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leaks and AHI #
#1
Is there any correlation between large leaks and low AHI numbers? I've been using a WISP mask and the leak #s while not high enough to give me a sad face on my Airsense, are still higher than I think they should be. However, my AHI has been less than 1 for many weeks. Last night I tried nasal pillows and my leaks were very low, but my AHI was 1.47, which is still a good # compared to 20 without therapy. I'm wondering now if the AHI #s that I've been seeing with the WISP are not accurate because of leakage.

Thanks !
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#2
The machine relies on its pressure sensor to detect respiration (inhale/exhale), the tidal volume and minute vent, and the presence of an open or closed airway. As leakage rises above the expected intentional mask vent-rate, the feedback becomes more ambiguous, resulting in undefined events and likely missed hypopneas. At very large leak rates the machine does not detect any events. So the answer to your question is that the detection of events is less reliable at higher leak rates, and likely biased to a lower number of detected events.

If you're happy with nasal therapy, have you tried nasal pillows? Leaks tend to be much easier to control.
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#3
yes. In my post I stated that I tried pillows last night and got higher AHI...thanks for the feedback.
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#4
I would trust the results with low leakage, 1.47 is a good start. I'm a big pillow fan for a lot of reasons, low leaks and comfortable. I've been away so forgive me if you have already talked about your pressure range. Do you need that big of range? I'm a fan of 4-5 range. Anything too low causes events too high will cause leaks? I was prescribed pressure of 17 and watching noticed my machine was running 11 to 12 with great results so I slowly backed off to 10-15 range with super low AHI.

Good work on paying attention to data and trying new things never hurt anyone.
Good Luck!

Doc J (despite my nickname I am not a doctor)

Remember to donate to the board if you can, it has helped a lot of people including myself.
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#5
[attachment=2015]my Autosense has gone close to 20 on occasion so I think my higher setting is ok...
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#6
(12-28-2015, 08:27 AM)app1nag Wrote: Is there any correlation between large leaks and low AHI numbers? I've been using a WISP mask and the leak #s while not high enough to give me a sad face on my Airsense, are still higher than I think they should be. However, my AHI has been less than 1 for many weeks. Last night I tried nasal pillows and my leaks were very low, but my AHI was 1.47, which is still a good # compared to 20 without therapy. I'm wondering now if the AHI #s that I've been seeing with the WISP are not accurate because of leakage.

Thanks !
Another check for you would be to see if the machine is set for pillow mask instead of nasal mask.

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#7
(12-28-2015, 08:27 AM)app1nag Wrote: Is there any correlation between large leaks and low AHI numbers? I've been using a WISP mask and the leak #s while not high enough to give me a sad face on my Airsense, are still higher than I think they should be. However, my AHI has been less than 1 for many weeks. Last night I tried nasal pillows and my leaks were very low, but my AHI was 1.47, which is still a good # compared to 20 without therapy. I'm wondering now if the AHI #s that I've been seeing with the WISP are not accurate because of leakage.

There's no clinically significant difference in those values of the AHI. It's very important to keep your leaks under control, much more important than that small difference in AHI.

You are correct in your observation about the smiley face. You need to look at the leak graph and make sure you're not experiencing significant periods of high leak. They will ruin your sleep quality.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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
[attachment=2021] This is last night and I am feeling tired today. Do you think these leaks are unacceptable? I spoke with my doc and he said everyone has leaks. I brought a 30 day compliance report for him to review but he provided very little insight. Sometimes I wonder if I know more than him about cpap therapy Sad
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#9
You've got enough large leaks that those are potentially as disruptive as apnea events. I don't know how anyone can tolerate air leaking around their nose and eyes and expect a refreshing sleep. Your profile shows you occasionally try nasal pillows. Have you tried the airfit p10? It's a lot easier to get a seal with a nasal pillow than a nasal mask.
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#10
(01-07-2016, 08:27 AM)app1nag Wrote: Do you think these leaks are unacceptable?

Between 2:40 and 4:40 you have a 2-hour period where your leak graph looks great. If it looked like that all night long the quality if of your sleep would be much improved.

Quote:I spoke with my doc and he said everyone has leaks. I brought a 30 day compliance report for him to review but he provided very little insight. Sometimes I wonder if I know more than him about cpap therapy

My doctor specializes in CPAP therapy and isn't able to look at a leak graph despite the fact that her assistants download my data and print a report for her. I had the same leak issues as you and had to self-diagnose the problem.

If you are not wearing a chin strap you need to try one and see if it fixes your leak issue. If you are wearing a chin strap you need to try a full face mask.

Your doctor is wrong to dismiss your leak issue so flippantly. If I were you I'd find a new doctor. At least I can talk to my doctor about these issues and she can give me recommendations on what to try. I adjust my own pressure, tell her what settings I'm using and why, and she at least seems to agree with my reasoning. At my next visit I plan to ask for a prescription for a new A10 VPAP Auto, and she will likely provide it. My insurance should cover a new machine, if not now then in November when I pass the 5-year mark.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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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