Really high leak rate, fairly low Apnea - problem or not?

[bobkat13]

Last night my leak rate was the absolute worst ever: 1.48 l/s!!!!!!

However.......my other numbers weren't so awful:

AHI: 6.3
AI: 0.5
HI: 5.8

This was my second night trying out the Respironics ComfortFull2 full face mask. Can I get some comments on this?

Oh, and by the way, my sleep doc on monday thought my numbers looked pretty good and he was pleased with the efficacy of treatment so far.

[yardbird]

Looks like your Hypopneas are what's pushing your AHI up. And with leaks? You sound like me!

If you get the leaks down, I am fairly confident that your HI will also go down as that seems to be the trend that I follow. When you have leaks you just don't have quite enough pressure to stave off the hypopnea. If you're leaking and having hypopneas, there's a chance that one or more of them can "grow up" to become an apnea.

So fiddle around with the mask fit and try to chase down those leaks. It looks to me like if you get the leaks under control you'll be in pretty good shape.

I'm not sure we're ever totally leak free all the time. I think there's just too many variables. But we can get darn close for a very large percentage of the time if we work on it a bit.

I look at it this way.... people WITHOUT sleep apnea don't get a perfect night's sleep every night. Sometimes they have a bad night. So... sometimes we have them too.

[DoriC]

How right you are. I'm not a cpapper and many nights I'm awake for whatever reason and I can hear the comforting humming sound of my husbands' machine while he's in a deep relaxing sleep. Go figure!

[Wulfman]

I think we discussed some of that here:

viewtopic/t41448/viewtopic.php?f=1&t=41 ... 06#p363406

It all depends on at what point the leaks screw up the event detection. In other words, if the leaks are too high, the events can't be detected and are not recorded......so it LOOKS like the numbers are lower. With the machine you have, I don't know where that point is.

How do you feel???


Den

[DoriC]

Den, last night Mike had LL for 23mins,first time in awhile, OA=0.7, H=0.4, Avg Leak=55, AHI=1.2. VS=8.3 occurring mainly during the LL. Can I assume from this he probably had more events during the LL period that went unrecorded?

[carbonman]

How right you are. I'm not a cpapper and many nights I'm awake for whatever reason and I can hear the comforting humming sound of my husbands' machine while he's in a deep relaxing sleep. Go figure!

Dori, you are the only "non-'paper" that I consider part of
the Sisters/Brothers of the Yahoo Hoserhood.
You are directly responsible for that deep, relaxing sleep
you speak of. You are certainly as well educated as most
'papers. You're more qualified to work at a DME,
setting up pt equipment than most RTs are.

You're very special.

[Wulfman]

Den, last night Mike had LL for 23mins,first time in awhile, OA=0.7, H=0.4, Avg Leak=55, AHI=1.2. VS=8.3 occurring mainly during the LL. Can I assume from this he probably had more events during the LL period that went unrecorded?

HA! I "beat" him......I had two LLs that added up to 26 min. last night.
(sometimes you just can't avoid 'em when you're asleep)

Can you assume it? No, not necessarily. The machine is still putting out XX cm. of air during that time, so "we" are probably getting SOME benefit from that. Snoring doesn't necessarily indicate or are precursors to A/H events either. For some they are, but not everybody. If you wake up feeling "good", that's what counts (in the long run).

In all honesty, I'm usually surprised to see the large leaks on my reports in the morning......I always seem to sleep through them.


Den

[DoriC]

Oh Gee, Carbonman, you're making my heart go pitter-patter! Does it change your feelings if I tell you I can't ride a bike?

Den, So if you slept through the LL then I understand that Mike can't hear at all out of his right ear and sleeps mainly on his "good" left ear. OK. I'm trying hard to remember that it's "only one night" and "he's feeling good".

[raylo]

I am sure there is a general correlation between leask and AHI, but I don't think you can look at it night by night. Last night my leak rate was the highest in a long time (.16 instead of .04), yet my AHI was the lowest in a week. It is hard to figure it out sometimes. I wish it was more straightforward that less leaks = less AHI. However there are times I have had 0 leak rate and my AHI has been higher than last night...aargh.

[bobkat13]

Den, you're right: we did discuss something along these lines in my earlier thread. I'm sorry for repeating myself so, but I continue to be rather confused. With those same leak rates and AHI that I DID list in that earlier thread, my sleep doc (who is a very GOOD doc) was pleased as he looked at ALL the data on the printout from the card. I don't have the card reader and software yet so I can only go by what data I have on the machine LCD screen under "Efficacy".

How did I sleep? Like compost. Sleep a couple hours, wake up for a while, then sleep about 6 or 7 hours. Because of this pattern and my own curiosity, I've learned that leak in first 2 hours of sleep is much lower and NO APNEA in first 2 hours of sleep 2 nights in a row.

I haven't seen my beloved husband since December 2, and he's coming home for a one month visit arriving in 2 more days - so I'm too darn excited and happy to sleep! I'm here and he's there (overseas working) for at least another year, alas......

[angelo]

I have a very similar problem with extremely high leak rates. In reviewing the data, last night I noticed my leak was very high (over half the night was large leak) at the start of the night and at the end, but there was an hour in the middle with normal leak. I am speculating that the normal leak may have been when I was on my back since I am a side or stomach sleeper. Has anyone used any of the sleep pillows that could help keep the mask in place while I am on my side or stomach.


Remstar Pro M
Ultra Mirage FF Mask
11.0

[DoriC]

https://www.cpap.com/productpage/SleePA ... illow.html

I know it's pretty expensive, I think we paid a little less a few months ago, but after a frustrating search for the right one,slicing and dicing, etc, we found this one which works very well for FF masks(thanks to RipVW). We also had success with the Chiroflow Pillow that we bought from our chiropractor(thanks to wulfman) but my husband likes to move the pillow around and because it's filled with water the Chiroflow is too heavy to do this easily.

[BlackSpinner]

I know it's pretty expensive,

That is filled with gold dust?
I am going to make one myself. There is probably $5 of materials if that in there - a pillow with cutouts.

[DoriC]

I know, but desperate times call for desperate measures especially for someone who can barely thread a needle. I envy people who can make things.