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Extreme leaks whenever I have an apnea...need suggestions
#1
Extreme leaks whenever I have an apnea...need suggestions
Hello everyone, I was diagnosed with sleep apnea on Nov 30 of this year and started using APAP the same day. my current pressure is 4-20 and my machinery is in my profile. I have been experiencing extreme fatigue and lack of energy so bad for 6 months that I have become bedbound and cannot leave my house anymore. My doctor told me this is the reason why I have such bad fatigue as my blood tests and everything else has been fine. Has anyone else ever experienced severe fatigue with their sleep apnea? 

Also, I have an issue. I have been using the sleepyhead software for a few nights now and it says that whenever I have an apnea, I have a severe leak. It says that I had a lot of severe leaks all night long and that it's not treating the apneas due to these leaks. I also can tell that when the machine pressure turns up, the mask tends to pop off my face or get a leak around my nose or jaw. 

I don't know how to post the full night of sleepyhead data as it doesn't want to select all of the data for some reason. Can anyone help? Here's a screenshot of one of my apnea events. I don't know why it's leaking so badly and I need some help as I feel horrible

It says I can't post images until i have most posts so here is the link to the imgur image... https://i.imgur.com/GX523Dp.png
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#2
RE: Extreme leaks whenever I have an apnea...need suggestions
Sorry to post again, I'm trying to go about posting all of my data, but I had a lot of trouble going to sleep last night so I had to constantly get up and turn off the machine and turn it back on again, so there's like 10-15 start times and stop times. Sleepyhead only wants to show me about 20-25 minutes on the highest view size. Any idea how I can get it to show the entire night like in most peoples graphs?
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#3
RE: Extreme leaks whenever I have an apnea...need suggestions
tstburn,
Try going back into the preference menu and check all your settings.

Also, on the daily page, scroll to bottom of graphs and look on the right and left side of page. There you will see a drop down box. Be sure the graphs and events are checked.

As far as not being able to see the entire night, just click out to a different day, then go back to the day you want to view.

Follow the tutorials in my signature line. This will show you how to organize your page for a screenshot, how to take a screenshot and upload to imgur for posting here.

We would need to see the following graphs: events, flow rate, pressure, and leak rate.
Include all the stats on the left side. You can leave off the calendar.
OpalRose
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Extreme leaks whenever I have an apnea...need suggestions
(12-11-2017, 04:49 PM)tstburn Wrote: Hello everyone, I was diagnosed with sleep apnea on Nov 30 of this year and started using APAP the same day. my current pressure is 4-20 and my machinery is in my profile. I have been experiencing extreme fatigue and lack of energy so bad for 6 months that I have become bedbound and cannot leave my house anymore. My doctor told me this is the reason why I have such bad fatigue as my blood tests and everything else has been fine. Has anyone else ever experienced severe fatigue with their sleep apnea? 

Also, I have an issue. I have been using the sleepyhead software for a few nights now and it says that whenever I have an apnea, I have a severe leak. It says that I had a lot of severe leaks all night long and that it's not treating the apneas due to these leaks. I also can tell that when the machine pressure turns up, the mask tends to pop off my face or get a leak around my nose or jaw. 

I don't know how to post the full night of sleepyhead data as it doesn't want to select all of the data for some reason. Can anyone help? Here's a screenshot of one of my apnea events. I don't know why it's leaking so badly and I need some help as I feel horrible

It says I can't post images until i have most posts so here is the link to the imgur image... https://i.imgur.com/GX523Dp.png

Hi, tstburn.

I bolded some of your quoted post for a reference. From my own experience, the answer is a very definite YES. To the same degree as you? Not exactly, but certainly I was close. I had around 13 years worth of Apnea suffering that went mostly untreated during that timeframe. I would get up and within roughly 3 hours of doing anything, I was completely done for the day. After about 3 months of treatment via my ASV machine, it is just now ever so slightly getting to where I wake up feeling less tired than when I fell asleep.

As for the mask, here's the link to AB mask primer for some suggestions. Mask Primer You probably have been referred to this already, but I wanted to help point you to where I learned to choose and fit the mask. It really helps to be certain, at least for me, to be settled on mask style, that is full face, nasal, etc. and get the model and size that works best for you. Size is a very misleading aspect IMO. I personally have chosen to stay within a FFM type. And ResMed's F20 AirFit in Small is the current go-to for me. Admittedly, I have not tried many masks other than F20 AirFit in Medium and Small, AirTouch in Small, and the Respironics Amara View in Medium. I personally have not tried anything other than these, mostly because I have to keep expenses to near zero. But, one other aspect, and it's probably RARE, I liked the above masks first try and didn't want to continue trying other masks.

I'll let more experienced AB members address SleepyHead info, as I'm not nearly as well-versed in it as I would prefer for my own usage. Stick with the CPAP treatment, it will pay off with perseverance.

