Switched to Hybrid - But Now AHI is High

BigEd · Post by **BigEd** » Sun Apr 22, 2007 5:32 pm

It's only been 1.5 nights, but I just switched from Swift nasal pillows to the Hybrid. I made the change to help me with mouth breathing issues. My AHI prior to the change was 2.1. My AHI reading from last night was 21.1.

Could mask leaks cause this number to jump? I was confident I had a nice seal, but my leak numbers were also up substantially.

I had been using the Swift nasal pillows for almost a year and had little to no issues, other than mouth breathing. I know it's only been one night, but I was so sure I had a good seal and was excited to see my new numbers. Is this common during the "getting used to" period of a new mask?

PS: I'm also dealing with a cold and quite a bit of nasal congestion.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): swift, AHI, seal, Nasal Pillows

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): swift, AHI, seal, Nasal Pillows

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): swift, AHI, seal, Nasal Pillows

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): swift, AHI, seal, Nasal Pillows

SleepySandy · Post by **SleepySandy** » Sun Apr 22, 2007 5:42 pm

Can you post your EncorePro Daily Details report from last night? That might give some clues.

BigEd · Post by **BigEd** » Sun Apr 22, 2007 6:21 pm

SleepySandy wrote:Can you post your EncorePro Daily Details report from last night? That might give some clues.

It was a short night. After 4 hours I pulled the data card and switched back to my nasal pillows. This info is from the four hours on the Hybrid. Note the leak level:

From last night (Hybrid):

From Tuesday (Swift Nasal Pillows):

Thanks

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): Nasal Pillows

oldgearhead · Post by **oldgearhead** » Sun Apr 22, 2007 6:37 pm

...humm, lots of noise (VS) and too much leak...

pastorgilbert · Post by **pastorgilbert** » Sun Apr 22, 2007 6:37 pm

Hi--I'm interested in finding out if anybody else has experienced a higher AHI on the Hybrid. I too found that to be the case, and yes, I too was fighting a cold at the time. Since the cold has just about gone, I'm beginning to see my AHI go down slightly again. Previously I was at about 3.0 AHI and then with the Hybrid it went up to about 10 AHI. Now, after a few days with not cold it's down to about 8.0. There may be a correlation with the cold.

The kicker is that I really love the Hybrid and have been able to sleep longer with it than any other mask, even with the cold. I'm thinking it's going to work out just fine.

I would give it a few more nights and see if you AHI begins to go down after your cold symptoms subside.

Pastordave

I'm not a doctor, nor have I ever played one on TV...

WearyOne · Post by **WearyOne** » Sun Apr 22, 2007 6:46 pm

I've only used two other masks besides the Hybrid, and my Hybrid AHI numbers are lower than the others. My AHI was between 1 and 2, but since I've taken the chin flap off, I'm now getting even lower AHI (under .5) and lower leak rates (a little lower that what is listed for that mask).

I haven't used any mask with a cold yet (only been on cpap a little over two months), so I can't compare to that.

Pam

SleepySandy · Post by **SleepySandy** » Sun Apr 22, 2007 6:48 pm

Holy cow!

Those leaks from last night are crazy.

BigEd wrote:Could mask leaks cause this number to jump?

I would have to say yes in this case.

This is some information I posted on another thread that's relevant to your question:

SleepySandy wrote:Your mask has an intended leak rate, also known as a vent flow rate. This rate is based on your pressure. Your mask manual will have a graph in it that will show you the leak rate for your pressure. When you look at your leak graph on the Daily Details Report, you want the rate to be as close as possible to the intended leak rate. When your leak rate is equal to the intended leak rate you are not having any leaks other than the exhaust from the mask. It's a simple statement but extremely difficult to reach. And if you reach it it's extremely difficult to maintain.

The ideal situation with leaks is to get them as close as possible to the intended leak rate and as consistent as possible (a nice straight line on the leak graph).

If I have many periods where my leaks went up a lot, that indicates a problem with mask leaking and is something I need to figure out and fix.

I did some analysis of my data a while back and I found that I had more events when my leaks were higher. So, I strive to keep my leak rate as low and as consistent as possible.

Large leaks are extremely important to pay attention to and work to stop if you're having them. Large leaks are leaks that are so big the machine can't compensate and also can't figure out what's happening in terms of events. So, if you have an event during a large leak it probably won't be recognized. Your ideal value for large leak is 0 minutes.

In your case the first thing you need to do is get rid of the large leaks. You spent 100 minutes in large leaks. During that 100 minutes your machine really couldn't tell what was going on. With leaks as high as yours I imagine you were definitely having events.

It looks like the very very beginning of the night had a reasonable leak rate but after that everything falls apart pretty quickly.

Your leaks with the Swift look a lot better than the leaks with the Hybrid.

Once you get the leaks stabilized you'll get a better idea of your AHI with the Hybrid.

There's a whole other issue with the Hybrid that you may encounter after you get the leaks under control. This has to do with the intended leak rate for the Hybrid. There are two Hybrid shells out there. The older one has a pretty high intended leak rate. The newer one has something called "Adaptive Flow" technology and the intended leak rate is lower. If you look at the front of your manual you'll see a graph with "Passive Exhalation Port Flow" at the top. If the pressure of 15 has a flow of 60, you have the old shell. This can be an issue because some people find an intended leak rate that high is just too high and the Hybrid won't work for them. I wouldn't worry about this at this time because you can't know anything about how the Hybrid will work for you until you get the leaks stabilized.

Mask