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Does a leak really matter if I have a low AHI?
#1
Does a leak really matter if I have a low AHI?
Some background:  Years ago I was in an airplane crash and got one side of my nose filleted.  It was surgically repaired and while it's not noticeable externally, I have a buildup of scar tissue internally.  This is generally not an issue but a mask that isn't quite wide enough presses against my right nostril, which then shuts off my air on that one side. I sleep exclusively on my right side.

Years ago, we addressed this by using Adams circuit nasal prongs.  It would leave my nares sore in the morning and over time I developed the habit of mouth breathing once I was sound asleep.  So I switched to a full face mask.  For the last couple of years I used a Resmed F20i mask, which solved many problems but position had to be absolutely perfect or I felt like I couldn't breath out of my right nare.  I was using the MyAir app and typically scored 97-100, gaining full credit for a perfect seal.  I will mention I have a short beard and mustache, typically between 1/4 and 1/2 inch long.

Last week I switched to the Resmed F20 which is physically bigger than the other mask and solved any problems with the mask pressing against the side of my nose,  Great!  But then I noted I was getting gigged by the MyAir software for having a poor seal.  No more perfect scores.

Initially, I felt I was being starved for air a little so I bumped up my pressure from 10cm to 12cm.  That took care of any sense of starvation.  It also took me down from 1-3 events per hour to essentially 0-1.

So the question becomes, aside from the personal goal of maxing out my score every night, does it really matter if my mask leaks, given what it has done to reduce my apnea?

I have played with the straps quite a bit but can't seem to find the sweet spot.  My Resmed Airsense 10 Autoset tells me I have a good seal when I use its "check fit" function but then in the morning I find I got gigged again by MyAir.  Perhaps I should just adjust my expectations and be happy my AHI is so low now.  God knows the mask is more comfortable than the old one.  I really can't feel a leak.

Opinions?
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#2
RE: Does a leak really matter if I have a low AHI?
How about an Oscar report to see leaks and flow rate, etc.....

How you feel is most important. I like under 1 AHI.
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#3
RE: Does a leak really matter if I have a low AHI?
IMHO it depends. Is the leaks are marginal then you are likely ok. If they are big, and I don't mean a little into large leak territory them no, they could be hiding significant events.
Unfortunately you will not be able to tell with the very limited data from MyAir, you will need OSCAR.

This is based on you having significant consistent low AHI
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#4
RE: Does a leak really matter if I have a low AHI?
I think MyAir is not going to give you the info you need in order to come to a good conclusion.

OSCAR really is so valuable in determining this for yourself.
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