Dave
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Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Extreme leaks whenever I have an apnea...need suggestions
Hello tstburn

It is good you have been using CPAP. In your previous thread, S2S noted your pressure setting is wide open and it might be better for it to be a narrower range. Most find that 4 is a very low starting pressure and 6-8 might be better. If you press the home button and the dial at the same time, you can get into the clinician's menu to change the settings.

It would help the gurus here to help you if you post the results of your sleep study if you have it. If not, ask for it.

Sleepyhead-in order to display the whole night, you have to select and click from left to right of any of the rows. The useful information to show are flow rate, mask pressure, pressure and flow limits. Large leaks show up as grey bands on all these so there is no need to show leaks as a row. With appropriate info from sleepyhead the gurus here can assist in helping you dial in appropriate pressure, if needed.

For me, it was hard to control leaks with my initial pressure of 16.8. The FFM did not suit and I found that the nasal pillows suited more. I have read that the F20 you have is a good FFM. Others have written of placing some 'cloth-like' item between the FFM and your face and that appears to help with leaks. Perhaps others will chime in with the name.

Keep with it, you will get relief from effective therapy.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: Extreme leaks whenever I have an apnea...need suggestions
tstburn, the chart you posted does not have a lot of information we can use to help you. It would be great to see some full-nights showing the events, flow rate, pressure, flow limit and snores and the Statistics pane on the left. Organization tutorial is in my signature links. One more important note, you are not charting or counting CA events. Be sure central/clear apnea events are charted by checking file/Preferences/Events and waveforms and ensure that Clear Airway events are checked.

The chart you posted shows that you have several obstructive apnea that have pretty good duration, and the unclassified events are even longer, but occur during a large leak, which may simply reflect the inability of the machine sensors to detect breathing. The size of those leaks suggest mask displacement and an open leak situation. Overall you don't appear to have air escaping your mouth. Your machine is set to wide-open default pressure range of 4-20 and it would be very beneficial to optimize this. By looking at the full night of data we can begin to see patterns where obstructive apnea are resolved at a particular pressure. Also, the use of EPR can make therapy more comfortable, but it's useless at low pressures like we see in your chart. In the Flow Rate chart we see here, your breathing appears unbalanced and irregular. You would need to zoom into about a 2-minute segment of that for us to make useful observations of why there are sporadic large inspirations or recovery breaths,while most of your breathing is clustered at a very low flow rate.

[Image: GX523Dp.png]
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Extreme leaks whenever I have an apnea...need suggestions
Hello everyone, thank you for your responces. I have now taken the correct screenshot of the sleepyhead software. I have noticed something continually though. Every time I have an apnea, it increases the pressure, and this causes a leak in my mask to blow out. It's even woken me up before where the pressure is at like 10 or 11 and I feel horribly fatigued and I have air blowing in my face. Looking at the data here, it shows my leak rate goes up VERY high every time I have an apnea. Any ideas?
[Image: b0eQTxE.png]]


Thank you sleeprider for the advice. Let me get a 2 minute screenshot, you posted that while I was typing this. I will adjust the pressure up to a 6 or an 8. My diagnose was moderate sleep apnea with an average of 15 events per night with an average lasting 60 seconds and up to 120 seconds. No central sleep apnea, just obstructive and hypoapneas. I did a 3 day sleep study

Edit, here you go Sleeprider. Here is a 2 minute with no apneas and one with an apnea.
[Image: 3R50csg.png]]
[Image: pV6qulz.png]]


I'm going to go try and purchase a new mask as I feel like my issue is the AirTouch F20 leaks whenever the pressure goes up when I have an apnea. Any advice on another good FFM? I was going to try the AirFit F20 as I've heard that one has almost no leaks...
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#8
RE: Extreme leaks whenever I have an apnea...need suggestions
Sleep rider, as the highest pressure shown is about 14, would it be a good idea for Tstburn to reduce the maximum pressure to about 16 and the minimum to 8 with EPR of 2, say?
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: Extreme leaks whenever I have an apnea...need suggestions
Tstburns

Your charts are like mine when I would be woken up by huge leaks. And there are also gaps in therapy where I tore my mask off in desperation, also as shown in your data. Difference is I was on CPAP and not APAP. Pressure appropriate to need would help with those leaks as would a better fitting mask.

The other issue which most of us have is opening our mouths to breathe which I found in my case caused more leaks and dryness which was the other factor waking me up. You write, Tstburn that you are unsure about humidification. Do you have the humidification tub which you have to fill every night?
Sleepyhead in 5 easy steps
Beginner's Guide to SleepyHead

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Extreme leaks whenever I have an apnea...need suggestions
I can try that pressure if you guys think that it would be a good idea. I know none of you are doctors but my fatigue is so horrible and the only thing my doctor thinks it could be is this sleep apnea. I can't see my doctor for another 3 weeks and they won't give me any advice over the phone, so I'm just desperate to try and do anything to relieve the horrible fatigue I experience. Sorry for how new I am, I am very overwhelmed by this software and I just want to feel better LOL. Also yes, I do rip off my mask in frustration and do wake up with huge leaks blowing in my face. I do have a humidification tub, I am not sure what brand it is though. It came with my machine when I bought it.
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