Tell me what you think

[Jeffj318]

I am a caregiver for my wife who uses CPAP. How do the leaks look? I am just an old fogie who needs some guidance.

She has been using CPAP for almost 2 years.
She said she feels fine in the morning and had no problems. I hear what appears to be a lot of air, however, that does not bother her and she continues sleeping.

She has no interest in anything CPAP related and depends on me even when she needed to get the machine. She was going through chemo so hence her lack of interest.
https://sleephq.com/public/a91e03b1-230 ... 5484da9c7d This is from last night.

[zonker]

I am a caregiver for my wife who uses CPAP. How do the leaks look? I am just an old fogie who needs some guidance.

if her ahi is so low and she is sleeping and feeling good, why worry about leaks?

[RogerSC]

When I was using the Dreamwear mask and sleeping on my side, I noticed if I tightened the mask up just a little bit more than was comfortable, that I could get really good leak numbers. And it didn't keep me from sleeping, just a little tighter than I initially set it up when I started with it. If she gets a little red spot on very bottom of her nose, a little aloe gel in the morning takes care of it. That might or might not work for your wife...the leaks in the posted data look pretty bad, I'd be working on getting them down some so she gets more therapy. Great that she feels good, but she might feel better and be more healthy if she could dial back on the large leaks. Lots of "ifs" there, better if she uses the CPAP, but even better if she gets good therapy from it.

[Respirator99]

Although the AHI is nice and low, her tidal volume and minute ventilation are very low for most of the night. This implies very shallow breathing and she's probably not getting sufficient oxygen. I'd try turning on EPR and set it to 3 - this may improve her ventilation and oxygen.

The leaks are above the "red line" of 24 L/min for over two hours - again, this could be compromising her therapy. You do need to work on the leaks.

[Rubicon]

Although the AHI is nice and low, her tidal volume and minute ventilation are very low for most of the night. This implies very shallow breathing and she's probably not getting sufficient oxygen. I'd try turning on EPR and set it to 3 - this may improve her ventilation and oxygen.

The leaks are above the "red line" of 24 L/min for over two hours - again, this could be compromising her therapy. You do need to work on the leaks.

IMO it's the leaks that are faux-causing the low VT and MV. I would get them fixed before I starting DWing.



Also I'd get an oximeter rather than guess the oxygen is really low.

Husband is caregiver? Get rest of medical history.

Get height, weight, etc. If she's a frail wisp jacking up the VT night not be such a great idea.

[Jeffj318]

I am a caregiver for my wife who uses CPAP. How do the leaks look? I am just an old fogie who needs some guidance.

if her ahi is so low and she is sleeping and feeling good, why worry about leaks?

That is kind of how I felt. Just wanted to check and make sure. Thanks for the input.

[Jeffj318]

I went back on OSCAR from January to the present.
January and February look good regarding leak rates. Not many days even over 20% high leak rate.
It is not until March that she is going up and down. She has mostly high, however, some are very low.
I wonder if it is just the nasal cushion moving around.

[Pugsy]

I wonder if it is just the nasal cushion moving around.

Entirely possible it is mask movement...how old is the cushion and how old is the headgear?

[zonker]

I am a caregiver for my wife who uses CPAP. How do the leaks look? I am just an old fogie who needs some guidance.

if her ahi is so low and she is sleeping and feeling good, why worry about leaks?

That is kind of how I felt. Just wanted to check and make sure. Thanks for the input.

you are most welcome. i'm a caregiver myself, so i know how you feel.

hope you are finding time to take care of yourself.

[Jeffj318]

I wonder if it is just the nasal cushion moving around.

Entirely possible it is mask movement...how old is the cushion and how old is the headgear?

Headgear is new. It is changed every six months. The cushions were changed every two weeks, however, now every three weeks because they always look in great shape.
Does any of this truly matter if the AHI is always below 1.0? Is the therapy less effective although it is helping even with mask leaks?

Pugsy, you know the story. My wife sleeps all night, and sometimes has to adjust the cushion, however, wakes up feeling good and not tired as she had before CPAP therapy.
She does not desire to fool around too much with all of this due to her years of having chemo and is now finally in remission. This is the last thing she wants to concern herself with. It is just me trying to be helpful after checking OSCAR or SleepHQ to make sure how her therapy is looking. Perhaps, just let it be and allow the pieces to fall where they may.

[Jeffj318]

I am a caregiver for my wife who uses CPAP. How do the leaks look? I am just an old fogie who needs some guidance.

if her ahi is so low and she is sleeping and feeling good, why worry about leaks?

That is kind of how I felt. Just wanted to check and make sure. Thanks for the input.

you are most welcome. i'm a caregiver myself, so i know how you feel.

hope you are finding time to take care of yourself.

Yes, I am finding time to take care of myself. Actually, since she is in remission, I am less and less of a caregiver than ever which is a great thing. We are truly blessed. I do hope everything is well on your end, Zonk.

[Jeffj318]

Pugsy and others... off subject a bit. I was searching for info about mask leaks and CPAPtalk subjects came up.
If this group is private, why can I find so much information on the internet just by doing a search? I thought whatever I wrote her would be private since it is a private group.
My wife does not want anyone that she has blocked out of her life to know what she is going through or anything related to her in general.
What is the answer to my question and possible concern?

If what I have written is going to be public knowledge then perhaps I need to delete all posts. I would print the information and then delete once you let me know how to do this.

[ozij]

It's not a "private group".
It's a public forum anyone can read.

I sent you a more detailed private message.

[Jeffj318]

It's not a "private group".
It's a public forum anyone can read.

I sent you a more detailed private message.

Thank you for the detailed information. I read the PM and it all makes sense now.

[Pugsy]

Pugsy, you know the story. My wife sleeps all night, and sometimes has to adjust the cushion, however, wakes up feeling good and not tired as she had before CPAP therapy.
She does not desire to fool around too much with all of this due to her years of having chemo and is now finally in remission. This is the last thing she wants to concern herself with. It is just me trying to be helpful after checking OSCAR or SleepHQ to make sure how her therapy is looking. Perhaps, just let it be and allow the pieces to fall where they may.

Yes, I remember your wife's story and my personal thoughts haven't changed. You have to take her wants into account.
I know you want the best you can get but she gets a say in the matter....and IMHO she has the primary say in the matter.

ResMed's line in the sand for large leak is 24 L/min and I think that is an ultra conservative number.
From my own past experience I tend to sort of shrug my shoulders unless I see leaks above 30-35 L/min and/or a large number of events or UAs....I saw one UA or unclassified apnea (means the machine couldn't decide what to call it because the amount of large leak interfered with the machine knowing what kind of event just happened) and otherwise not much going on at all in terms of events even during the big leak time. I doubt the machine is missing much and that would be my main concern.
No it's not a very pretty leak graph but I have seen worse and the time in big leak above the 35 L/min line is really not all that prolonged. It's not like she spent half the night with really big leaks where the machine couldn't tell what was going on and the nice low AHI isn't really nice and low.

She's been through an awful lot and she's happy with how things are and doesn't want to screw around with trying to achieve "perfection" or worry about anything else. I can't say as I blame her for feeling that way either.
Sometimes we have to make compromises and I think that this is one of those times. She's sleeping good and feeling good...trying to fix those leaks could cause more problems with her sleep than the leaks are causing....and ultimately she gets to make her own decisions.

Besides...there's not a whole lot you can do without her being on board and she's not on board. In her mind she's feeling good and sleeping good and simply doesn't want added stress and again I can't say that I blame her.