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Moe_Howard
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Post subject: Re: Help With OSCAR Please | Posted: Wed Sep 23, 2020 11:16 am |
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Joined: Thu May 07, 2020 1:03 pm Posts: 63
PAP Mask: Philips Respironics DreamWear nasel headgear with arms
PAP Machine: Res Med 10 auto set.
Humidifier: Yes
Pressure Setting: Fixed Pressure is 12.2---E.P.R. is off
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Hi Everyone, please help. I want to switch my machine over to a fixed pressure. (I'm thinking 11.8) Enclosed are several screen shots from last night. Any help would be greatly appreciated.
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Moe_Howard
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Post subject: Re: Help With OSCAR Please | Posted: Wed Sep 23, 2020 11:18 am |
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Joined: Thu May 07, 2020 1:03 pm Posts: 63
PAP Mask: Philips Respironics DreamWear nasel headgear with arms
PAP Machine: Res Med 10 auto set.
Humidifier: Yes
Pressure Setting: Fixed Pressure is 12.2---E.P.R. is off
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here are 2 more screen shots from last night.
Attachments:
Screenshot (50).png [ 186.2 KiB | Viewed 610 times ]
Screenshot (49).png [ 176.58 KiB | Viewed 610 times ]
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Pugsy
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Post subject: Re: Help With OSCAR Please | Posted: Wed Sep 23, 2020 11:27 am |
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Joined: Wed Aug 02, 2017 8:01 pm Posts: 2144
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirCurve 10 VAuto
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It's really hard to evaluate the settings when faced with that amount of large leak spread out through the night like that. You are deep enough into large leak territory that the machine might be missing something. It's a maybe.
_________________ I may have to rise but I refuse to shine.
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Moe_Howard
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Post subject: Re: Help With OSCAR Please | Posted: Wed Sep 23, 2020 11:55 am |
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Joined: Thu May 07, 2020 1:03 pm Posts: 63
PAP Mask: Philips Respironics DreamWear nasel headgear with arms
PAP Machine: Res Med 10 auto set.
Humidifier: Yes
Pressure Setting: Fixed Pressure is 12.2---E.P.R. is off
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Hi Pugsy, It's defiantly a mask leak ( as I tape my mouth closed nightly) and I've tried several different types of masks (full face, nasal, pillows) and can't stop those mask leaks unless I put my mask on real tight (and that hurts when I wake up). I've learnt that as long as my AHI is under 5 and the air from the mask leak doesn't wake me , I should live with those masks leaks.
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Pugsy
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Post subject: Re: Help With OSCAR Please | Posted: Wed Sep 23, 2020 12:44 pm |
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Joined: Wed Aug 02, 2017 8:01 pm Posts: 2144
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirCurve 10 VAuto
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The problem with leaks that big and that prolonged and that often is we don't know for sure if the AHI is low because nothing happened or the machine simply couldn't sense something happening.
So while I understand what you are saying....you are wanting an evaluation as to pressure setting based on potentially less than optimal data input for that evaluation. Most likely nothing happened and the AHI is low because nothing happened but I can't in good conscious reassure someone when faced with that amount of leak for that amount of time.
So 32 % of the night in large leak and deep enough to potentially impact the machine's ability to sense, record and respond to apnea events. Did they happen...most likely not but I can't say for sure.
But for 68 % of the night your setting seems to work well and quite adequately. What you want to do or not do about the other 32 % of the night is up to you.
_________________ I may have to rise but I refuse to shine.
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Pugsy
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Post subject: Re: Help With OSCAR Please | Posted: Wed Sep 23, 2020 12:47 pm |
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Joined: Wed Aug 02, 2017 8:01 pm Posts: 2144
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirCurve 10 VAuto
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FWIW....I don't personally get too worried until leaks get above 30 to 35 L/min because for me that's where I learned from my machine that the machine starts running into trouble sensing, recording and responding. That's why I am concerned with yours....I see a lot of time over 35 L/min.
If you are okay with it and sleeping good and feeling great....then that is your choice to ignore the leaks.
_________________ I may have to rise but I refuse to shine.
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Moe_Howard
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Post subject: Re: Help With OSCAR Please | Posted: Wed Sep 23, 2020 1:36 pm |
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Joined: Thu May 07, 2020 1:03 pm Posts: 63
PAP Mask: Philips Respironics DreamWear nasel headgear with arms
PAP Machine: Res Med 10 auto set.
