Mask leaking but decent AHI

[WakeMeNot]

Quick background:


1) Tried CPAP multiple times but unsuccessful. Have lost weight in past couple of years and AHI without CPAP has gone from 39 to 23.

2) Trying again and using DreamWear under the nose for past couple of nights with better results (nose is sore but used avg 5 hours over two nights)

3) SleepyHead software says I have a bad leak issue with 18% of time above "threshold leak rate"

4) Decent results with avg AHI over two days of 4.12; Obstructive Index (whatever that is) of 2.5

QUESTION: With resonably good AHI should I worry about leak rate at this point in time?

Thanks...and before you ask...I dont know how to load reports yet. Hope to learn in next week or so.

WakeMeNot

[Pugsy]

Do the leaks cause you to wake up during the night multiple times?
How are you feeling and sleeping in general?

[WakeMeNot]

Understand the question and the reason behind it but I really can’t answer confidently.

I wake up a lot anyway so can’t answer if it is the mask leaks. Waking up more because of the slight discomfort of wearing mask I think. Generally tired but possibly a little less so than usual.

Thanks for reply.

[lynninnj]

Understand the question and the reason behind it but I really can’t answer confidently.

I wake up a lot anyway so can’t answer if it is the mask leaks. Waking up more because of the slight discomfort of wearing mask I think. Generally tired but possibly a little less so than usual.

Thanks for reply.

Ever try lansinoh/ lanolin under your nose to create a tacky sticky feel to help the seal? sold as nipple cream in breastfeeding section but it’s really just 100% lanolin. A little goes a long way.

Sorry if you already tried it an if not maybe will help your nose also.

Ayrs nasal saline gel is good also if using some of the nasal masks and creates tacky also.

[Pugsy]

Here are my own personal thoughts about leaks....
any leak that wakes me up needs to be fixed no matter how big or how little because it is messing with my sleep and anything that messes with my sleep quality needs to be worked on

but when a leak doesn't wake me up then I look a little deeper into the leak before I decide to ignore or work on.

I look at just how bad the leak was and how long was I in "really bad" leak territory. The machine flags any leak over 24 L/min as a "large leak" but there are degrees of "large leak" that we have to look at. Was the "large leak" flagged because the leak was 29 L/min or 49 L/min????
Potential negative effects of large leaks get worse the further into large leak territory you go. The machine actually does a decent job up to around 30 to 35 L/min of sensing, recording and responding to whatever it is facing. It's not like the whole thing goes in the toilet at 27 L/min...more like 47 L/min is in the toilet. When leaks get too large then the machine can have a problem sensing and responding to apnea events. At 47 L/min and a really low AHI number we don't know if it is low because nothing happened or it's low because the machine simply couldn't sense anything.

Then I look at just how long I might have been up in "large leak" territory....was it 10 minutes or was it 1 hour or 2 hours?????
10 minutes I don't even bat an eyelash over.....now an hour or more then I would look at some other things as well.

18% of the time in large leak over a 5 hour period might sound like a lot but it's really just a little less than an hour and I am betting it is in multiple chunks and not one solid time frame.

And finally factor in experience....2 nights is essentially brand new even though you have tried cpap before.
Eventually with time and experience you will have a better sense of how to answer, with certainty,the questions I posed above.

ResMed will give you a Mr Smiley face on your machine LCD screen for leak management until you spend 30% or more of the leak above 24 L/min. It actually takes a lot of leak to get Mr Frowny to show up. I have had some pretty leaky nights over the past 13 years but probably only had Mr Frowny show up maybe half a dozen times.

So....just how deep into large leak territory did you go?

[WakeMeNot]

Thank you for the lengthy and specific reply.

I only vaguely understood the first part - don’t even know how to read/find leak data—but that is to be expected given my newness. TOTALLY understood the Mr Happy Face reference though on ResMed. Lmao.

I’m going to resist the temptation to ask more questions now and wait until I have a week or more of data and know how to post reports.

Again my thanks for taking the time for such a thorough post.