no data you would be guessing. It probably could be done, but it would be time consuming. It would be simply trial and error after making small changes.

Hope that helps some,

Sorry, I forgot to comment on the apnea breakdown you gave. That is not a real high % of centrals compared to what I see in my results. It suggests your main issue is obstructive apnea, and that usually can be solved with more pressure, but the pressure may increase the central frequency, so you have to watch that. If you are using Flex, turning that off may reduce your obstructive events some without increasing pressure.

Hypopneas are more complicated. Typically they are not broken down into central and obstructive because it is very difficult to do. It is my view that they can be due to flow restrictions and are obstructive in nature, and they can also be due to reduced effort to breathe which is a central type of issue. My personal view is that one could allocate them roughly based on your ratio of obstructive to central events. That is pretty simplistic, but is the best I have come up with.

Let me give you a brief introduction. The software is free and you can download it here. And here is another link to a basic manual on how to use it. It was developed by an Australian who wanted to give users of CPAP machines access to the detailed data that these machines store on a SD card. To use the software you need a PC or Mac and a SD card reader. If you don't have a SD card reader, you can get a basic one that plugs into a USB port for as little as $5 at a place like Walmart.

The software is very useful in viewing what is really going on during the night. Without it, all we can see is very basic summary data, that is mainly designed to monitor compliance. Here is an example of the main daily detail screen from my machine for last night.

On it I can see my mask was leaking a bit, but not often over the suggested maximum of 25 L/min. I can see I took a fairly long time to go to sleep, but made it through the night without getting up. My AHI was lower than I normally get. I am currently testing a lower fixed pressure of 10.6 cm. This compares to when I was using as much as 15 cm in auto control. The majority of my events are still central (clear airway) while obstructive is not that bad.

And you can monitory your progress over time with the Overview tab. Here is my last 6 months. The solid red pressure bars are when I was in fixed pressure CPAP mode. My latest change to 10.6 cm is not doing so well, but I will probably give it another day or two before I give up on it.

That gives you an idea of what it can do. Assuming you have had a SD card in your machine, all this data is likely all there already. SleepyHead can let you look at it all. And for what you don't understand it is pretty easy to post a screenshot here for comments. What I have shown you is just scratching the surface. The resolution of the data is amazing and you can zoom in on by just clicking on areas of interest to see what happens on a breath by breath basis. That black kind of mess for Flow, and blue mess for Mask Pressure expands out so you can see each breath you took during the night.

Hope that helps. I think it is simply amazing software. I couldn't have gotten to where I am for AHI without it.

I agree 100%!

I am less familiar with the DreamStation machines, but on the ResMed machines you cannot trust the green happy face that says mask fit is fine. Leaks have to be absolutely terrible to bring up the red unhappy face. SleepyHead is a far more reliable guide to evaluate your mask leakage. It graphs the actual leakage throughout the night, so you can see when and at what pressure the leaks occur at.

I presume that is the ResMed AirTouch F20 mask?