Base line information for newbies.

[so much noise]

Hello to all here on the cpaptalk forum.
My name is Bud and I am currently on my second attempt at CPAP, first time was 10 years ago and lasted maybe 3 months. Now I use a computer and do a lot of research on all things important to me.
I am determined to make this thing work, although I still have questions. I have read many posts on this site but am a little confused about readings and what to do to correct them.
I have the ResMed S8 Elite II(set at 9) w/h4i, Swift LT mask, chin strap and using the Pur-Sleep aromas.
My questions are,
What is?
Leaks, actually I do know this, but do not know how or if they are related to the definitions below.
AHI
AI
HI
My first nights reading are Leak- 0.42L/s AHI - 9.3 AI - 2.2 HI - 7.1
I am getting ready to kick my current doctor to the curb in regard to my treatment, prescribed a machine without my knowledge or input and hangs up on my DME (Apria) very nice people there. The way I felt today is a great improvement, never really knew what its like to actually feel waking up, if that makes sense. And not to be apprehensive about going to sleep.
Thank you all again for all of the information, advice and guidance provided on this site, looking forward to coming back in the future.

Bud

[Slinky]

Hi Bud. Welcome to the forum. You can find loads of information if you click on the Yellow Lightbulb at the top of the page (Our Wisdom) and the second thread at the top of this page as well (Where A Newbie Should Start or similar).

AI = apnea index = the number of apneas you experienced PER HOUR
HI = hypopnea index = the number of hypopneas you experienced PER HOUR
AHI - apnea/hypopnea index = the number of apenas AND hypopneas combined you experienced PER HOUR

Leak = the rate of therapy lost thru mask leaks, mouth leaks and lip leaks AT OR BELOW which you spent 95% of the night. Too high a Leak rate can affect not only your therapy but also skew the reported data. These xPAPs can compensate for some Leak. With the Resmeds it is important that you have the correct Mask Selection setting for the mask you are using in order to get an accurate reported Leak rate.

Ideally, your AHI would be below 5.0 but Rome wasn't built in a day and it can take some time to acclimate to xPAP therapy.

We usually advise first get our Leaks under control, then concentrate on lowering our AI, and THEN our AHI.

[rested gal]

Welcome to the board, Bud.

I agree with Slinky about the importance of getting leaks under control first.

Your first night leak rate of .42 is a bit too high, imho. Ideal leak rate with a ResMed machine is 0.0. General rule of thumb is, if the leak rate exceeds .40, it's too much leaking. But since it was your first night, you might have been adusting and readjusting the mask quite a bit during the night which might have driven it up some. After a few more nights, if you still see a leak rate hitting .40 or above, you'll need to become a detective. You'll need to figure out where the leaks are coming from -- mask, mouth, or both.

If a person is not wearing a FF mask (Full Face -- covers nose and mouth together) you don't want to mouthbreathe while you sleep. Treatment air gushing out into the bedroom isn't going the right way down to hold the airway open.

With a ResMed machine, it's the AI number (the Apnea Index number, as Slinky mentioned) that I'd want to see be well under 5. I wouldn't worry too much about trying to get the total AHI down if the AI is very low and the bulk of the total AHI consists of an HI (hypopnea index) of no more than, say 9 or so, being added in. Personally, I mentally cut the HI in half when looking at results from a ResMed machine, but that's just me.

Sounds like you're off to a good start, Bud. Go after 'them thar' leaks with a vengeance!

If you noticed the main air hose tugging the mask out of place any time when you turned over, you might want to think about rigging up a hose hanger of some kind. But you may have already done that. Looks like you've dug into the message board already and have gotten a good start on trying to make your therapy go well.

LINKS to Hose hangers and methods of managing the air hose
viewtopic.php?t=10640

[drubin007]

How do you get the leaks to 0?

surely everyone yawns, and that contributes to the leak factor... In 2.5 weeks, the lowest I have gotten to is 0.08, with the highest being 0.64

my numbers for everything else seem to be good by what rested gal writes.

[klockemy]

I don't think anyone ever gets them to 0 for the whole night. You just want them as close to 0 as possible. If you had software, you could see your leak line, which you would want to keep as flat and as close 0 as possible. A quick, small leak isn't going to hurt you. It's the big leaks that last a long time that will compromise your therapy. This link http://www.klockemycomputers.com/cpap/summary.pdf is what a report looks like. As you can see by my leak line, I develop leaks when I shift positions and that is something I am working on. Just keep in mind that since I don't use a ResMed, my machine doesn't take into account of what the mask's intentional flow rate is supposed to be. Your tell your machine what mask you are using and it automatically subtracts the intentional leak rate, leaving behind your actual leak rate. Us Respironics people have a little math to do for that one. The mask I was wearing during the time on my reports has a leak rate of 38L/m for 10cm. I think someone else can probably elaborate on what is an acceptable leak loss. For me, if it is enough for me to feel and keep me awake, then it's too much.

[ttg]

Welcome, Bud. It looks like you have the same flow generator and mask (my 2nd) as I do. Make sure you set the mask type on the machine to SWIFT as this should adjust for the leak rate for your mask and make your rate numbers more accurate as klockemy stated. If you need any assistance with altering the mask setting, PM me and I would be glad to help. Those Pur-Sleep aromas are great, aren't they?

[socks349]

Klock, you just need to look at the chart that is supplied w/your mask, for instance 9cm H2O on the swift II is pretty much 29l/min design leak rate. Your Res machine will display this number so you pretty much just subtract whatever vent rate from that determined by the chart - the remainder is leak. If that leak is less the 2 or 3 then you're doing Ok, but for a totally good situation (ie no signif leaks) then you should be very close to the design leak rate of the mask.