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AHI skyrocketed with new mask
#1
I have been using Airfit P10 nasal pillow for a few years. I recently changed to the full face Airfit F10 due to leakage because I stated mouth breathing.
Upon changing to the full face mask my leakage went down but my AHI which was in the 5 range is now about 15.
Should I be retested? Could it be that my pressured is not correct? My current pressure is 11. I am using the Airsense Auto 20 as a CPAP as per my physician.
Thank you for your input.
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#2
The mask changed, not you, so getting re-tested seems pointless. These machines have a mask type setting on them, did you update this? It could also be that your brain is getting adjusted to the new, different sensations and preventing you from getting into deep sleep. So the increased AHI might be more sleep/wake junk. I have also found that different mask types result in AHI changes for me, so an adjustment in pressure might be needed. Taking a look at some SleepyHead graphs might help isolate what is happening.

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#3
(11-02-2016, 03:48 PM)jjso Wrote: I have been using Airfit P10 nasal pillow for a few years. I recently changed to the full face Airfit F10 due to leakage because I stated mouth breathing.
Just how bad were the leaks with the P10?

Quote:Upon changing to the full face mask my leakage went down but my AHI which was in the 5 range is now about 15.
That is a huge jump. But without knowing a lot more about the leaks with both masks and the breakdown of events with the new mask it is hard to answer your question:
Quote:Should I be retested?
However you may be able to avoid a formal overnight PSG in the lab by using the Auto feature on your machine. More on that in a bit.

You also ask:
Quote:Could it be that my pressured is not correct? My current pressure is 11. I am using the Airsense Auto 20 as a CPAP as per my physician.
At a minimum you need to contact the doctor and let him know about the rather drastic increase in AHI with the new mask.

But you can also make better use of your machine as well. Exactly which AirSense machine are you using? The AirSense AutoSet? The AirSense AutoSet for Her? Or the similarly named AirStart Auto?

The two AutoSets both record full efficacy data: With the appropriate software you can see exactly what is going on with your breathing---at the breath-by-breath level---all night long. If you are using an AutoSet, it would be reasonable to switch to AutoSet mode with a pressure range of 9-20 for a few days to see where the machine thinks the pressure should be and whether the AHI comes down with more pressure. That detailed data will likely answer your questions about whether you need more pressure or whether you need to be retested. You can run the idea of switching to Auto for a week or two by your doc if you are not comfortable with doing it on your own.

In other words, a week or two of "auto titrating" with your current machine should allow you to avoid an expensive, stressful trip to the sleep lab.

If you have the AirStart Auto, it does not record the same wealth of data as the AirSense AutoSets do. But it still records enough information to make it worth switching to Auto mode with a pressure range of 9-20 and seeing where the machine wants to take the pressure.

Questions about SleepyHead?
See my Guide to SleepyHead
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#4
If you had a large leak rate with the P10, the machine cannot detect apneas and hypopneas. Changing to a mask that has a much lower leak rate means, previously unscored events are now detected.

The P10 does apply pressure more effectively and it's possible the AHI increased, especially given you are using fixed pressure.

What type of events are in this increased AHI. If it is OA, then change your machine to auto mode, and set a minimum pressure of 11, and maximum of 20 and see what happens.

Post data. SleepyHead is free....get it.
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#5
Hi jjso,
WELCOME! to the forum.!
I wish you good luck with your CPAP therapy, hang in there for more responses to your post.
trish6hundred
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#6
Chill, Robysue, Sleeprider and Trish6hundred,
Thank you so much for you quick responses. They were so full of useful and helpful information. This is truly a terrific board and resource.
I have downloaded Sleepyhead and will download my data into it.
My CPAP machine is a Resmed AirSense 10 Autoset.
During the past 13 days with my Resmed P10 nasal pillows my leakage varied from a low of 29l/min to a high of 55l/min. The mask fit fine. I am positive that the leakage was due to my breathing through my mouth while I was asleep.
I've only used my new full face F10 mask for the past 4 days and my leakage and varied from 12l/min to 14l/min. Currently I have the medium size, and I ordered a large size which will arrive on Friday. I believe the larger size will fit better and may allow for less leakage.
I will try the "self-titration" that was mentioned to get a clearer picture of what's going on.
Thank you again for all your guidance and knowledge.
I truly appreciate it.
All the best.
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#7
Resmed defines a large leak with the P10 as anything over 24 liters/minute. You are in large leak 100% of the time with the P10, therefore the AHI cannot be reliably measured. Your increase in AHI with the new mask is a more accurate reflection of your actual results.

Once you get things sorted, it will help us if you post some data. You are using your Autoset in a fixed pressure CPAP mode, and it is capable of operating in a range. Is that something you want to try? Also, your machine has a number of comfort features like Ramp and EPR (exhale pressure relief). We can help you to use those features if the pressure is a problem for you now.

We cannot advise you on any changes without knowing more about the types of events that are causing your current AHI. The following links will help guide you to Organize and post your data:

https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur
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#8
Unless you have a really large head, you may find that a small works better. At least that is the case with the similar Simplus mask. I found templates on-line that you can print out, cut out, and use to determine the correct size. I just don't remember where now, probably some of the on-line suppliers listed at the top of this page.

Other things that can cause a lot of leaks are having the straps too tight or too loose, or the mask just not fitting your face. Mask liners can also help. In my experience, they mostly don't stop the leaks so much as diffuse them enough that they are not annoying.
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#9
jjso,

Sleeprider is correct: With those kinds of leak numbers on the P10, all of the data is likely to be incorrect. You may very well have been having a huge number of event that the machine could not detect in the presence of the extremely large leaks.

In this case, my guess is the data from the FFM is much more accurate.
Questions about SleepyHead?
See my Guide to SleepyHead
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