Sierra

What kind of AHI numbers are you getting? If you are able to change the set pressure, perhaps try reducing it to 15 and see how much your AHI is affected. It takes some time to get used to a CPAP. It may be necessary to run a lower pressure for a while and then work up to the full necessary pressure.

What kind of a mask are you using? Is it possible it is a nasal pillow type that is going too far into your nose, and is blocking the flow?

I use the ResMed AirFit P10 nasal pillow mask, but I find it does not stay in place, and I open my mouth when sleeping. I have taken to wearing a Breathewear Halo Chin Strap. I put the mask on first, and the chin strap on second over top. Seems to work well.

I use the AirSense 10 AutoSet, and a P10 nasal pillow mask, and have had no such issues. However I do not use the ResMed MyAir reporting. Since I started used it I have only had the unhappy face on the machine once. That was when I was trying a F&P Brevida nasal pillow mask. It had obviously come out of place several times during the night. With my P10 mask I also use a Breathewear Halo chin strap to keep the mask in place.

What are the max and min pressures that the machine is set at? When you first turn it on to use it, it flashes up a status screen and the min-max pressures are displayed. Leaks tend to be worse with higher pressures, but if you need the pressure for treatment, then you need it.

On the Ramp feature I like to set mine to Auto. This feature actually holds the pressure at a fixed level until the machine decides you are asleep. Then it ramps up quite quickly to your minimum pressure. I also like to use EPR when it is in the ramp mode, but then have it turn off when the ramp is over. If you want to know how to do that, post again and I will take you through it.

As far as mask leaks I have not had good success with the full face versions I have tried. About all I can say is keep trying to adjust the straps to get the right level of tightness. Start with them quite loose and work your way up until the leaks just stop. Leaks near the top of the mask, then adjust the top straps. Leaks near bottom, adjust the bottom straps. This is best done lying on your back in bed. If you Put your mask on, turn the machine on, and then use the Settings menu to run the Mask Test. It will take the pressure up to your maximum pressure set value. Leave it like that until you get the mask fitting well. Then there is an option to stop the mask test. Good luck!

I did some more checking on the N20 mask. It has a dead space volume of 103 ml, while the P10 nasal pillow mask actually has more dead space at 123 ml. The purge flow rate is essentially the same. So, the P10 would probably be slightly worse not better for air freshness. Purge flow does go up with air pressure so 7 cm would give more flow than 6 cm.

One further thought I had is possibility that the flow diffuser that controls the purge flow rate may be plugged. Not very likely with a new mask, but I guess possible. You manual has some instructions on how to clean it. It is located on the outside of the elbow connected to the mask. Looks like they just suggest a toothbrush using soap and water. Put your hand in front of the diffuser when you are wearing the mask with the machine on. You should feel the flow of air coming out.

Hope that helps some,

You have some good questions, and I don't think your experience is uncommon for new users of CPAP. Some questions for you:

1. Do you have the AirSense 10 AutoSet model? It should say on the front of the machine, down beside where you have the humidifier water level indication.
2. Is your machine set to CPAP mode or AutoSet mode? In CPAP mode you only have one fixed pressure. In AutoSet mode you have a minimum pressure and a maximum pressure. The machine automatically adjusts the pressure depending on your needs, up and down between those two pressures. These pressures may be shown briefly on the screen when you first start the machine.
3. Do you have EPR turned on, and if so what is it set at? (1, 2, or 3).
4. Are you using a heated Climate Air hose? It should be marked on the grey fitting at the end of the hose. It is darker in colour because there is a spiral wire running down the hose that is used for heating.
5. Is your Climate Control set to Auto?
6. Is your temperature set to 27 C or 81 F?
7. What AHI numbers are you getting? That number should flash on the screen when you shut it off each morning.

Sorry for all the questions but all of that stuff makes a difference.

I will assume initially that your machine is set to CPAP mode which would mean one fixed pressure of 6 cm. In my opinion that pressure can be too low to be comfortable to some people. Switching your mask type should not make any difference. Each mask is designed to have a purge flow rate based on the dead space (size of the mask). A larger volume mask like a full face will have more purge flow, and a smaller volume mask like a nasal pillow style will have less purge flow. The idea is to control the CO2 level in the air so you are getting low CO2 when you breath in. For comfort purposes with the low air pressure you are using, you may be better off with a nasal pillow mask, like the AirFit P10. It is unlikely to help with the air flow issue. For that you most likely need an air pressure increase to at least 7 cm.

It is not that hard to make these changes yourself, and I can give you some instructions on how to do it, if you are comfortable in doing it. And comfortable with telling your doctor you have done it. The other option is to ask the doctor to change the pressure.

If it were me setting the machine up for a single pressure I would set it at 7 cm. I would turn on the EPR and set it at 3 cm. It reduces the pressure on exhale only by 3cm. So you would be feeling the assistance of 7 cm pressure to breath in, and only the resistance of 4 cm to breath out. Should make it easier to breath overall. Then I would turn the ramp back on, but set it to Auto with a start pressure of 7 cm, and set the EPR (exhale pressure relief) to function during the ramp time only. In auto it would only use the two pressure until you fall asleep. If you want to know how to do that, post again, with answers to as many of the questions above as you can. It is not really that hard. You just enter a special Clinician Menu which functions pretty much the same as the standard user menu. Many CPAP users adjust their own settings.

The SleepyHead software only displays data that is captured by your machine and saved on the SD card in your machine. To bring the data from your machine into SleepyHead you just remove the SD card and put it in a SD card reader. When you open SleepyHead and ask to import the data, it should find the data. But, no it only displays data already there, and there is no ability to make changes to your machine setup with the SleepyHead software. Until you get very familiar with SleepyHead I would not suggest making changes to your setup. Instead I would suggest using it to monitor what is going on and from that generate questions for your doctor or sleep specialist.

I like to look at my AirSense 10 data in detail using the free SleepyHead software. The software allows you to see minute by minute what your air leakage is. That should quickly tell you what the problem may be.

Could it be the machine? Not likely. Is it possible the mask type has been changed and is not correct for your actual mask. The typical nasal pillow mask, the ResMed AirFit P10 should have a mask type set at "pillows". Setting it incorrectly might change the leak report, but not sure.

You posted in a thread titled "BiPAP Machine Functionality". You have a couple of responses to it. Here is a link to your post

https://myapnea.org/forum/bipap-machine-functionality/1#comment-17300