app1nag - Therapy Assistance Thread

[PoolQ]

Leaks, AHI, therapy, and comfort.
Leaks: you need pressure not volume for therapy to work. With a large leak you get lots of volume and not enough pressure. If you have a smaller leak, <24L/M on Resmed, Then you are getting enough pressure but the leaking air may disturb your sleeping.

AHI: is only accurate if the leaks are < what the machine can compensate for. If the machine cannot blow enough air, volume, to still be able to reach the pressure needed for therapy, then the AHI is unknown no matter what the meter says.

Therapy: this is the pressure that has to be maintained inside your airway and if your not having leaks and your AHI is low then you can say your treated. This does NOT mean that you are comfortable with the treatment.

Comfort: This is your sleeping time and most people have spent years and some amount of money developing a comfortable sleeping routine. Now you have added a hose, machine, mask, air pressure, maybe leaking air, stress, worry, concern on top of your nice comfortable sleeping routine. For most of us we cannot do that and just sleep like we always have and no Doctor can prescribe what settings you need. Persistent trial and error with small steps is the only way until you either get comfortable or have run out of changes and are at the best you can get.

[Inspired]

[quote='app1nag' pid='141927' dateline='1449493566']
I know I should be concerned about leaks but I am still getting <2 AHI each night. Is the AHI index still accurate despite a high rate of leakage? I've been on therapy less than a week and will be making adjustments as I progress with the device. I believe leaks are coming from opening my mouth and not a poorly fitted mask. As a hypothetical, if my mouth stays open all night yet my AHI is still <2, does that mean therapy is still working, or is the AHI a false reading because of the high leakage?

thanks !

RLeonard
[ is the AHI a false reading because of the high leakage?]

From what I've read on this site, we cannot trust ANY of the data as long as we have excessive leaks because the leaks make it difficult for the machine to figure out what is going on.

By the way, what is a "cpap pillow"?

Keep on keeping on, change one thing and try it for a week before changing something else...eventually it will all work out one step at a time.

[sonicboom]

I would check your data to see whether you are having other "events" that aren't quite enough to qualify as OAs or CAs or hypops such as RERAs and user defined events (such as UF1 and UF2) in SH software. There was another discussion about this a few months ago so I would search the forum for high leaks and low AHIs to see the discussion.

[Inspired]

Here are examples of low AHI but problematic leaks, which keep me working on this...I see improvement but once leaks are better I'll trust the AHI.

Fourth day on Cpap:


After adding chinstrap 3 days later:


After changing to Dreamwear nasal mask:



Am going to try side sleeping only...more work to do!
[/quote]

Tried reposting charts without personally identifiable info but it's not working. Oh well, onward ho!

[rleonard]

PaytonA, PoolQ and Inspired:

Wow, what a wealth of information. Thank you all very much.

As for the question, By the way, what is a "cpap pillow"? - it is a pillow with cutouts in the sides to accommodate your mask when side or stomach sleeping. I have found it to be very comfortable and easier to deal with than the regular pillow.

Another question: Can too much pressure (more than you really need) cause mouth leaks?

[PaytonA]

What causes leaks is a mask not being adjusted appropriately (this includes being correctly sized) for the pressure being used or a pressure that is to high for the particular mask or a mask that does not fit your face properly.

I would concentrate on correcting the mask first. In most cases, you can find a mask and adjustment combination that will reduce leaks to an acceptable level. Reducing the pressure, unless there are other reasons besides leakage for doing so, may be inappropriate to your medical situation.

Best Regards,

PaytonA

[rleonard]

PaytonA

Makes sense. I was using the Dreamwear when the high leaks occurred. Switched back to my Sleepweaver Advance last night and all went well. I have never had leak problems with it. I do keep a record and the Dreamwear always records higher leaks than the Sleepweaver. I just like the Dreamwear from time to time as it is so easy on and off and moving around with the air hose connection on top.

Thanks again.

[app1nag]

First night using Wellue ring with cpap and wondering if these #s are good, bad, or ?

Thank you

[G. Szabo]

Ideally, your oxygen should move around 98-96% 
There are periods when your oxygen goes below 92%. When this happens, I fine-tune my treatment setting.

[app1nag]

Thanks for the reply. What types of tweaks do you try?