Need feedback on some SH data

[jex]

Hi,

Before all let me give some info:

I'm using PRS1, my mask is Mirrage Quattro and I have beard. I always knew the mask leaked as sometimes I have to adjest it.
Later I can try locating my diagnostic exam but the data was frightning, 80 episodes or more. After I started using CPAP my AHI dropped to less then 3 (later I'll post more data at the stories thread). The preassure is set to 10-14.

I've been using CPAP for 3-4 year now. Yesterday I installed SH and started looking at my data.

All data shown is the last 7 days column from statistics at SH.

AHI: 2.19
RERA Index: 1.85
Flow Limit Index: 0.66
Average Pressure: 11.86
95% Pressure: 13.80
Average Total Leaks: 37.52
95% Total Leaks : 60.00

PRS1 shows me no Large leak.

What do you guys and gals can share with me regarding this ?

[trish6hundred]

Hi jex,
WELCOME! to the forum.!
Hang in there and someone will help you soon.
Best of luck.

[jex]

thanks, trish
Glad to be here, looking eagerly for the feedbak!

[JJJ]

AHI: 2.19
RERA Index: 1.85
Flow Limit Index: 0.66
Average Pressure: 11.86
95% Pressure: 13.80
Average Total Leaks: 37.52
95% Total Leaks : 60.00
PRS1 shows me no Large leak.

Altogether, not bad. The holy grail is an AHI of zero, but few attain that. Your leaks seem a bit high. From my personal experience, when my leaks are lower my AHI goes down as well.

Your pressure range of 10 - 14 are doing the job, but you might improve your AHI if you tweak the pressure a bit. I note that your 95% pressure was 13.8, which means that you are probably hitting 14 frequently. The machine knows that you are having an event that needs more pressure than 14 to overcome, but the machine cannot give more than 14 because of the upper pressure setting. And if your average pressure is 11.86 your lower setting of 10 might be a bit too low. Also, you have only 4 cm. difference between your lowest and highest, which may not be quite enough.

I would suggest changing the pressure to a range of 10.5 - 16 and watch it for at least a couple weeks without making any other changes. If it doesn't improve your AHI then you can always change it back. Whatever changes you make, be scientific. Make just one change and see what happens over a couple of weeks. If you make several changes at the same time you will not be able to tell which of the changes was the beneficial one.

[Sleepster]

Average Total Leaks: 37.52
95% Total Leaks : 60.00
PRS1 shows me no Large leak.

Your leaks seem a bit high.

Keep in mind that Resmed measures unintentional leak.

The OP is using a PRS1 machine and is reporting total leaks. You have to subtract the intentional leak, which varies with pressure and mask type but is on the order of 35 L/min.

Keeping that in mind I think his leak data looks ok. I agree with you about everything else you said.

[jex]

JJJ, After I took a look at this data, I increase the upper limit to 14.5, somewhere (here I think) I saw someone saying that to increase in 0.5 increments and check what happens. But I can increase it alittle more. The odd part is that, after I increased it to 14.5, my wife slept on the living room because she said I was snoring too much.

I do not have yesterday's data here, but the other days, shows Vibratory Snore in the range 50-70 (also I find it weird but I have 2 Vibratory Snores entries, one "Vibratory Snore" and one "Vibratory Snore #2")

Sleepster, I do not understand the Resmed reference. For the rest do you want to say is that the "real" leak count is found subtracting 35 (in your example) ?

[zonk]

before tinkering with pressure, try avoid sleeping on your back, lower or turn off Flex and read here
http://www.apneaboard.com/adjust-cpap-pr...re-on-cpap

unlike Resmed, PR do not tell us what count as large leak

Quattro intentional leak at pressure 14 = 44 l/m

unintentional leak (mask plus mouth leak) = total leak 60 L/m minus intentional leak (vents leak) 44 L/m = 16 L/m =

[Sleepster]

Sleepster, I do not understand the Resmed reference. For the rest do you want to say is that the "real" leak count is found subtracting 35 (in your example) ?

JJJ has a ResMed machine. Those machines report only the unintentional leak rate, and they set a maximum of 24 L/min (or something like that) as being the acceptable tolerated amount. So when a ResMed user like JJJ sees a leak rate above that he may be thinking that's bad.

Alright, so here's the deal with leak rates. Good CPAP machines have a flow rate meter that measures, well, the flow rate. You need a certain amount of leaking to keep the hose purged of your own exhaled air. That's why you have the exhalation port shooting air at your bed partner. That's what we call the intentional leak rate. You have to look it up if you want to know what it's supposed to be. Your mask manufacturer makes this information available on the literature that comes with your mask and you can also look it up on their website. The leak rate varies with your pressure setting, so when you go to look it up you see a graph of leak rate versus pressure and you have to read your value off the graph. A good average number is 35 L/min, so let's just say that you looked it up and found out that that's what it is for your pressure and your mask.

Let's say you have a total leak rate (measured by the flow rate meter) of 60 L/min. You have to subtract the intentional leak rate to figure out how much is leaking due to a poorly fitting mask, or a mouth-leak, etc. When you do this you get what's called the unintentional leak rate. If your intentional leak rate is 35 L/min, and you subtract that from 60 L/min, you get an unintentional leak rate of 25 L/min, which is just barely too high. So as long as you keep your total leak rate under 60 L/min, which you are doing, you're in good shape. Which is why your machine is telling you that you are spending 0% time in large leak.

In your profile you list your machine as a PRS1. Not sure if you have a REMstar or a BiPAP. You list your pressure as 10-14 so I'm guessing you have the REMstar Auto CPAP. You should be able to look around in the numerous menu choices within SleepyHead and find a way to have it display total leaks or unintentional leaks. For it to report unintentional leaks correctly it has to know how to figure the intentional leak for your machine's pressure and for your mask type. I'm not sure the author has this completely figured out yet for your machine. I have one of the BiPAP's and I know SleepyHead can't correctly report unintentional leaks for my machine so I just set it to report only the total leak and guesstimate the unintentional leak. I also have EncoreBasic software and it confirms that my unintentional leak is well under control. And like yours, my machine reports 0% time in large leak.