30 Days, AHI vs Leaks ?

[OB-Left]

So I have reached the 30 day mark for my treatments and have never felt better !!:grin: With your help my starting pressure has been changed from 4 to 6 and treatment range increase from 5-12 to 6-12.

30 day ave AHI = 1.98 (O =.35, H = .37, CA = 1.23)
Last 7 ave AHI = 1.36 (O =.13, H = .41, CA = .82)
Friday night I had my first sub 1.0 AHI score.





However, I had a High Leak rate. Over limit less than 1% but near double normal. Next night leaks drop but AHI goes back up to just under 1.0? So is this still me getting used to treatment, or is my pressure in need of more adjustment? Or is shooting for that low AHI number continuously a pipe dream?

[under pressure]

You're doing well, your leak rate is in the acceptable area which for ResMed is below 24 lpm, so doesn't appear that you are having a big problem with leaks.

Your AHI is terrific and keep in mind that the Centrals you are showing are most probably Sleep/Wake Junk (SWJ)......when we transition between wake state and sleep state you'll usually see a few scattered centrals get scored. If this was in a sleep study environment they would probably ignore those centrals, so don't sweat your AHI number, it really does look good.....lots of folks would be envious of your Index!

Probably at this point rather than chasing your tail for a low AHI number you should go by how you feel in the morning. More energy, less daytime sleepiness and so forth, that's your main target and it sounds like you feel a lot better now.

I'd tend to just stay the course for now with now big adjustments and keep monitoring your numbers like you're doing, maybe try and get a little lower leak rate, but it's really not bad at all......strive for comfort at this point.

[trish6hundred]

Hi OB-Left,
It sounds like you are off to a really good start, keep up the good work and hang in there for more responses to your post.
GOOD JOB.!

[vsheline]

Hi OB-Left,

Your amount of leaking looks okay to me. At least 95% of the time during the night of June 5 the leaking was 21.6 L/minute or less.

On June 6 your centrals we're happening throughout your sleep period and were happening at all pressures, which I think is pretty normal. These do not look to me like SWJ.

I think your number of central apneas (about one per hour) is nothing to be concerned about unless the central apneas are lasting longer than about 30 or 40 seconds I think, or a pulse oximeter shows your SpO2 is dropping below 90% I think, or unless you are feeling poorly upon waking up.

Most health insurance companies are not concerned unless the sum of central apneas plus central hypopneas is at least 5 per hour.

I think a difference of 6 cmH2O between Min Pressure (6) and Max Pressure (12) is a little large. I suggest the Min Pressure be increased to 8, so the pressure will be more stable. The higher the Min Pressure is, the more slowly the machine between events will gradually decrease the pressure. A pressure of 8 seems to be about the pressure you need most of the time.