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I have had problems with my Resmed S9 APAP staying at 20 cm for 2-3 hours at a time which wrecks me the next day.

This problem has been ongoing for many months and when I think I have fixed it it comes back

Using Sleepyhead I can see that during this spell of high pressure it looks like I am double inhaling.

Is this possible??

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To start with the strange waveforms only appear when I am sleeping on my side . When I am sleeping on my back the waveforms are normal. I have discovered this by videoing myself when I am sleeping using my tablet and using Sleepyhead  . A home made sleep study!!!

Also these strange waveforms appear when Im using a conventional full face mask, Simplus , Quatro Air and  F20 .

But when I use a hybrid type mask Amara View and Dreamwear the waveforms are normal and I have not had the high pressure problem.. In fact I could lower the starting pressure using the Dreamwear.

I think I have finally got a answer to the problem of high pressure but with little help from the hospital.

Good detective work.

The only trouble is that both the Amara View and the Dreamwear are too painful to wear. The part of the cushion separating the mouth area from the nose cuts in!! to the base of my nose and partly into my nostrils.

Im not sure if a liner will work as its the edge of the cushion, in the nasal area, which is causing the problem

I am sure they are not, but a lt of people tend to tighten their masks up to tightly.

A lot more than they need to to stop leaks, I was no exception at the start, if it leaked, tighten it more, but this was not the answer.  New mask the correct size and not so tight and it was a lot better.  The breakthrough happened when I got Nasal Pillows and a good chin strap (which the main manufacturers do not appear to make).  The first chin strap that worked was a stretchy leg bandage just pulled open and put over my head from the chin to the top of my head, it was strong enough to keep my mouth shut but not strong enough so that I couldn't open my mouth in an emergency.  This worked for me for years.  I had tried just about every mask on the market at the time, which must have cost a fortune at the time.

Try another mask or try the Dreamweaver, which is made of cloth, but hard to seal for some.  These are expensive and most NHS Sleep Clinics do not stock them, but if they do it is worth trying, if you buy there is a sizing kit and usually a 30 day return for refund.  Biggest problem is not so much the cost, but they need replaced often and need washed every day.



Sleep2snore said:

I am sure they are not, but a lt of people tend to tighten their masks up to tightly.

A lot more than they need to to stop leaks, I was no exception at the start, if it leaked, tighten it more, but this was not the answer.  New mask the correct size and not so tight and it was a lot better.  The breakthrough happened when I got Nasal Pillows and a good chin strap (which the main manufacturers do not appear to make).  The first chin strap that worked was a stretchy leg bandage just pulled open and put over my head from the chin to the top of my head, it was strong enough to keep my mouth shut but not strong enough so that I couldn't open my mouth in an emergency.  This worked for me for years.  I had tried just about every mask on the market at the time, which must have cost a fortune at the time.

Try another mask or try the Dreamweaver, which is made of cloth, but hard to seal for some.  These are expensive and most NHS Sleep Clinics do not stock them, but if they do it is worth trying, if you buy there is a sizing kit and usually a 30 day return for refund.  Biggest problem is not so much the cost, but they need replaced often and need washed every day.

I trialled the Sleepweaver before it came out, I believe I still have it somewhere, but I could not get on with it then.
I used a liner on the Dreamwear last night but still was too painful to use and had to change masks during the early hours..
What was interesting was that even using the Dreamwear my pressure was still going up to 16 and no doubt would have gone higher if I had set the upper limit higher.

Your machine should not go higher unless you need more pressure.

The machine I have was set at 10 to 20 when I got it and it has never ventured above 12.9.

I have a ResMed 10Auto which I found to be a little better than the Dreamstation.  I tried three machines but settled for the ResMed Airsense10Autoset.  The only mask I can use is Nasal Pillows, I couldn't get anything else that I could get on with.  My Nasal Pillows were 22 years old, the hospital decided I had to retire them and pick new ones   The new ones are very soft with no hard body to come near the nose.  However, they do not go over the head like the old ones, so I tie wrapped the hose to the side I do not lie on.  

I did adjust the low pressure up so as the machine could react quicker and the rise in pressure didn't disturb me.  It now sits at 11.

I get AHis of 0.0 sometimes and it is usually 0.3Ahi, the worst I had was 0.6 and that was a bad night on more than just CPAP.  Plus, it was one of those nights that I found it impossible to stop it leaking for some reason that is only know to ghosts of the night as it was a mystery to my why I could not stop the leaks.

How high does your machine go to if unrestricted?

If the top limit is unrestricted then it will go up to 20 for up to 5 hours a night. 

The hospital say that I need this pressure as my Apnea is getting worse but my AHI is nearly always under 1

Last night with the maximum set to 16 my 95% was 15.94 but my AHI was 0.4

I believe I have found a reason for the pressure going up to 20 and staying there.

Its early days yet and I need to find the best fix

I'll be interested to know what you have found.  Give it time so you can prove what is happening.

I had my machine pulse at full pressure for the second time when it was switched on, turning it off then on again a couple of times with a pause solved it, but it should not do that!  Of course it happens and you react so quickly automatically that I didn't get a chance to see what had happened.  If it does this again I will be ready, but I will still hit the off button without thinking

I thought I had this problem solved but it got stuck at 20 again last night. My 95% pressure was 19, AHI  0.1 and leak 1 l/min.

Sleepyhead shows that it was stuck at 20 for approx 30 mins .

That is hard to believe.  A pressure of 20 is quite high and very few require that amount of pressure.

1 ltr/min is nothing, the machine should cope with that without any problems at all.

A lot of people get mixed up with pressure and volume/flow which is not the same thing.

A machine will increase the flow without increasing the pressure if there is a leak.

It will only increase the pressure if you require it.  If it went to high pressure it might suggest that you are tucking your chin when you are asleep (tucking your chin down onto your chest) this is quite a common problem.

Even a kink in the hose (which is not very common) will cause it to rise in pressure.

Does Sleepyhead show any flow limitations?

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