AHI<2....Still feel tired

[NeedSleepLA]

Here is my data from 8 out of the last 9 nights of sleep. Forgot to put my smartcard in for one night (damned short term memory).
I am not sleeping while driving any more, but I still get tired during the day. Looking at the data, is there anything else that I should focus on?

[Pugsy]

What is your intentional leak rate for your mask at your pressure range? I have a chart that shows the Comfort gel FF mask leak rate being at 31.4 L/min at 15 cm and 36.7 L/min at 20 cm of pressure. Does your mask paperwork show anything different? If not, looks like you need to work on leaks a bit. It's extra work at those higher pressures to keep the leaks down.

[NeedSleepLA]

What is your intentional leak rate for your mask at your pressure range? I have a chart that shows the Comfort gel FF mask leak rate being at 31.4 L/min at 15 cm and 36.7 L/min at 20 cm of pressure. Does your mask paperwork show anything different? If not, looks like you need to work on leaks a bit. It's extra work at those higher pressures to keep the leaks down.

I think the leak rates you mentioned are correct. I don't have my mask paperwork with me at the present time. I have recently loosened up on my straps due to a busted up nose. It is healed now, but I don't want to push it. The sleep doc told me that extra leaks are better than a blisterd/busted nose. I tend to agree.
I have a medium mask but may need to go to a large. Small facial movements cause air leakage around the corners of my mouth.

[Gerald]

Needsleep........

I don't know whether I can do much to help you or not....but, I'd suggest that you work on your "leaks". Loss of pressure means loss of therapy.

Now for a "clue".....I've noticed that, lately, my BP is higher at night......I don't seem to be breathing correctly.....and I may have somethiong going on besides sleep apnea.

To check myself, I've been wearing my Oximeter for the past 10 days....logging my O2 saturation levels all night.

To my surprise, I've found my O2 saturation levels are below where they should be....and yet, my AHI scores are below 1.0 nearly every night. I think I'm a lazy, shallow breather.....and that may be what's causing my O2 levels to go down....and my heart rate along with my BP to go up. My FL (flow limitation) chart looks like yours.

I'm not sure what's causing this....but the Oximeter is telling me that something's going on. You may be experiencing something similar......and an Oximeter would help you figure it out. I can highly recommend the SPO-7500 from turnermedical.com

Gerald

[NeedSleepLA]

Needsleep........

I don't know whether I can do much to help you or not....but, I'd suggest that you work on your "leaks". Loss of pressure means loss of therapy.

Now for a "clue".....I've noticed that, lately, my BP is higher at night......I don't seem to be breathing correctly.....and I may have somethiong going on besides sleep apnea.

To check myself, I've been wearing my Oximeter for the past 10 days....logging my O2 saturation levels all night.

To my surprise, I've found my O2 saturation levels are below where they should be....and yet, my AHI scores are below 1.0 nearly every night. I think I'm a lazy, shallow breather.....and that may be what's causing my O2 levels to go down....and my heart rate along with my BP to go up. My FL (flow limitation) chart looks like yours.

I'm not sure what's causing this....but the Oximeter is telling me that something's going on. You may be experiencing something similar......and an Oximeter would help you figure it out. I can highly recommend the SPO-7500 from turnermedical.com

Gerald

I currently do not own an Oximeter, but was thinking about getting one. I think you have made up my mind. Thanks

[cflame1]

Plus you don't want to get into the large leak category... if you end up with large leaks, then your data isn't reliable.

[cflame1]

double posted

[Gerald]

Needsleep......

An Oximeter allows us to look at the "problem" from another direction.

If the oximeter shows that we're getting enough O2.....and the "M" series shows that our AHI score is low....we then have a "double confirmation" that we've got our therapy under control.

But if one or the other shows "non-confirmation", then we've got a "contradiction"......something ain't right......and that makes us study harder to see what detail we're missing.

In my case, something doesn't add up....something is going on that contradicts the low AHI readings I'm getting. I've got a "fooler"....I'm missing a detail. Ultimately, I'll figure it out and make some sort of correction.

I suspect you have a similar situation.....and with good tools, you can figure it out. You've got a great "blower"......and if you add one more good tool (the oximeter), you'll be doing a better job of managing sleep apnea than 99.99% of all the others with our condition.