Humidifier: Yes
Pressure Setting: Fixed Pressure is 12.2---E.P.R. is off
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Thank you Pugsy for getting back to me so fast.
Would you suggest I change my auto settings? And if so, to what?
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DeltaBravo3.8
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Post subject: Re: Help With OSCAR Please | Posted: Wed Sep 23, 2020 1:39 pm |
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Joined: Sat Jul 04, 2020 8:38 am Posts: 477 Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS
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I haven't looked for this piece of data, but I will after I post this. Maybe leaks happen during higher pressures. It does happen that way to lots of PAP users. Limit it to 12 maybe.
If you want to know how to set straight CPAP, you can change Mode to CPAP or set both pressures at the same number. 11.8 may be a bit too low to catch all your events. Somewhere around 12-13 may be better. On the leaks and just letting it run regardless...both you and Pugsy are right for the reasons you are stating what you plan on. Really it is your choice. I am aware you've fought this for a bit and haven't seemed to gain ground, so your reasoning is fair. As is, roughly 68% good therapy is better than zero. You've stated you're willing to accept that, so it's good enough a reason to run with it. I see the point Pugsy is making in having you realize it's still less than optimal. An alternate is run with it as is, and occasionally try to tackle the leaks, just not as a priority. Try to limit the adjusting to weekly only or every other week or something similar, so that you're still moving on and picking the battle and on your terms.
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DeltaBravo3.8
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Post subject: Re: Help With OSCAR Please | Posted: Wed Sep 23, 2020 1:41 pm |
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Joined: Sat Jul 04, 2020 8:38 am Posts: 477 Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS
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Try posting OSCAR graphs with it in this order at least once. Events, Flow rate, pressure, leaks, FL. Just those 5 in one shot.
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Pugsy
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Post subject: Re: Help With OSCAR Please | Posted: Wed Sep 23, 2020 1:57 pm |
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Joined: Wed Aug 02, 2017 8:01 pm Posts: 2144
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirCurve 10 VAuto
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I am sorry but I cannot in good conscious make advice on auto adjusting pressures based on data with this amount of large leak.
Obviously with leaks of this magnitude at a fixed pressure we can't blame higher pressures. It's a mask fit issue.
It all comes down to masks...and fit and leaks...and until those are dealt with then optimal pressure ranges are a crap shoot.
I myself don't panic when I see a large leak that is random and not prolonged. As long as it doesn't wake me up and I feel decent then I shrug my shoulders and move on. So I let a lot of leaks slide but I wouldn't/couldn't let the amount of large leak I see on your reports slide if that was what I consistently saw on my reports.
If you can't get a better handle on the leaks....let your body be your guide. It won't lie to you. If you are sleeping good and feeling good then most likely the machine isn't missing events but if you want me to tell you that it's okay and nothing is happening....I simply can't do it because I can't prove it. I am data driven...pure and simple...I know that once leaks get over 30 to 35 L/min on a ResMed machine things get "iffy" in terms of accuracy of recording. For that reason I can't offer the assurance that it seems like you want. I just can't do it.
_________________ I may have to rise but I refuse to shine.
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Moe_Howard
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Post subject: Re: Help With OSCAR Please | Posted: Wed Sep 23, 2020 2:56 pm |
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Joined: Thu May 07, 2020 1:03 pm Posts: 63
PAP Mask: Philips Respironics DreamWear nasel headgear with arms
PAP Machine: Res Med 10 auto set.
Humidifier: Yes
Pressure Setting: Fixed Pressure is 12.2---E.P.R. is off
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Thank you both for the info.
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Moe_Howard
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Post subject: Re: Help With OSCAR Please | Posted: Fri Oct 30, 2020 11:05 am |
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Joined: Thu May 07, 2020 1:03 pm Posts: 63
PAP Mask: Philips Respironics DreamWear nasel headgear with arms
PAP Machine: Res Med 10 auto set.
Humidifier: Yes
Pressure Setting: Fixed Pressure is 12.2---E.P.R. is off
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Hello Everyone, Please tell me if there's room for improvement with my settings. I've enclosed 4 recent screen shots below. Thanking everyone in advance.
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DeltaBravo3.8
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Post subject: Re: Help With OSCAR Please | Posted: Fri Oct 30, 2020 2:19 pm |
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Joined: Sat Jul 04, 2020 8:38 am Posts: 477 Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS
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Fixed pressure does seem to help, especially on the leak aspect. If you feel good for the therapy as it presents itself here, I'd run with it.
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