low AHI vs. leaks

[tish280]

I need help!
Since I started using Cpap in September, 2015, my AHI has averaged 13. Recently, my AHI stayed around 5. I was so happy! Then I started having high leaks. So I replaced my Amara View cushion. No more leaks! But immediately my AHI is averaging 18. (Unfortunately, I threw away my old mask, or I'd use it!) I called my doctor's office, and they said they had no idea why this would happen. Does anyone know how this correlates? And even better, what I can do to go back to 5 AHI? I appreciate any words of wisdom!!!

[LSAT]

I need help!
Since I started using Cpap in September, 2015, my AHI has averaged 13. Recently, my AHI stayed around 5. I was so happy! Then I started having high leaks. So I replaced my Amara View cushion. No more leaks! But immediately my AHI is averaging 18. (Unfortunately, I threw away my old mask, or I'd use it!) I called my doctor's office, and they said they had no idea why this would happen. Does anyone know how this correlates? And even better, what I can do to go back to 5 AHI? I appreciate any words of wisdom!!!

Download Sleepyhead software and show us some detail.

[grifho]

I need help!
Since I started using Cpap in September, 2015, my AHI has averaged 13. Recently, my AHI stayed around 5. I was so happy! Then I started having high leaks. So I replaced my Amara View cushion. No more leaks! But immediately my AHI is averaging 18. (Unfortunately, I threw away my old mask, or I'd use it!) I called my doctor's office, and they said they had no idea why this would happen. Does anyone know how this correlates? And even better, what I can do to go back to 5 AHI? I appreciate any words of wisdom!!!

First off, I am on board with downloading Sleepyhead.

However, I did make this exact same observation as you in another thread. I noticed that my high mask leaks correlated with a low AHI, and vice-versa. I think that the mask leaks were making it hard to record the apnea events that it couldn't prevent, therefore you had an artificially low AHI. Now that your mask leaks have gone away, it's recording more of them. The answer is not to get back your old leaky mask, but to understand that your new mask must be preventing many more events than the leaky mask. It's just that we don't get a statistic for "events prevented", as they are addressed immediately and thus can't be recorded. So I wouldn't be concerned with the higher AHI, as the leaky mask would have given you an even higher AHI if it were capable of recording the events it couldn't prevent. Does that make sense? It does to me.

So with that non-leaky mask, you now know you have a high AHI. Well, at least it's a more accurate number than it was before. Perhaps the Sleepyhead data can help figure out the high AHI.

[palerider]

I think that the mask leaks were making it hard to record the apnea events that it couldn't prevent, therefore you had an artificially low AHI. Now that your mask leaks have gone away, it's recording more of them. The answer is not to get back your old leaky mask, but to understand that your new mask must be preventing many more events than the leaky mask. It's just that we don't get a statistic for "events prevented", as they are addressed immediately and thus can't be recorded. So I wouldn't be concerned with the higher AHI, as the leaky mask would have given you an even higher AHI if it were capable of recording the events it couldn't prevent.

all of this rather patently wrong, and the advice is quite bad.

mask leaks do not affect the machines ability to record apneas. the machine still records the ebb and flow of your breathing, even with bad mask leaks, (up to the point where the leaks are so incredibly bad that the machine cannot maintain pressure.

you DO need to be concerned about your AHI. but without any data (presented by SleepyHead) it's just a guess as to what is going on.

this is also an incorrect statement:

It's just that we don't get a statistic for "events prevented", as they are addressed immediately and thus can't be recorded.

since the machines do not address events immediately (excepting Auto Servo Ventilation machines, which actually DO address breathing events on a breath by breath basis.

[grifho]

all of this rather patently wrong, and the advice is quite bad.

mask leaks do not affect the machines ability to record apneas. the machine still records the ebb and flow of your breathing, even with bad mask leaks, (up to the point where the leaks are so incredibly bad that the machine cannot maintain pressure.

you DO need to be concerned about your AHI. but without any data (presented by SleepyHead) it's just a guess as to what is going on.

Regardless of the theorizing, my advice is that she continue to use the new mask, which is less leaky. Is that controversial? When I said she "shouldn't be concerned about the higher AHI", I meant of course that she shouldn't use that as a reason to discard the non-leaky mask. Obviously she needs to work on getting the AHI lowered, as I mentioned later. Where's the bad advice?

She IS having high leaks. I've heard in various places that high leaks give unreliable AHI scores, and tish and myself have found that the leaks give us lower scores. This is empirical information, so it shouldn't be summarily dismissed. In my case the leaks were probably too low to impact the AHI, but who knows. In any event, I think the idea of high leaks, such as tish received, giving unreliable AHI scores seems to be the consensus opinion among informed CPAP users, from what I've heard.

since the machines do not address events immediately (excepting Auto Servo Ventilation machines, which actually DO address breathing events on a breath by breath basis.

Huh? The machine prevents the events. You told me so. So if they are not addressed immediately, when are they addressed?

