help, way too many leaks last night

[Clementine]

Thank you for the info and reassurance. I need that daily, going through this crazy odyssey!

It seems like the top number should be higher to push the high AHI and leaks down. But I will sit on 7 and 13 for a few days and figure out what to do then.

[retired_guy]

Just for comparison Clem, here's a report of my night last night. It was a great night! I slept log-like clear up to the 7:30 puppy alarm going off. But as you can see, my leak graph is not all that great. It's good enough, but not great. The only complaint I have is that goofy smiley face in the top right corner.

[Clementine]

That is good to see; thanks for sharing it. Your SH report looks different, tho. ???

I am envious of your AHI of zero !!

[Clementine]

I'm sorry to be such a squeaky wheel. I need help!

I upped my pressure to 13/7 from 12/6 a few nights ago. Here's last night's graphs:



argh. Previous nights look much the same.

Last night, the leaks woke me up -- my mask (p10) was unseated and I had to put it back into place, more than once.

I just cannot seem to get the AHI down to 5 or below. I have what seems like massive leaks (but yet get the smiley face).

I just emailed this same info to my DME person. Not sure I will get much help ....

anyone here have any ideas? Higher pressure? Push the lower number up closer so that it is a tighter range, like 13 and 9?

I am really getting bummed about all of this. Makes me think I'm just not suited to the P10, and I don't know what to try next. I've tried several nasal masks, and I won't go to a FFM due to claustrophobia. Seriously, yesterday I was considering just stopping this whole apnea therapy. I've been at this since July 7. It seems things are not getting better.

[Clementine]

More numbers from last night.

Statistics
Channel Min Med 95% Max
EPAPExpiratory Pressure (cmH2O)
W-Avg: 8.06 7.00 8.18 8.98 9.00
IPAPInspiratory Pressure (cmH2O)
W-Avg: 12.06 11.00 12.18 12.98 13.00
Minute Vent.Amount of air displaced per minute (L/min)
W-Avg: 5.23 0.75 5.00 7.62 17.88
Resp. RateRate of breaths per minute (Breaths/min)
W-Avg: 12.26 2.00 12.40 15.40 25.60
Resp. EventA ResMed data source showing Respiratory Events (Events/hr) 0.00 0.00 0.00 7.00
Flow Limit.Graph showing severity of flow limitations (Severety (0-1))
W-Avg: 0.00 0.00 0.00 0.00 0.22
Leak RateRate of detected mask leakage (L/min)
W-Avg: 15.99 0.00 10.80 42.00 52.80
SnoreGraph displaying snore volume (??)
W-Avg: 0.04 0.00 0.04 0.06 0.30
I:E RatioRatio between Inspiratory and Expiratory time (ratio)
W-Avg: 36.90 3.00 37.00 50.00 75.00
Insp. TimeTime taken to breathe in (Seconds)
W-Avg: 1.31 0.44 1.30 1.54 2.00
Exp. TimeTime taken to breathe out (Seconds)
W-Avg: 3.70 1.32 3.48 5.34 10.00
Tidal VolumeAmount of air displaced per breath (L/min)
W-Avg: 432.17 160.00 380.00 720.00 1820.00

Time over leak redline 26.403%

[surferdude2]

I going to give my stupid opinion and it is that you need to find some way to restrict your movements or else no mask is ever going to stay leak free all night. I think (just guessing) that you are a physically active sleeper because you are basically uncomfortable and you need to find out why that is so you can find some way to sleep without having to seek different positions all night long. Try to spend an entire night in each of the basic positions and then compare to see which gave the best results. By best results, I mean the position that you were most successful in staying with all night. If you find one best position, then pile up some pillows or whatever so that you are practically forced to stay in that position all night and then compare your CPAP leakage and AHI index reading to see if you are rewarded.

HTH

[Clementine]

Thanks so much for your help; I do not think it is a stupid opinion. I appreciate all help from everyone here.
I am a mover at night as you guess; yes, I am very active. I have RLS and I'm all over the place, according to my hubby. I don't think I even have a best sleeping position. I'm always flipping over and around. I will think about this, however.

[retired_guy]

Awww Clem, what are we going to do with you?

I thought it was a good idea for you to increase your low end but I was a bit nervous about you increasing the top.

I do think there is too much wiggle room between your low and your high. I think the problem lies in "pressure support." You're on four, which kind of means the machine has to do a lot of screwing around during the night to keep your epap and your ipap where they seem to belong.

I think at this point for you what is needed more than anything is a little period of stability. To accomplish that, I think you should contact your sleep doc and suggest putting your machine on CPAP mode with pressure of 11, maybe 12 for awhile. By getting to a constant you should be able to eliminate the tendency of your masks to fly across the room. Anyhow, I think it's something worth discussing with them. If 11 or 12 is too high, then 10 to start with. Then evaluate for awhile.

As far as your "events" are concerned, I don't think I'd put much stock in the numbers right now. The CA could be a misreading, or still just a matter of getting used to the higher pressure. The OA's could also be misreadings.

[Clementine]

I haven't even concerned myself with the CAs. It's that stupid leak chart that gets me all upset . . . It just looks awful. And then when the leaks wake me up, I'm not a happy camper. That darned P10 won't stay put. But I get a smiley face in the morning. So maybe I should just quit looking at the leak chart since it upsets me.

Okay, maybe I'll put the top number back to 12. The 12 just didn't feel strong at all to me. So, mess around with the bottom number? I'll try 12/7 tonight.
Am I able to change to a fixed Cpap myself? Cannot remember if that is in the clinician's manual.

Anyway, I have sent my charts and questions to my DME, and she usually sends on to the sleep dr. So, we'll see what they suggest. But I feel like the sleep dr esp is out of the picture, since my next appt is in Feb.

[retired_guy]

You can make the changes yourself, but I would really like you to discuss the options with your DME person first, then the sleep doc if necessary.

I still think its the variance in exhale versus inhale that's got your P10 all excited. So I would at least shorten up the pressure support from 4 to 3.