Sudden increase in leak/ahi rate

[whome]

Hi!

I seem to have a sudden issue with leaks & an increased AHI (and the consequential feeling awful), starting very suddenly on Feb 23. On Feb 22 my AHI was .32 and on Feb 23 2.93.

My yearly AHI average (from the stats page of SleepyHead) is 0.71. Last 30 days it's 2.75 and last week 3.53.

My leaks: for the last year 0.3, for the last 30 days 2.76 and the last week 3.05.

I'm using a ResMed Mirage Quattro full face mask with a ResMed S9 Elite.

I've tried changing the cushion and the straps. I haven't changed my pillow, bed, drugs, or any other habits I can think of. I use the padded liners, but I switched to the CPAP Gel Mask Leak Sealer to see if that made a difference and it didn't, so I went back to the liner.

I'm out of ideas as to what to try next. If the mask was no longer suitable, I'd think I'd see a gradual change, not such a sudden one. Does anyone have any suggestions?

[D.H.]

Perhaps the hose sprang a leak? Maybe it's got one or more holes, or maybe one or both of ends are not sealing securely.

[whome]

Oh, good thought! I have a spare - I'll try that tonight.

Thank you

[mesenteria]

I'm fishing and whistling at the same time, but could it be a glitch in the software, a firmware update that went sour? Is there a way to assess the machine to see if it is providing the requisite flow/pressure changes that are indicated?

[D.H.]

I'm fishing and whistling at the same time, but could it be a glitch in the software, a firmware update that went sour? Is there a way to assess the machine to see if it is providing the requisite flow/pressure changes that are indicated?

Good point. However, it's also possible that the settings got changed. The DME can do that remotely. Even if you can't check the actual pressure delivered, you should be able to easily check that it's at least set correctly.

[TedVPAP]

Trying to guess as to why your numbers have changed when you tell us nothing you know has changed is not proving useful.
My suggestion is that you post daily data from a recent night so we might be able to see how you can improve your treatment.

[whome]

I switched out the hose and it doesn't seem to be any better. I'm pretty sure the settings didn't get changed. I appreciate the suggestions! Here's my graphs from last night.

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[Jas_williams]

Based on your graphs the leak rate does not seem to be an issue you only went over the large leak time for a very short time and it looks like you took the mask off or scratched your nose or something. It more looks like you need to increase your pressure some to combat the Obstructive Apnea as your constant pressure of 16 does not seem to be cutting it any more ? as to why I cannot comment. Unless your machine has developed a fault or on the day in question you enabled EPR or some other change, it just seems more pressure is needed, maybe if you post a daily graph for one of the days earlier that had a low AHI we can see if there is some change in the settings that you missed ?



Jason

[whome]

Ok, so this is weird. If I go back to before the change, the days have no data. Here's the last 3 months:

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And if I go to the last day of before it changed, I get this:

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It's a mystery wrapped in an enigma

[TASmart]

It looks like in those days before your detailed data was not being written to the SD card, that kind of number is what I get if I put the card in after the night is over because the machine does not store detailed data and Sleepyhead cannot plot and use what is not there. You would get a better look at the AHI if you were to get a copy of Resscan, which can be obtained via request from the apneaboard website. Those number where you have no detailed data are not correct.

EDIT: This happened to me when my AirSense 10 just did not write to the card some days, I had the machine replaced under warranty.

[Pugsy]

S9 statistical data like you see where there is "No Data" for the graphs is not always accurate because SleepyHead needs the missing detailed data files to get a 100% accurate AHI.
So the change might not be so much in you as in the SH data being reported when there are no data files available.

You probably need to get ResScan and evaluate the AHI back before the change. ResScan doesn't need those missing detailed data files as much as SleepyHead does.

ResScan is Windows only software though.

[TedVPAP]

I switched out the hose and it doesn't seem to be any better. I'm pretty sure the settings didn't get changed. I appreciate the suggestions! Here's my graphs from last night.

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Zoom in and show us what a typical OA looks like. If it looks like a real OA event, then you need more pressure.

[whome]

I downloaded ResScan and it didn't have any detail data either :=(

Here is the detail of an OA - they all look like this on the flowrate graph- a sort of heartbeat pattern, then a flat piece and at the end of the flat piece the OA.

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[LSAT]

That example was just barely an OA...it was just over 10 seconds long.

[TedVPAP]

That looks like a real OA to me. I think you need more pressure.