Leak rate question

[weepingwillow]

Is this leak rate problematic? I taped the heck out of my mouth last night and the leak rate does seem to be improved, but this chart is still not where I want it to be (and I feel like garbage). Thanks!

[G. Szabo]

The leaks are in the acceptable range. However, to get more help with your settings, it would be better to post the Details folder instead of the Events folder. Follow the chart organization suggested in the Wiki.

[weepingwillow]

Ope, sorry about that! I've reattached it with the Details folder visible. 

At the risk of being scolded for changing things too frequently, I'm also attaching screenshots from the last couple nights.

[cdplatt]

It's difficult to tell without the details, but what are your min and max pressure settings?  It appears your min pressure is around 7, but your OA events look to kick off when your pressure drops into the 9 area.  Leaks are well controlled and are unlikely to be causing a problem.  I suspect you should raise your min and max pressure.  If it was me, I try a min pressure at 9 and set the max to 15 or higher.  Your system won't go to the max unless it needs to.

[weepingwillow]

cdplatt, thanks for your reply. Last night (my original chart) my range was 7-10. I'm also attaching some charts showing when I had it at 8-20, 10-20, and 10-16.

[G. Szabo]

You are switching between CPAP and APAP. 
I suggest sticking to APAP. 
I agree that your minimum should be increased, even to 12 cm.
It would be best if you also reduced your EPR to mitigate CAs. Try EPR=2 to start.

[weepingwillow]

Thanks for your input. My thinking was that APAP might be waking me up with all of the changes, and leaks might make it think I need higher pressure than I actually do. FWIW, I've done a few sleep studies, and my titration suggested 10cm. But I definitely appreciate the input from users here and have found this community to be more helpful than my medical providers. I'll try a higher min again.

[cdplatt]

What position are you sleeping in and what position is your head in?  Are you using a thick pillow?  I'm asking because even with cranked up pressure, you're still experiencing O/A - the pressure is not keeping your airway open as I would expect.  A flatter pillow or cervical collar may help if body/head position is contributing to airway closing.

[weepingwillow]

I sleep on my side, probably 70% left side 30% right side. My pillow is on the thicker side. I tried a thinner pillow and a cervical collar one night but I only made it through the first half of the night with it-- it was awful. See graph.

EDIT TO ADD: I'm pretty sure I don't tuck my chin when sleeping. I don't fall asleep or wake up with it tucked, and I find that position uncomfortable.

[Expat31]

It would be interesting to see your sleep study, with of course you personal details obscured. 

Thanks.