Ravik,
I understand that you sleep better on straight CPAP than APAP. That's as good of a reason as any to keep running with a fixed pressure or a very, very tight pressure range.
Unlike ajack and Fedman, I don't think you can just dismiss the VS2 data. Yes, sometimes PR machines mis-score a lot of things as VS2s. On another forum there's a long term poster who has strong evidence that when her pug is sleeping in the bed, her PR machine picks up the dog's snoring. Others have sleuthed that sometimes their PR machines will pick up the hose scraping against the side of the bed as snoring. But the fact remains that
if you are snoring, then it's likely to be flagged as VS2s as well as VSs. My own hypothesis is that snoring has to have certain characteristics to be flagged as a VS rather than a VS2 and those characteristics are something the machine is using to decide the snoring really is a sign that the airway is in danger of collapsing, so a pressure increase is warranted. (It is worth noting that VS snores are NOT recorded in CPAP mode on the PR machines.)
So I think it's well worth testing the hypothesis that you could be snoring and that the snoring could be responsible for the fact that you feeling tired again. You could try bumping the pressure up by 0.5-1.0 cm to see if that does anything. Or you could try running in a really tight APAP mode for a week or two to see if the machine wants to give you more pressure. In other words, you could try min pressure = 8 and max pressure = 9 for a week just to see how often the machine increases the pressure for things other than clusters of OAs and Hs.
As for the leak numbers: In my opinion, they are not high enough to worry about in the sense of adversely affecting the quality of your data or the efficacy of your therapy: Except for obvious leak problem that you fixed at the beginning of the night on June 19, none of the leaks are flagged as official Large Leaks by your machine. The PR machines do not have a "fixed" value for determining a Large Leak, but at 8cm, they are usually quite capable of dealing with a
Total Leak Rate of 60-70 L/min before flagging an official Large Leak. (Remember that Total Leak Rate includes the intended leak for your mask; also remember that Total Leak Rate is the TOP graph in SleepyHead.) Your 95% Total Leak Rate numbers are well below that.
That said: The leaks might still be disrupting your sleep even if they're not large enough to adversely affect the data or the efficacy of your therapy. And if they're disrupting your sleep, then that could be what's causing you to feel tired during the day: A night of pulling at the mask all night to readjust it to fix leaks is not particularly restful. And it is possible to do a lot of pulling at the mask while you're in very light sleep.
You ask:
Quote:As this is full face mask mouth breathing should not matter right?
In theory you're right: Mouth breathing in a full face mask should not increase the leak rate.
But full face masks are prone to "springing leaks" because the seal has a much larger footprint on the face. When your face relaxes in deep sleep that can cause the jaw to pull away from the mask in such a way as to trigger a leak. When the mask is pushed against your pillow when you turn over, that can disrupt the seal and cause a leak. And, unfortunately, when you fit the mask with a closed mouth at the beginning of the night and then later on your mouth opens wide, that can cause the mask to shift enough on your face to cause a leak. A mask liner might help if the leak problem is caused by any of these things. But you really only need to worry about the leaks
if you think they might be disrupting your sleep.
