May have solved leakage problem

Colombia · Post by **Colombia** » Thu Nov 05, 2009 9:57 am

Thanks to Rested Gal I had my first night with zero leakage.

All my recordings since 22 Oct have been between 0.64/sec and 0.30/sec.
I sleep on my side or face down and turn or change positions through the night.

I started the process of elimination to address the leakage, first by taping the mouth at night resulting in only a slight improvement.

Last night, again at the suggestion of RG, I added an elastic strip across the mask over the nose to
prevent movement when changing positions. It was a bit tight at first and required further adjustments, but finally resulted in a secure fit and zero leakage. The Headrest Nasal Pillow CPAP Mask with Headgear was an excellent choice for me personally.

I was expecting to see great numbers with zero leakage, but was disappointed after reviewing the nightly results.

Press 10.8 (stays between 10.4 and 10.
Leaks 0.0
AHI 7.2 (I've had better numbers with higher leak rates)
AI 0.9
HI 6.3
Settings: Min press 9.0, Max 15.0, EPR 2, Fulltime, Auto

Plan: Continue with above process and settings and monitor the leakage.

I'm new and have used my APAP for two weeks. I feel much better, but I think I can
do better.

I would appreciate advice on future steps to take with my therapy.

Thanks to all for the support and advice/suggestion.

LinkC · Post by **LinkC** » Thu Nov 05, 2009 10:42 am

The best advice I can offer at this stage is:

Don't make changes based on one night's numbers. Keep the same "configuration" for at least a week before tweaking anything. Otherwise you'll be chasing your tail forever.

KatieW · Post by **KatieW** » Thu Nov 05, 2009 12:20 pm

Good that you figured out the leaks. I'm a newbie too (in 3rd week), and would suggest staying the course for another week. Someone gave me that advice, and I found that my AHI dropped, without any pressure changes.

jweeks · Post by **jweeks** » Thu Nov 05, 2009 8:32 pm

Colombia wrote:AHI 7.2 (I've had better numbers with higher leak rates)

Colombia,

Note that AHI numbers are not necessarily accurate when you have higher leak rates. This might be the first time that your machine is reporting your true AHI. Also notice that your AI numbers are very low, which is good. I'd let things settle down for a week or two. Your body might get used to the treatment and your AHI might trend downward. If not, then it might be worthwhile to consider a tiny bump in pressure. You might be right on the edge of where you need to be. It would be handy to see your data graphs before doing any speculating. And if you feel good, you might want to leave well enough alone.

Winning the leak battle is a huge victory. Congrats!

-john-

rested gal · Post by **rested gal** » Thu Nov 05, 2009 9:08 pm

Well done, Colombia.

I agree with the others... stick with your current settings for a few more days. Then, if you absolutely just want to make a change to see what happens, I'd raise the minimum pressure and leave the maximum pressure as it is.

The minimum pressure is the really important pressure, imho. Minimum pressure is the one I'd want to set high enough to prevent most apneas right from the start. Your AI (apnea index) is quite low, which tells me your minimum pressure is ok where it is. Another cm or two for the minimum might bring the apneas to zero. Or might not.

There's no particular extra benefit in having zero apneas as long as your AI is low. Your AI is low. With a ResMed machine, the AI is really just about all I pay attention to (as long as the "HI" hypopnea index is not much over 10.) I think you're really doing fine right where you are, even if you never change another thing!

Colombia · Post by **Colombia** » Fri Nov 06, 2009 9:14 am

Thanks for the suggestions.

I will continue with the current settings.

I turned up the heat on the humidifier last night and received my first "rain-out". I'm not sure if heat
is necessary in my case. I have been using the humidifier without heat until last night without problems. The nightly temperature here in Medellin is constant staying between 70 and 73 deg. year round and I sleep with the windows open. I've had no problems with dry throat. (humidity is constant at 56%)

I removed the mask following the "rain-out" before turning off the machine which may have effected the readings. I will continue to monitor the daily readings for consistency. I have been feeling good and no longer require daily naps and my energy levels are returning.

Plan: Keep current settings and use no heat.

5 Nov 09

Usage 2:11
Press 10.6
Leaks .24
AHI 6.8
AI 0.40
HI 6.4

Thanks again for comments and suggestions

Colombia · Post by **Colombia** » Mon Nov 09, 2009 6:30 am

I'm finally seeing consistent numbers.
The added elastic pressure strap holding the mask in place has helped
with leaks. The pillows seem to produce some discomfort following a few hours of use, but
again I'm a newbie and still adjusting to the mask and use of nose pillows.

Thanks again for the help.

Press 10.6 to 11.0
Leaks 0.0 to .36
AHI 3.3 to 6.8
AI 0.0 to 0.40
HI 3.2 to 6.4

Date Hours Press Leaks AHI AI HI
5-Nov 2:11 10.60 0.24 6.80 0.40 6.40
6-Nov 7:22 10.80 0.36 6.30 0.40 5.90
7-Nov 7:07 10.60 0.20 3.30 0.10 3.20
8-Nov 6:10 11.00 0.00 6.40 0.00 6.40

Machine	Mask	Humidifier

Additional Comments: 11-14 cmH2O

May have solved leakage problem

May have solved leakage problem

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