08-04-2024, 02:07 PM
RE: Chin Tucking as cause of apnea
I think I have been fretting over high AHI scores needlessly for years due to my often Large Leak cluster of events. It has always been a wonder as to why many times I may feel better with a 7.30 AHI than a 2.75 AHI and a frustration that for 18 years I could never get an AHI below 1.75 yet I see other's OSCAR reports showing frequent < 1.00 and even 0.00 scores. I am concluding that if you Large Leak for more than a few seconds your AHI is not accurate. Take out the OAs, CAs, and UAs of a Large Leak cluster then calculate the AHI for a more accurate score especially if the events are within a tight cluster of an event every minute (AHI 60.00) which seems like more suffocation, not apneas. Why average in a short time period of AHI 60.00 with hours of AHI < 2.00? Does this not skew the AHI?
The possibility that my AirSense 10 is false flagging of events during a Large Leak gray area is part of my issue with a possibly skewed AHI. I can have 20 events within a 20-minute cluster within a gray area. The large amount of compacted events raises the AHI giving a false indication of the quality of therapy over a total sleep session. In other words, pull out the Large Leak time and its cluster of events from X hours of sleep and the AHI score will drop dramatically. Why be concerned over a 7.00+ AHI when it was a 20-30 minute cluster of events within a Large Leak gray area that caused the score? The AHI would be < 1.00 with the cluster excluded. Even if the events are accurate, they skew AHI's meaning toward the overall sleep session with over 90% of the sleep time in an AHI of <.50.
If a cluster of events is seen on a report even though over a gray Large Leak area the interpretation includes, "positional," and "chin tucking." The advice will be to use a low pillow and a soft cervical collar and may give suggestions on how not to roll to the back during sleep. Some CPAP users strap their chins, tape their mouths, collar their necks, and put nostril-opening spring strips to their noses when another mask could be all that is needed to get AHI down by reducing Large Leaks.
I don't expect perfection from anyone or a machine, but I would like those concerned with CPAP therapy to take a closer look at apnea clusters within Large Leak gray areas and give more consideration to the possibility that these event clusters may not be caused only by sleeping positions that restrict airflow. They could be false flagged events due to a Large Leak. How can the machine flag events and measure airflow limitation if the air pressure is lost in the mask by air freely flowing out its perimeter? Does the rate of 75 events an hour make sense inside a Large Leak gray area? Could not the cluster of events be eliminated by fixing the leak problem as opposed to wearing a soft collar, mouth tape, or a chin strap? I do understand that it is jaw-dropping that may cause the Large Leak, but is it worth disturbing sleep with a collar if one or two event clusters in a gray Large Leak area are showing nonexistent events? Would not a mask that functions with a jaw drop be better advice than a collar or at least give it as an alternative try before a collar?
The possibility that my AirSense 10 is false flagging of events during a Large Leak gray area is part of my issue with a possibly skewed AHI. I can have 20 events within a 20-minute cluster within a gray area. The large amount of compacted events raises the AHI giving a false indication of the quality of therapy over a total sleep session. In other words, pull out the Large Leak time and its cluster of events from X hours of sleep and the AHI score will drop dramatically. Why be concerned over a 7.00+ AHI when it was a 20-30 minute cluster of events within a Large Leak gray area that caused the score? The AHI would be < 1.00 with the cluster excluded. Even if the events are accurate, they skew AHI's meaning toward the overall sleep session with over 90% of the sleep time in an AHI of <.50.
If a cluster of events is seen on a report even though over a gray Large Leak area the interpretation includes, "positional," and "chin tucking." The advice will be to use a low pillow and a soft cervical collar and may give suggestions on how not to roll to the back during sleep. Some CPAP users strap their chins, tape their mouths, collar their necks, and put nostril-opening spring strips to their noses when another mask could be all that is needed to get AHI down by reducing Large Leaks.
I don't expect perfection from anyone or a machine, but I would like those concerned with CPAP therapy to take a closer look at apnea clusters within Large Leak gray areas and give more consideration to the possibility that these event clusters may not be caused only by sleeping positions that restrict airflow. They could be false flagged events due to a Large Leak. How can the machine flag events and measure airflow limitation if the air pressure is lost in the mask by air freely flowing out its perimeter? Does the rate of 75 events an hour make sense inside a Large Leak gray area? Could not the cluster of events be eliminated by fixing the leak problem as opposed to wearing a soft collar, mouth tape, or a chin strap? I do understand that it is jaw-dropping that may cause the Large Leak, but is it worth disturbing sleep with a collar if one or two event clusters in a gray Large Leak area are showing nonexistent events? Would not a mask that functions with a jaw drop be better advice than a collar or at least give it as an alternative try before a collar?
I only give suggestions from experience as a fellow CPAP user, not professional advice.
