Concerned/Worried - New Air Sense 11 AHI High

[Dog Slobber]

Uhhh... the link expired.

Oh! Hard to read then. Apologies. The original link was for May 27. The past couple of nights have been better though. I didn't upload last night to SleepHQ yet, but I have May 28 to compare.

See below:

May 27 Link - High leak rate (time off by an hour): https://sleephq.com/public/7acdc834-177 ... 929ac979e8

NOTE: May 27. First OA looks very long. Had mask issue and pulled it off to fix and the machine ran for a bit without me in it. Must have registered a big apnea.

This is not how OAs or any apneas are flagged. High leak rates don't flag apneas.

Why are your links expiring?

[Movieman]

This is not how OAs or any apneas are flagged. High leak rates don't flag apneas.

Why are your links expiring?

Oh, I did not think that high leak rates flag apneas. I thought if leak rates are too high that I would actually get more OAs, Hypopneas, etc., that the machine would flag. My thinking was that the machine can't provide sufficient pressure if leaks are too high to treat the apneas.

I do not know why my links are showing expired. They were still marked as "active" on SleepHQ and I did notice when I clicked on one that is said it was expired. I cancel/expired the links now since they wouldn't open.

Can you see these links? Hope you can.... May 27 is with old mask and May 30 is with new mask. Much better.

May 27 - https://sleephq.com/public/bdf07a9e-dd2 ... 640f0ee08d

May 30 - https://sleephq.com/public/0ec4bd21-000 ... 268e25f285

I also have an upload stuck for a few days on sleepHQ.

[Dog Slobber]

Oh, I did not think that high leak rates flag apneas. I thought if leak rates are too high that I would actually get more OAs, Hypopneas, etc., that the machine would flag. My thinking was that the machine can't provide sufficient pressure if leaks are too high to treat the apneas.

No.

These machines can maintain pressure with leaks by increasing flow. So long as the leaks aren't too excessive, which yours aren't.

But a contributing factor to the clustering at the 1:30-2:30 timeframe, may be the inability for the machine to deliver adequate pressure. Not because of leaks but because the configure has handcuffed it.

Look at how the pressure has flatlined at 10cm. The machine wants to deliver more pressure, but you've told it the most it can deliver is 10.

Your minimum *and* maximums are too low.

[robysue1]

Oh, I did not think that high leak rates flag apneas. I thought if leak rates are too high that I would actually get more OAs, Hypopneas, etc., that the machine would flag. My thinking was that the machine can't provide sufficient pressure if leaks are too high to treat the apneas.

The problem with long, large unintentional/excess leaks (above 24 L/min on a Resmed) is two-fold:

1) The machine has more trouble tracking your breathing. So it may not flag an apnea or hypopnea because it can't track the breathing.

2) The machine has a harder time maintaining the pressure needed to prop your airway open. So you might have more apneas and hypopneas than you would normally have.

As Dog Slobber has said, your leaks are not yet too excessive in terms of the machine dealing with them. But I would ask the question whether those leaks are waking you up or keeping you awake.

On 5/27, both the nasty clusters seem to occur just after you've had a period where your unintentional leaks are right around 15-20 L/min. Is it possible you woke up and fiddled with the mask for an extended period before finally getting back to sleep?

[Movieman]

Your minimum *and* maximums are too low.

Oh, no. I hope not. I saw how the max pressure was topped out. However, I had higher pressure settings before and I kept pulling the mask off at night without remembering it. My doctor even sent me for a sleep study/titration not more than a year ago to see why this was happening. They determined my settings were too high, and that was at 8cm - 11cm. The titration showed 7cm keeps my airway open, so they recommended my current settings which have worked until recently.

I sure hope my pressure needs didn't change in less than a year, but I'm sure it's possible. downbytheriver has the same opinion as you. Just concerned that higher pressure will cause issues again.

Oh, I did not think that high leak rates flag apneas. I thought if leak rates are too high that I would actually get more OAs, Hypopneas, etc., that the machine would flag. My thinking was that the machine can't provide sufficient pressure if leaks are too high to treat the apneas.

The problem with long, large unintentional/excess leaks (above 24 L/min on a Resmed) is two-fold:

1) The machine has more trouble tracking your breathing. So it may not flag an apnea or hypopnea because it can't track the breathing.

2) The machine has a harder time maintaining the pressure needed to prop your airway open. So you might have more apneas and hypopneas than you would normally have.

As Dog Slobber has said, your leaks are not yet too excessive in terms of the machine dealing with them. But I would ask the question whether those leaks are waking you up or keeping you awake.

On 5/27, both the nasty clusters seem to occur just after you've had a period where your unintentional leaks are right around 15-20 L/min. Is it possible you woke up and fiddled with the mask for an extended period before finally getting back to sleep?

I was out of it, but yes I do remember waking up to fix the mask on May 27. I have no idea how long I was awake as I must have just fallen back asleep. So, you think it was arousals causing those crazy events? It does make sense. May 30 report events were way down and that was a new mask, the Vitera FFM.