[palerider]

all of this rather patently wrong, and the advice is quite bad.

mask leaks do not affect the machines ability to record apneas. the machine still records the ebb and flow of your breathing, even with bad mask leaks, (up to the point where the leaks are so incredibly bad that the machine cannot maintain pressure.

you DO need to be concerned about your AHI. but without any data (presented by SleepyHead) it's just a guess as to what is going on.

Regardless of the theorizing, my advice is that she continue to use the new mask, which is less leaky. Is that controversial? When I said she "shouldn't be concerned about the higher AHI", I meant of course that she shouldn't use that as a reason to discard the non-leaky mask. Obviously she needs to work on getting the AHI lowered, as I mentioned later.

She may be having pretty bad leaks then. I've heard in various places that high leaks give unreliable AHI scores, and tish and myself have found that the leaks give us lower scores. This is empirical information, so it shouldn't be summarily dismissed. Where's the bad advice?

don't be concerned about higher ahi, <- bad advice
higher leaks hide apnea events <- incorrect
masks don't 'prevent' events, pressure does, all the masks do is deliver the pressure to your airways.

since the machines do not address events immediately (excepting Auto Servo Ventilation machines, which actually DO address breathing events on a breath by breath basis.

Huh? The machine prevent the events. You told me so. So if they are not addressed immediately, when are they addressed?

if a bridge prevents you from falling into the water, has it "addressed immediately" your falling into the water? I think most people would say 'no'.

[tish280]

Thank you so much for your advice! The old mask is gone, so that's obviously good! I am going to try to install Sleepyhead...any helpful hints about that to a tech-incompetent?

[grifho]

don't be concerned about higher ahi, <- bad advice
higher leaks hide apnea events <- incorrect
masks don't 'prevent' events, pressure does, all the masks do is deliver the pressure to your airways

I already explained the first one, and I'm sure tish understood it the first time.

As for the bottom 2, I could respond with a logical answer, but I'll drop it to avoid the hassle of arguing.

And if I was absolutely wrong on anything else , then I just "mistyped"

[grifho]

Thank you so much for your advice! The old mask is gone, so that's obviously good! I am going to try to install Sleepyhead...any helpful hints about that to a tech-incompetent?

Good luck, tish! Let us know how it's going. I probably won't be giving any more advice, based on the responses I'm getting--well from one person

But, I'll leave you with this from a long-time member at this site who says the same thing I'm saying---"your leak numbers are too high which means that AHI (hourly average) may be distorted DOWN not UP "

viewtopic/t50717/New-User-Questions.html

[OkyDoky]

Thank you so much for your advice! The old mask is gone, so that's obviously good! I am going to try to install Sleepyhead...any helpful hints about that to a tech-incompetent?

Tish,
You can learn how to download Sleepyhead here. https://sleep.tnet.com/resources/sleepyhead
Then after downloading here you can learn how to organize your graphs, take a screenshot, and post using Imgur here. https://sleep.tnet.com/resources/sleepyhead/shorganize
It is 3 pages long so at the bottom of each page click on the link to go to the next one.

[tish280]

Thanks!

[tish280]

I downloaded Sleepyhead and I get an error message when I try to open the program: "The program can't start becausse MSVCP120.dll is missing from your computer. Try reinstalling the program to fix this problem." So I uninstalled, and reinstalled, but I get the same message. This happened on both of my computers. Is there a way to fix this problem?

[OkyDoky]

I downloaded Sleepyhead and I get an error message when I try to open the program: "The program can't start becausse MSVCP120.dll is missing from your computer. Try reinstalling the program to fix this problem." So I uninstalled, and reinstalled, but I get the same message. This happened on both of my computers. Is there a way to fix this problem?

On the Sleepyhead download page at the bottom it addresses this. On some windows computers they didn't put in that required file. You can get it here from windows. https://www.microsoft.com/en-gb/downloa ... x?id=40784 When you click on the download it will give you 3 choices. With a 64 bit computer I used vcredist_x64.exe
Once you download that you shouldn't have a problem.

[tish280]

Thank you so much! Now I just need to download my data-my SD card.

[palerider]

But, I'll leave you with this from a long-time member at this site who says the same thing I'm saying---"your leak numbers are too high which means that AHI (hourly average) may be distorted DOWN not UP "

viewtopic/t50717/New-User-Questions.html

first, you are *ASS-U-MEing* that her leak numbers are REALLY BAD, without ANY indication of what they are. are they just above the 24lpm line, are they 50-100-150lpm? YOU DO NOT KNOW. the distinction is important, as has been said before.... therefore, the most appropriate comment is the second one in this thread.

secondly, in your ignorance (ignorance can be cured, should one stop being so hard headed) you're confusing leak numbers from -- and advice about -- a machine that is generations older than the one the OP has, and had different requirements, AND that behaved differently. if you knew more, you might stop mixing up your fruits when getting info. a 10.3lps leak from the machine in the thread that you referenced is a truly huge leak. are the OPs leaks truly huge? YOU DO NOT KNOW, no data has been posted.