Higher Leak, Lower AHI?

[DoriC]

I've been noticing this pattern on and off for a long time but never understood why. It seems that when Mike's leak rate is a little higher,but not excessive, his AHI is usually lower, instead of 2.5 it's 1.5, and strangely enough he seems to feel better on those days. I seem to think he's sleeping more deeply on the higher leak nights. Any explanation?

[SleepingUgly]

Hmmm... I don't know. I would think if the leaks are REAL high, the AHI may be invalid. But I don't know what effect, if any, mild to moderate leaks have on the AHI.

What makes you think he's sleeping more deeply on the higher leak nights? Is it possible the leaks are higher because he's sleeping too deeply to notice, and adjust them? Do these nights tend to follow worse nights of sleep so that he might actually be sleeping better because he's more sleep deprived?

[cpaptex]

In my case, I've noticed is if the pressure is too high I get leaks and my apneas increase. Perhaps, the regular pressure is a little low for your Husband and when the leaks occur the pressure goes up and apnea decrease. I think that both issues are possible based on what I've learned. It all depends on where your starting pressure begins.

The DME is always asking me if my mouth gets dry, but I don't ever breath at night through my mouth. Does your Husband?

My CPAP starts out at a pressure of 8.5 and when it goes up to 15-17 because of a leak or recurring apneas I usually wake up and turn the CPAP off and then back on and then I go back to sleep.

I've only been on a CPAP for a month, but I do talk alot to the DME and my Dr. about my concerns. This forum has also been a tremendous source of information.

[HoseCrusher]

From outside the box...

I have also noticed this. I think that a looser fitting mask is much more comfortable and you get a better nights sleep. The down side is that it leaks a little more.

[Slinky]

Maybe he needs the little higher pressure that the higher leak rates tend to cause and that might then entail a different fitting of his mask or an adjustment to the fit???

[DoriC]

I should mention that he sleeps at straight pressure=11cms. I tend to think that if the mask is leaking a bit more than usual there is more air circulating inside the mask which may be preventing some apneas. Not exactly higher pressure occurring to compensate for leaks but something similar. It doesn't happen every night, usually depends on how he's sleeping on his bed pillow. Hose Crusher, I'm glad you notice this too.

[Lizistired]

I'm glad he's feeling better!

[DoriC]

Thanks Liz! I just want you to know that whenever I see your name I think of my darling granddaughter Liz(Elizabeth) who's 22yo, and volunteering with the Peace Corps in Peru. She left in July and won't be home until May. Her BF is in Paraguay because they tried but couldn't get the same program. . I miss her so much but thanks to Skype, we talk to her every Sunday! It's Summer there and she went to the beach today so she looks tanned and gorgeous! Sorry I went OT!!

[SleepingUgly]

Tell her that tanned and gorgeous at 22 means spotted and wrinkled at 44!

[DoriC]

You tell her, Aunt Sleeping Ugly! That's why I'm the best Grandma in the world, I say NOTHING and give lots of HUGS!

[Lizistired]

That's great DoriC, You must be really proud of her. That's a terrific thing to be doing (especially during this economy) and will be an experience she will never forget. Tell her to enjoy it, sun, tan, beach and all!

[DoriC]

There's a little method to her madness. One of the perks of serving in the Peace Corps is that it will pay for her Master's in Special Education for Bi-lingual special needs children. The same for her BF, he'll be able to do his Masters in International Business/Political Affairs(something like that?). So hopefully they'll have a good future for what they're sacrificing now living in pretty sub-standard conditions. They both consider themselves the lucky ones because their villages have indoor plumbing and their electricity works...most of the time!

[Lizistired]

It's a great time to be doing it. I was in the Army and stationed in Germany when I was 22. I wouldn't trade anything for it. Nude beaches and all!

[fuzzy96]

okay 2 things come to mind
1)

Maybe he needs the little higher pressure that the higher leak rates tend to cause and that might then entail a different fitting of his mask or an adjustment to the fit???

to me this is counter intuitive. although i have a lot of respect for slinky i disagree. a leaky seal will cause the machines output to be more but only to the point that it allows a maintenance of the pressure setting. however if the leak is too great the pressure is not maintained. it may be a case where one pressure is good for suplined sleep yet another lower pressure is neede for side sleep. the lower pressure thereby is more comfortable and still does the job. thus better sleep.

2)as with any leak the air goes out the mask wherever possible. more airflow may be washing more co and co2 out of the mask effectively raising the 02 level.

of course this is all conjecture or as some say rants from a madman

[ozze_dollar]

Well i dont know. I recently changed my mask and cushion because I was feeling rotten.I looked at my card and noticed a lot of leaks. I might add I was not aware of any of them. So as i said i changed the mask and what a difference. In future I will change my cushion every 3 months.The one I changed was at 6 months.I thought it was fine.