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ahi 0.62 :) but with LL 33%
#1
back on my PAP machine. i tweaked my settings. 8-16cm gave me a 7.71 AHI so i changed to 12.5-15cm and got a 0.62. I might raise the max back to 16. Curious thing though was that i had a large leak 33% of the time. Should i be concerned since I did so well anyway?
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#2
How large was the leak?

And you do know to not make changes too quickly, right? Changes should be done then let simmer for at least 10 days so you get a good idea of trends. One night is nothing in terms of data.

And you are writing down all the changes you are making, right? Wink
PaulaO2
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Breathe deeply and count to zen.

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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#3
I would rather take a starting point from which I am doing well, and see how that goes, so I will start from here. I appreciate your reminding about the data, because I know that a single point or two of data is very unreflective, but a very good or worse number has with it a strong emotional response.

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#4
It looks to me like you may be mouth leaking. With that much leaking going on the AHI may not be accurate. It might help to try a chin strap. You can purchase one or make a homemade one to try. Just remember, if you try a chin strap, that you are trying to entice your mouth into not leaking. You are not trying to force your mouth not to leak.

Best Regards,

PaytonA
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#5
aquacifer, agree with all above.

Your PAP machine can't efficiently do it's job if it is chasing leaks all night. Your AHI numbers are good, but may not be accurate due to the high leaks.

Try to find out where your mask is leaking. You may have to make adjustments or buy liners. Or are you mouth breathing! A chin strap could be in order.

Also; Paula02's advise on changing pressures is important. Your pressure settings seem good, but try to leave it alone for a week to 10 days and watch your data.
Well-done
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#6
Your new pressure settings are kind of interesting. At 12.5 you mostly control all the the AHI but have some excessive VS that drives the pressure higher. The maximum pressure was driven by a flow limitation, and both hypopneas occurred near the maximum pressure. Leaks are not correlated with higher pressure, but appear to occur mostly at minimum pressures.

I agree with others, that changing anything right now would be a bit premature, and it also appears a higher maximum pressure is contraindicated by the data at this point. You might be sensitive to higher pressures given that all hypopnea occurs there, but this is not enough information to make that conclusion. If anything, a slightly higher minimum pressure might get those snores so the system does not jack up your pressure. If changes are considered, I would look at narrowing the range, not broadening the upper pressure. Priority for now is leaks.
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#7
See how you had events recorded right after a high leak ended? Those are either false readings or you were having events during the mouth leaks. Could be you had events and opened your mouth to gasp and breathe.

Like Payton said, a chin strap isn't to weld your mouth shut, it is just to close it. You want it tight enough that your mouth cannot open when you are relaxed but loose enough you can chew with effort. We are tricky when asleep and can open our mouth quite easily, even against a strap! You can make a homemade one for a few nights to see if it helps. Take an ace bandage and wrap it around your head from chin to top of head like those old photos of folks with mumps. If the leaks drop or at least decrease, then you can invest in a good chin strap. If not, then it is the mask leaking or coming off.

I think you should leave the settings where they are for now until you get the leaks fixed or controlled. Changes made until then just are wild guesses based on faulty data.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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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#8
dittos for above on leaks. I wonder if you would post a night at 8-16 showing the 7 plus AHI.

I would suggest that you drop back to lower start pressure if you had control of leaking there, and then work up gradually. Maybe you won't have the issue at 10 that you are having at 12.5.

At any rate, hope you are able to find chin strap or tongue placement solutions for continued happy sleeping!

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
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