Gerald

[Wulfman]

Looking at the data, is there anything else that I should focus on?

Single pressure.......CPAP mode.


Den

[Goofproof]

Forget what the data says until you get the leak rate between 35 to 40 LPM, also if you don't lower the top pressure use CPAP as Den says. Tape will help the nose heal, but keep the mask pressure even by adjusting the straps, the mask needs to set flat on your face. Jim

[ozij]

An auto's ability to analyze and respond is affected by leak -- you've got a few thing going on:
A minimal pressure on which the machine rarely stays for long
The same minimal pressure letting snore and flow limitations happen
And leaks that art too hight.

I'm with Den on trying constant pressure; I would start at 15.5 -- the FL's and snores + hint that 15 may be too low.

O.

[NeedSleepLA]

Looking at the data, is there anything else that I should focus on?

Single pressure.......CPAP mode.


Den

Den or anyone else. Why single pressure CPAP as opposed to APAP? I was originally on CPAP 15 now on APAP 15-20. AHI is lower on APAP.

[NeedSleepLA]

Forget what the data says until you get the leak rate between 35 to 40 LPM, also if you don't lower the top pressure use CPAP as Den says. Tape will help the nose heal, but keep the mask pressure even by adjusting the straps, the mask needs to set flat on your face. Jim

Goof, I think the mask is flat and even on my face.
It's hard to tell from the manufacture's chart the exact leak rate, but it looks like for my mask the leak rate is 32ish-40ish for pressures 15-20cmH2O.
For the past 4 nights, my average leak rate is 46.25l/min with no large leaks. Is this acceptable? If not, what else can I do to get the leak rate under control?

Personally, I think I need to go up to a large mask as opposed to the medium that I am using. I have to wait another month to get a new mask from the DME.

Small facial movements cause air to blow out of the mask by the corners of my mouth. As you can see in my avatar, I have some facial hair. I shaved it completely off last week (what a sight) and it appeared that my leak rate was worse. Don't know for sure if this was the cause or if the RemZZZ material that I was using to try to help my nose bridge heal was adding to the leak rate. Now that my nose bridge is healed, I am no longer using the RemZZZ and I am also letting the hair grow back on my face and my leak rate is decreasing. Also I have noticed that the higher the humidifier setting, the higher my leak rate is. But no matter what the humidifier setting is, I wake up with a dry mouth due to the fact that I am a mouth breather. Too many variables!!!

One day I suppose I will get the hang of this mess.....

[Wulfman]

Looking at the data, is there anything else that I should focus on?

Single pressure.......CPAP mode.


Den

Den or anyone else. Why single pressure CPAP as opposed to APAP? I was originally on CPAP 15 now on APAP 15-20. AHI is lower on APAP.

The title to this thread is "AHI<2....Still feel tired"
Changing pressures from an APAP can disturb a person's sleep.
The Comfortfull 2 mask can be a nightmare for many users. (leaks like Hell and very uncomfortable despite its name)
Leaks and snores are driving the pressure changes in most of your reports.
In some cases (with significant leakage amounts), leaks can make collected data unreliable.
Single pressure removes most of the variables when compared to using a range of pressures.
Pick a pressure, use it for several nights, and move up as needed to find the optimal pressure.
If you're using a "normal" bed pillow, you might want to look into getting one that is designed for or works better with this therapy.


Den

[Goofproof]

Hold the mask flat against your face with the xPAP running at the pressure you use, adjust the straps with equal tension to hold the headgear in place, also center the webbing so the mask won't get pulled out of place on your head. After you put the mask on lightly pull the mask away from your face, so the seal can center itself on your face.

As far as facial hair, I wouldn't let my looks affect when I was going to die, but that's just me. Hair isn't a sealing surface unless you coat it with wheel bearing grease. Unless you get the leak rate under 40 LPM avg, the readings you get may be wrong, giving you a false sence of treatment. There is no need to use a ramp, or to set your machine to a higher range than is needed to open your airway.

Den's single CPAP pressure takes a lot of problems off the table, some are being bothered by pressure changes, also the machine chasing leaks by raising pressure, and causing even worse leaks. (RANGE), also a wide APAP range makes the machine slow to respond to your pressure needs.

But your worst problem is leaks, and until you get that under control, nothing else will work..... Jim