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Trying to gt ahi and leak rate under control
#1
I a fairly new bipap user (as of early May) .   My sleep study showed an AHI of 73 and I am now at around 7.  But, I can't get below that number consistently.   I will occasionally get a 3 but only once in a while.   My leak rate is high, typically 20 - 35 lpm (at 70% per sleepyhead).  I've tried 4 different masks and still getting these readings.  My most recent masks were the Dreamwear which I found very comfortable but would frequently leak when I rolled on my side.  So, I switched to the Airfit P10.  I find this mask pretty comfortable (though the hose is not as unobtrusive as the top of the head connection on the Dreamwear mask) and it doesn't leak when I roll on my side (at least I don't hear any leak) but in the morning the leakage numbers are high and I often get the red frowny face.   I even added a chinstrap and taped my mouth but that didn't make the numbers improve so I don't think it's a mouth breathing issue.

Here's my question.  How important is the leaking given that:
1.  I don't wake up because of it
2.  The mask pressure is not dropping due to the leaks (per the Mask Pressure chart in Sleepyhead)


Secondly, is there anything I should change to try to get the AHI down from 7-8 or should I be content with the fact that it's come way down and I'm feeling much less tired during the day.
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#2
Welcome to Apnea Board. I will defer to others that are far more knowledgeable on settings, suggestions, etc. Certainly, you can tell by the AHI decrease, obviously, you're headed in the right direction. For the leaks, I'd suggest giving the Mask Primer article a try for lots of useful tips while you wait for others to chime in.

Best wishes on future success,
Dave B.
I am not a doctor nor do I pretend to be one. Follow my advice as a choice not an order. 2 of these  Coffee Coffee per day keep the bad times away.
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#3
The aircurve will keep up with your leaks as long as they do not exceed 24 l/min.  I have the same machine and mask, sometimes I exceed the 24 l/min but not for very long and I do not get terribly worked up over it.  Best thing to do is get a few more posts, and post images of your sleepyhead reports.  Post them  and members will be able to give you some great input.  Good luck and keep up the good work.
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#4
(08-12-2017, 03:46 PM)silversnore Wrote:  Best thing to do is get a few more posts, and post images of your sleepyhead reports.  Post them  and members will be able to give you some great input.  

How many posts are required before I can post images?
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#5
Four posts.  You can use this link https://sleep.tnet.com/reference/tips/imgur to post your charts to the site.
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#6
You can link to an Imgur image now, but put a space in the URL...like h ttp://ImgurURLhere.com

For your mask, get a snuggle hose and place the cover from just a couple inches away from the nasal pillows. It will be soft and quiet, and I find it helps to hang the hose from the headboard.

AHI 7 is kind of high, and your strategy to correct that depends on the types of events. Be sure to let us know what EPR setting you are using.
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#7
Hi sirto,
WELCOME! to the forum.!
Good luck with CPAP therapy, you have come to the right place for guidance.
trish6hundred
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#8
(08-12-2017, 05:53 PM)Sleeprider Wrote: AHI 7 is kind of high, and  your strategy to correct that depends on the types of events.  Be sure to let us know what EPR setting you are using.

Pressure relief is set at 4 cm.
I just ordered a soft cervical collar.  Will report back when I get some data.
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#9
I missed that you're using a bilevel. If your events are mostly central reduce PS or the difference between IPAP and EPAP. If events are obstructive, increase minimum EPAP pressure. Since you have not posted any charts, that's the best I have. I suspect your events might be central from the pressure support.
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#10
(08-14-2017, 10:32 AM)Sleeprider Wrote: I missed that you're using a bilevel.  If your events are mostly central reduce PS or the difference between IPAP and EPAP.  If events are obstructive, increase minimum EPAP pressure.  Since you have not posted any charts, that's the best I have.  I suspect your events might be central from the pressure support.

Not sure how you'd define mostly central.

Over the last week the avg CA was 2.3, HI 0.36, OA 3.48  so CA is 36%
Over the last month CA 1.58, HI 0.31, OA 3.63  CA was 27%
Since start of treatment (3 months)  CA 0.81, HI 0.94, OA  4.49  CA was 12%

Hadn't noticed before this that the CA% is increasing though I don't know why.

Given these numbers do your original suggestions still apply?
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