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Leaks with low AHI
12-07-2015, 08:06 AM
I know I should be concerned about leaks but I am still getting <2 AHI each night. Is the AHI index still accurate despite a high rate of leakage? I've been on therapy less than a week and will be making adjustments as I progress with the device. I believe leaks are coming from opening my mouth and not a poorly fitted mask. As a hypothetical, if my mouth stays open all night yet my AHI is still <2, does that mean therapy is still working, or is the AHI a false reading because of the high leakage?
12-07-2015, 08:23 AM
(12-07-2015, 08:06 AM)app1nag Wrote: I know I should be concerned about leaks but I am still getting <2 AHI each night. Is the AHI index still accurate despite a high rate of leakage? I've been on therapy less than a week and will be making adjustments as I progress with the device. I believe leaks are coming from opening my mouth and not a poorly fitted mask. As a hypothetical, if my mouth stays open all night yet my AHI is still <2, does that mean therapy is still working, or is the AHI a false reading because of the high leakage?
forgot to mention, my Airsense gives me a smiley face in the morning even though I am seeing high leakage #s in Sleepyhead.
12-07-2015, 08:24 AM
Resmed machines can nominally compensate for a leak up to 24 L/min. Above that you can't place any reliance on the AHI reading.
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12-12-2015, 07:33 PM
This is where I am confused because I get 2 and below for my AHI's my leaks are always from 6 to mid teens, I have never had a red face and I would say most of my leaks are from my mouth, note, I do wear a chinstrap.
But and its a big but, I am still extremely tired every day and this has been going on for nearly two years now.
So even though I have leaks all night long because they don't get to 24, no red face?
AHI is good so I just continue as I am and being exhausted every day.
Sleep Dr. said everything was fine. Said he couldn't do anymore for me.
Sorry app1nag for butting in here, you're a newbie and I'm an oldie but im still confused.
Good luck on your Cpap journey.
12-12-2015, 07:36 PM
Hi Gabby, have you ever tried a FFM? Just wondering if that is what you really need or would help your leak rate?
APNEABOARD - A great place to be if you're a hosehead!!
EVERY ACCOMPLISHMENT BEGINS WITH THE DECISION TO TRY!
01-26-2016, 01:46 PM
I know I am late to this tread but will give it a try anyway. I was wondering the same thing as APP1Nag. Last night my Resmed recorded a leak of 30LPM yet my AHI was only .7. I know I need to work on the leak but if my AHI was .7 then is my therapy still more than adequate?
01-26-2016, 03:07 PM
From my limited experience, ResMed is conservative with flagging events and to top it off, the higher the leak, the easier for the machine (any brand) to miss an event.
Everything I post on this board is nothing more than an opinion expressed by an apneak. Normally, it's based on facts and experience but sometimes, I may get things wrong or not have all the facts.
I reserve the right to change my mind. Why? Because tomorrow I may know better.
01-26-2016, 06:51 PM
Here are examples of low AHI but problematic leaks, which keep me working on this...I see improvement but once leaks are better I'll trust the AHI.
Fourth day on Cpap:
After adding chinstrap 3 days later:
After changing to Dreamwear nasal mask:
Am going to try side sleeping only...more work to do!
01-27-2016, 09:40 AM
Interesting analysis. Looks like you are getting somewhere and you definitely have been through worse than I have. What mask were you using before the Dreamwear?
The leak rate I mentioned of 30LPM occurred with my Dreamwear mask. What I can't figure out is why I do not feel any leaks and I feel okay in the morning? When I switch back to my Sleepweaver Advance mask I have very few if any leaks whatsoever and my events are similar to those on my Dreamwear (average only 1.52 overall). I like the Dreamwear for the hose connection on top but I have a hard time breathing in it. My initial sleep study suggested a pressure of 6cm but with the Dreamwear I was suffocating. it wasn't until I ramped it up to 10cm with EPR of 3cm that I could actually breath normal. I did notice last night that my leak problem is related to mouth leaks. Seems that pressure builds up and my nasal passages are too narrow to handle the exhale so it is forced out of my mouth. My allergies are a problem right now which may be causing a narrowing in my nasal passages. The Sleepweaver's construction doesn't seem to create this problem as the pressure surrounds my nose rather than goes straight into my nostrils.
Thank you for discussing this problem with me. Looks like we both have some work to do. I have finally been able to learn to sleep on my side using a cpap pillow on top of my regular pillow. It takes the pressure off of the shoulder.
01-27-2016, 11:50 AM
I do not think that narrowing of your nasal passages is the problem. Many of us can suffer from "chipmunk cheeks" resulting in air being expelled from our mouths. It stems from not sealing one's mouth off from one's airway. The solution is what we call the tongue seal. By pressing your tongue against the roof of your mouth, you can seal the mouth from the wirway and eliminate mouth breathing/leaks. The trick is getting your body to maintain this seal while you are asleep. Some of us have trained our body to maintain this seal by practicing it a lot while awake. A chin strap can help to make this easier and also kind of remind your body while asleep that you need to maintain the seal.
If you are not able to make this work for you, a full face mask would solve the therapeutic problem. Some people hate FFMs and some like them but it is a solution.
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