AHI / Leakage Question

[VABeach]

Still new and learning.

I am starting my second month and am doing well with compliance, but I do have a question about my data. I do not have the software yet but I have been tracking the data from the LED daily. My average AHI is 4.8 and the highest AHI was 5.6 and the lowest has been 3.4.

As for leakage, that is a different story. On a good night the leakage is 0.2 L/s and on a bad night it has been as high as 0.66 L/s resulting in an average leakage of 0.32 L/s over the first month.

I am aware of the leakages (I think) because they wake me up and I make an adjustment and go back to sleep. I have been surprised by how I have become use to mouth leakage so I am not sure how long I am sleeping with leakage.

My questions….Is my average AHI of 4.8 accurate given the wide range of leakage? Am I missing apnea events during leakage?

Thank you in advance for responding to my questions.

[Pugsy]

wiki/index.php/Mask_Leaks


How do you feel??? Generally an AHI of less than 5 is considered quite acceptable if you are feeling well.
While leaks can impact therapy somewhat it is more easily seen when you actually get the software and can see for sure if the leaks are large enough and long enough in duration to really make a huge difference.

Yeah, over .40 L/sec on a ResMed machine is likely going to be more than the machine can handle but .20 L/sec is not so bad. Remember an average is just an average. It can be misleading. If you had a large leak for a few minutes but the rest of the time you didn't have much leak, it still might show an elevated leak rate when in fact for the most part of the night things were quite good. When you get your software you will be able to see the correlation much better.

[Guest]

Pugsy,
Thank you for the link....I should have been able to find that, but I am still new.

As for your question about "How do you feel?" .....I feel more rested especially first thing in the morning and not as tired in the PM, but I do think I can do better and will definely stick to the therapy. If nothing else, I do like dreaming a lot more. The dreams are usually pleasent and similar to 25 years ago.

Again, thanks for the information.

[Pugsy]

Pugsy,
Thank you for the link....I should have been able to find that, but I am still new.

As for your question about "How do you feel?" .....I feel more rested especially first thing in the morning and not as tired in the PM, but I do think I can do better and will definely stick to the therapy. If nothing else, I do like dreaming a lot more. The dreams are usually pleasent and similar to 25 years ago.

If you are feeling pretty good then keep at it. Leaks, even small ones, can be annoying at the least. Seems like there is always room for improvement. I had to do a bit of taping my mouth when I first started because I had a habit of breathing through my mouth a little (probably gasping for air) but I don't seem to need to do that anymore. I don't strive for perfection in the leaks because I toss and turn a lot and it just is difficult to achieve if I move around a lot. I just want to be "close" in the leak thing.

With time you will get the leaks under a bit more control and likely your AHI might even drop a little more. I used to average 40-44 L/min (at my pressure 33 is the normal vent rate) now I average right at 33 L/min most nights.
My machine reports leaks differently than yours but my 33 average would be like a 0.0 leak on your machine. Your machine reports leaks in excess of the normal vent rate. Mine doesn't, I have to do the math myself. If you can get your leak at or below .20 L/sec, you will be doing very well. When you get it below .10 L/sec, you will be doing great. Remember, look at the leak graph when you get your software. That really tells the whole story.

[Gerryk]

Leak rate is important but many people look at that number and think that is the amount that is actually leaking. It is but it isn't. As was previously stated the masks and nasal devices have a leak rate or the vent rate. I have a quattro full face with an M series machine. My leak rate and my vent rate were sometimes up over 100. I had a couple instances where the machine shut down even though it was not set to shut down it did and was replaced. Some machines out there claim that if you put in your mask type it will know that the vent rate is XX amount and will adjust for that. Just remember to consider the leak or vent rate of your mask.


I did find that when I had a lower leak rate my AHI was also lower.
Gerry

[jweeks]

I am starting my second month and am doing well with compliance, but I do have a question about my data. I do not have the software yet but I have been tracking the data from the LED daily. My average AHI is 4.8 and the highest AHI was 5.6 and the lowest has been 3.4.

Hi,

One thing that the software can do is break down this AHI number into component parts. If your AI is very low, and the rest of the AHI is all hypos, then I wouldn't worry too much. But if the AHI number is mostly AI events, then you probably can do better. At least for me, the AI events seem to disrupt my sleep far more than the hypos, and I feel much better on nights when the AI numbers are less than 2 per hour.

-john-

[aayjaber]

I have a similar concern about the AHI reading which in my case similar to yous ranging from 3 to 5. I have major leaks from both the mask and also leak from mouth. I wake up at night and in the morning with very dry mouth. I wake up extremely tired and fatigued. Most of the day I have day time sleepiness. Some days I nap twice or more. I question the validity of the data collection and analysis. To our disadvantage we come across as treated while we are not, this affects both medical and disability insurance. There are research papers on the topic that supports the view that the AHI values with leakage are questionable.