New user confused on leak data

[mattmill]

I've been using my Dreamstation Auto for about 2 weeks now and still confused on leaking. I use a P10 and keep bouncing between large and medium size but settling on medium for now. I find that as I move around, I am a stomach sleeper, the large gets dislodged and i feel the flow on my eyelashes (a strange sensation to wake to). But the Medium is rubbing above my upper lip/nose between nostrils. The respiratory therapist only fitted me with the large and included the medium "as a backup" She downloaded my data and said all looks good with no issues. I go back to the Doc 6/15.

I've attached a few days from last week from SleepyHead:
May 12 I used the LARGE
May 13 I used the MEDIUM.

Thanks!
matt
I guess I am not allowed to post images as a new member (add the http://)

i.imgur.com/993hEn5.png
i.imgur.com/azIFpzL.png
i.imgur.com/K6SJGTI.png

[robysue]

Your leak data looks fine to me. On the two nights of data shown, the unintentional leak rate (bottom leak curve) is usually well below 10 L/min and the machine can easily compensate for that much leak. Yes, on one night there appears to be a borderline Large Leak late in the night, but it lasts for less than 30 minutes, and even at its worst, it's barely above 24 L/min.

Your AHI data, however, remains a wee bit on the high side: The goal is to get the AHI to stay below 5 consistently. The problem seems to be mainly obstuctive---i.e. OAs and Hs. Hence it's possible that your min pressure setting is too low. That makes it harder for the machine to quickly increase the pressure up to where you need it to be before the obstructive events start to happen.

Since your 90% pressure level is pretty consistently around 11-12 cm, you probably need a min pressure setting of at least 8 cm (and maybe 9) instead of the current 6cm setting that you are currently using. Bumping up the min pressure by 2 or 3 cm at one time, however, can be difficult to adjust to. I would suggest that you consider first raising the min pressure setting to 7cm and leave it there a week or two. Then increase the min pressure again to 8cm.

[mattmill]

Is changing my minimum pressure something I should just do, or have the respiratory therapist or doc do?

[robysue]

Is changing my minimum pressure something I should just do, or have the respiratory therapist or doc do?

Technically speaking the doc is the one who has to authorize a change in the script before the RT can change the min pressure settings.

Many folks around here, however, are comfortable enough to make minor changes in their pressure settings without involving the doctor. It's not illegal to do so. But the doc or RT may give you a stern wet noodle whipping if they notice that you did it on your own.

When I was a newbie, I did make sure to get the OK from the PA in my sleep doc's office each time I wanted to make a small pressure change. My current sleep doc knows that I have a lot of knowledge about my own condition and that I thoroughly understand my machine and its settings. He's given me the green light to experiment as I want since he knows that future titration studies are unlikely to actually reveal anything new about my multiple sleep problems. And hence both he and I believe that I'm more than capable of finding the things that work best for me in terms of treating both my OSA and my other sleep problems.

Since you are still new to PAPing, it's important to ask: Does your doc know what your daily AHI numbers look like? If not, you should definitely let him/her know that the AHI is often in the 6-8 range and that you would like to have the min pressure increased to see if that helps. Most likely he'll be happy to authorize the change in settings.

[trish6hundred]

Hi mattmill,
WELCOME! to the forum.!

You can get the clinicians manual for your machine here, I think the link is at the top of this page.
Hang in there fore more responses to your post and much success to you with your CPAP therapy.

[mattmill]

Hi mattmill,
WELCOME! to the forum.!

You can get the clinicians manual for your machine here, I think the link is at the top of this page.
Hang in there fore more responses to your post and much success to you with your CPAP therapy.

Thank you, I did get it as the RT had almost everything turned off. I now have AHI on.

---

Is changing my minimum pressure something I should just do, or have the respiratory therapist or doc do?

Technically speaking the doc is the one who has to authorize a change in the script before the RT can change the min pressure settings.

Many folks around here, however, are comfortable enough to make minor changes in their pressure settings without involving the doctor. It's not illegal to do so. But the doc or RT may give you a stern wet noodle whipping if they notice that you did it on your own.

When I was a newbie, I did make sure to get the OK from the PA in my sleep doc's office each time I wanted to make a small pressure change. My current sleep doc knows that I have a lot of knowledge about my own condition and that I thoroughly understand my machine and its settings. He's given me the green light to experiment as I want since he knows that future titration studies are unlikely to actually reveal anything new about my multiple sleep problems. And hence both he and I believe that I'm more than capable of finding the things that work best for me in terms of treating both my OSA and my other sleep problems.

Since you are still new to PAPing, it's important to ask: Does your doc know what your daily AHI numbers look like? If not, you should definitely let him/her know that the AHI is often in the 6-8 range and that you would like to have the min pressure increased to see if that helps. Most likely he'll be happy to authorize the change in settings.

I will ask the office this week since I won't see them for another month.

[dawoodsman]

I might be wrong, but are you asking why the doc is saying there is no leak problem when the data says there is, or perhaps you KNOW there is as you notice it yourself or it wakes you up?

What I understand about these machines is they average out values and do not always report temporary leaks. I discovered a fairly major leak issue that was actually waking me up, yet the doc said nope no problem. It was big enough to kick off the fit test sensor to reflect a leak, yet the docs thought there was no real issue.

[OpalRose]

Well, the doctors don't have to sleep with it.
Even a small mask leak may wake you and disturb sleep.

The machines will report large leaks and that's when your readings may not be accurate.

[cate1898]

Welcome to the forum mattmill! Sounds like you are getting some good feedback from other experienced users that will eventually lead you to greater success. Glad you found us here and best of luck!

[mattmill]

Well, the doctors don't have to sleep with it.
Even a small mask leak may wake you and disturb sleep.

The machines will report large leaks and that's when your readings may not be accurate.

I think it is the smaller leaks that I am feeling/being woken up by that I am wondering about. I feel like there are 2-3 times a night I wake to a blast of air across my face and the whoosh. It's easily fixable by slipping the pillow to the left or right depending on which side I am lying on at the time.

Last night was good in the sense I didn't wake at all, that I remember, but I didn't have time to look at the data before leaving for work. I'll be curious if I am fixing them in my sleep or they are not happening.