Sierra

I don't think your setting are all that bad. Your main component, based on this one night, of AHI is obstructive apnea. It looks like you have Flex turned on. The first change I would try is to turn the flex off. It can make obstructive apnea events appear more often for the same fixed pressure setting. If that does not help, then next you might want to try 10.5 or 11 cm for your set pressure to see if that helps any. More pressure can initiate CA events, but it looks like they are OK for now. As for the leak rate the DreamStation machines display both the total leak rate (upper green trace in the graph) as well as the real leak rate. The top trace includes the intentional purge leak rate for the mask plus unintentional leaks. The bottom curve is the important one as it is the real leak rate where the intentional purge flow is subtracted out. Short story is to ignore the top curve and pay attention to the bottom one. I don't think the leak rate is too bad. If you right click on the Leak Rate vertical scale it should bring up a menu of options. One is to display the Leak Rate Red Line. If you turn that on, it gives you a better idea of where you stand for leakage. I believe it is set for 24 L/min. The Statistics section shows you are over the redline 5.5% of the time. I try to keep that number to 1% or less. You may want to set the scale of this graph to a maximum of 50 so it displays the more useful bottom trace better. Doesn't matter if the total leak rate trace goes off the graph as it is kind of irrelevant.

Hope that helps some. If you have questions, post again...

I checked my machine when I went to bed last night. Without going into the Clinical Menu there should be an option for Climate Control. The default is Auto. However, if you put it to Manual then there is a dial setting that you can set to Off. I have my Essentials set to Plus in the Clinical Menu Options section. That might be giving me a little more access to the settings from the User Menu.

With my AirSense 10 I can go into the Clinical Menu and under the Comfort section you can put Humidity Level to off. You may have to put Climate Control into Manual first. I can't remember. I still put water in the humidifier, but in the morning there is essentially none gone. For my off grid trailer use I also turn off the heated hose tube temperature, to save power consumption.

If you are still awake, then I see no problem using the CPAP without humidification. When I use our trailer and run off batteries I turn it off. You might notice a slight difference in comfort, but not a lot.

One possible way to troubleshoot this is to use SleepyHead or OSCAR and look at the leak rate when you disconnect the mask hose from the slimline hose. You should get an indication of how high the flow goes and whether or not it shuts the machine off. Next then try it by just removing the mask from your face with it the hose connections still made. You can again see how high the flow goes and whether or not it is high enough to shut the machine off. I suspect it shuts off based on a flow rate, not a flow switch. But that is just a guess.

Rebecca Rottapel has my email if you can contact her to get it. Do you use TripAdvisor? If so we could exchange some PM's there. I am a destination expert at the Huatulco sub forum and use RonAKA as my sign on name.

I just have a standard APAP machine, but have never had the issue with aerophagia. My current pressure is 11 cm. It seems to be more of a problem as the pressure goes up. I think most just get used to it over time, but if there are any opportunities to reduce pressure that may help.

You are not the first one with this problem. I recall there have been one or two others with the problem, and unfortunately do not recall if there ever was a solution. You could try a search here to see what you find. One possible cause could be having the mask type set wrong for the actual mask you have. For example if you have a nasal pillow mask which uses a lower purge flow, but have the mask set on full face which uses a larger purge flow, then perhaps the machine does not see the flow as high enough when you take the mask off. The other possibility is that your set pressure is very low, and when you remove the mask the flow does not go high enough to shut the mask off. One other possible cause is the way you take your mask off. Do you remove the mask and leave it attached to the machine? If so the flow rate may not go high enough to shut it off. If you disconnect the hose from the mask first before taking the mask off, the flow will likely be higher. I have the ResMed AirSense 10 but I do not use the auto stop feature, only the auto start. I just manually turn the machine off and then remove the mask, as my wife is usually sleeping when I get up and I don't want to disturb her with the big whoosh of air when you let it auto stop. So, I don't even know if my machine would shut off if I just removed the mask first. I know for sure that if the hose disconnects in the night that will shut the machine off if I don't get it reattached in less than about 5 seconds.

ResMed claims they can't detect the difference between the types of events when the leak rate is high. They "solve" the problem by simply not reporting any events during the high leak rate period, which is the grayed out areas on an OSCAR report. If anything larger leaks make the AHI lower, not higher, because some events could be occurring but are not reported.

The P10 is very different from the N20 and FX Pillow mask. It has a fine plastic mesh screen on the front. There is one on each side of the mask and because of the fine mesh and the large overall size of the exhaust area it is very quiet and very hard to even detect the air flow from it. See this photo of what it looks like. If you enlarge it and look carefully you can see the mesh pattern.