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Leak rate and Apnea
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retired_guy Offline

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Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
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Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #11
RE: Leak rate and Apnea
I agree Salty. Just watch things for a few days and see if the Centrals don't calm down on their own. Also, since you're sleeping on your back, if you would elevate the head of your mattress that would probably help to calm down some of the OA's.
10-26-2014 08:26 PM
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saltydawg2 Offline

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Machine: Resmed S9 autoset
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Sex: Male
Location: North Carolina

Post: #12
RE: Leak rate and Apnea
How much would you think I should raise head; 3-4 inches? I would guess I would need to start incline at waist, or raising would be like adding a pillow, which I know won't work. Much higher than that, and it would keep me from even attempting to sleep on my side. Thanks!
(This post was last modified: 10-26-2014 08:56 PM by saltydawg2.)
10-26-2014 08:52 PM
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retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #13
RE: Leak rate and Apnea
Whatever you can reasonably do should help, Salty... And yes, starting at the waist is a great idea. You want to keep your chin from falling down on top of your chest. As I have said before, your ears should be closer to the floor than your nose.
10-27-2014 12:12 AM
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vsheline Online

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Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #14
RE: Leak rate and Apnea
(10-26-2014 08:15 PM)saltydawg2 Wrote:  Last night, I really had no "clusters" of apneas, but those I had still shows leak peaks. My AHI was under 7, which was a record low for me, especially for almost 8 hrs. of sleep. I for the first time had more Central Apneas than Obstructive. A few more nights of sleep, and I will consider that an issue.


Your doc might not be concerned unless the AHI is above 5.

Centrals tend to reduce over time as our system adapts to sleeping under pressure.

After a month or two (or longer) of therapy, if your Central Apnea Index (average number of CA per hour of sleep) remains above 5 per hour, then perhaps your doc might become concerned about the CAI being too high. But it sounds like your CAI is already much lower than that, so I would not be especially worried about the centrals.

If the clusters of obstructive apneas return, as Zonk pointed out, these may be occurring while you are flat on your back, which is usually the worst position for sleep apnea.

In addition to raising the head of the bed as much as comfortable, you might try adding a 3 inch "mattress topper" on your bed, to see if that would allow you to sleep on your side. (Works for me.) Also, placing several pillows to keep you at least partly off your back may help reduce the severity of obstructive events.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 10-27-2014 01:32 AM by vsheline.)
10-27-2014 01:26 AM
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vsheline Online

Advisory Members

Posts: 1,915
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #15
RE: Leak rate and Apnea
(10-24-2014 04:18 AM)saltydawg2 Wrote:  I have noticed that my air leaks are generally low, average .06-.32%, over the last month. But during those clusters I mentioned, the leak rate spikes at same time, at each individual event, mostly OA. Flow rate shows drop every event, which I would expect. Going all the way down the page, everything else shows increase, as well. If I am at constant pressure, why would the leak rate increase during those events? Thanks for any help understanding.

Keeping the unintentional Leak below 24 Liter per minute is more important when in AutoSet therapy mode. If the unintentional Leak gets higher than 30 L/m, the machine will stop trying to distinguish between CA versus OA. Also, when the unintentional Leak is much above 24 L/m, the target pressure setting algorithm will be less accurate, so therapy might not be targeting the right pressure.

When in CPAP therapy mode, the unintentional Leak might be perhaps twice as high as 24 L/m and the machine might still be able to maintain adequate mask pressure (at the target 14 cm H2O).

But at some point the machine will not be able to pump enough airflow to maintain the 14 cm H2O mask pressure and you may get obstructive apneas from the mask pressure being too low.

Or, it is also quite possible that sometimes even 14 cmH2O is too little pressure (perhaps when in REM sleep while also flat on your back, double whammy double trouble), and when in apnea, perhaps you are moving and causing extra Leak.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 10-27-2014 01:54 AM by vsheline.)
10-27-2014 01:45 AM
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