I don't get it...

[rholmack]

I just don't get it! The nights I feel like I sleep really good, the data looks terrible. AHI is like 8-15, the leaks looks pretty high and so forth. The nights I feel like I sleep bad, the data looks really good. AHI is under 2, leaks look low. What gives? Do others have this problem?

[Goofproof]

I just don't get it! The nights I feel like I sleep really good, the data looks terrible. AHI is like 8-15, the leaks looks pretty high and so forth. The nights I feel like I sleep bad, the data looks really good. AHI is under 2, leaks look low. What gives? Do others have this problem?

Excessive leak rates make the data false. To keep my results true I make sure my leak rate is under 40 LPM. Jim

[Janknitz]

Is your APAP setting wide open? That may be disturbing your sleep when you're not leaking AND causing the leaks. Check your settings.

[robysue]

There's far more than AHI and leak rates that goes into the subjective quality of our sleep. Pain, restlessness, insomnia, congestion, weather, bedroom ambiance (in terms of temperature, humidity, and light), a bedpartner's problems, stress, level of physical activity, and more can effect the subjective quality of our sleep.

So it could also be that on the nights where you are not sleeping well to begin with in terms of other issues, that you are sleeping light enough to not be spending significant times in REM or the deeper NREM stages where your apnea may be worse to begin with or you might be more (sub)consciously avoiding sleeping on your back---hence a lower AHI than you expect. And it could be that you're sleeping lightly enough that either your chin and jaw is not flopping open because you never get into a deep NREM sleep or that you are more conscious of the need to be careful about the mask when you are rolling around. Either one of these could lead to better leak numbers on a night where you aren't sleeping particularly well to begin with.

And in contrast---on the nights where nothing but the OSA is disturbing the quality of your sleep in any meaningful way? Well on those nights, you might have significantly more REM and more deep NREM, and/or you might spend significantly more time rolled onto your back---all of which could increase the AHI. On the leak end of things, on those "good nights" you might be much more relaxed in NREM (more stage 3/4) where your jaw, mouth, and chin get super relaxed and fall open. Or you might be much less aware of how tugging on the hose or mask in your sleep is triggering mask leaks. Or both.

Just how bad are the bad leaks on the nights where you subjectively feel as though you got a good night's sleep, but the data shows otherwise as far as the OSA is concerned?

[rholmack]

My APAP setting is from 8-14. It's spends first couple of hours at 8 and and then it ramps up to 11 or so after a couple of hours and stays there for a few hours and drops back down. I'm assuming I roll over or something. It stays for a little while and ramps back up. I've thought about upping it to 9 for the low number and 12 for the high number since it seems to stay in that area for therapy.

I have a chin strap that I use to keep my mouth shut. My wife says I don't do the lip thing any more, which helps for her to stay asleep. I got a hose system and that has really helped with hose management. I still wake up some nights to move the hose. Heck, the other night it was wrapped around my neck. That's a first!

For my exact leak rates, I'd have too look at the data. But going by memory, when the leak is good it's less than 2. The other nights, I'm getting over 20. This would be the subtraction of full minus the intentional.

I'm sure what's going on here, but it seems strange to me.

[gasp]

My APAP setting is from 8-14. It's spends first couple of hours at 8 and and then it ramps up to 11 or so after a couple of hours and stays there for a few hours and drops back down. I'm assuming I roll over or something. It stays for a little while and ramps back up. I've thought about upping it to 9 for the low number and 12 for the high number since it seems to stay in that area for therapy.

I have a chin strap that I use to keep my mouth shut. My wife says I don't do the lip thing any more, which helps for her to stay asleep. I got a hose system and that has really helped with hose management. I still wake up some nights to move the hose. Heck, the other night it was wrapped around my neck. That's a first!

For my exact leak rates, I'd have too look at the data. But going by memory, when the leak is good it's less than 2. The other nights, I'm getting over 20. This would be the subtraction of full minus the intentional.

I'm sure what's going on here, but it seems strange to me.

I wholly endorse the new lighter Respironics hose. I don't even know the hose is there anymore. No drag. I use a hose cover and it seems to be enough muffling to not hear any potential cracking sounds the hose makes when handling it before installing it. https://www.cpap.com/productpage/respir ... ubing.html

[jbn3boys]

It might help if post a copy of your report from each of the "good/bad" nights. (One where you felt like you slept good, but didn't, and one where you felt like you slept bad, but had good numbers.)

I'd look into the leaks you are having. I think if your leaks are around 20, that could be effecting the accuracy of the data.

[rholmack]

Okay, I'll try it tomorrow.

[rholmack]

Okay, how do you get an image in here?

[rholmack]

Okay, here's a bad night:


Here's a good night:


Let me know what you think.

[jbn3boys]

I don't know much about SleepHead, but to me it looks like your leaks are out of control. There is no real useable data when the leaks are not controlled.

You might want to start a thread stating that you need help with leaks with *name of your mask*.

Maybe others will have other ideas.

[Pugsy]

I don't know much about SleepHead, but to me it looks like your leaks are out of control.

SleepyHead's leak scale looks roller coaster because it does highest and lowest as scale boundary.
Highest was only 39 L/min on one and 34 L/min on another. Visually looks ugly but actually not bad since it is also total leak. When I have a leak to 25 or 30 it looks just as ugly. Now if maximum leak was 80, the scale would go to 80.

These leaks are really quite acceptable and if this were an Encore Viewer report the line would barely move visually.

[rholmack]

I'll go back to my original dilemma: The top plot shown above had a small AHI and most of the plots look good, but I felt terrible all day. I was really tired and even fell asleep at work. The bottom plots don't look so good and my AHI was 14. I fell okay today even though I woke pretty early today. What gives? Anybody else have this occurring?

It seems to me that when I have a low number day I should be feeling better! Wouldn't that be what you'd expect?

[Pugsy]

It seems to me that when I have a low number day I should be feeling better! Wouldn't that be what you'd expect?

That would be what I would normally expect but I a potential variable.
Hours of sleep are not the same. The high AHI night has significantly more hours of sleep. Also that last high AHI hour is really ugly, I am wondering if you were possibly in and out of sleep during that time. Maybe those were awake or semi awake events being scored and thus falsely elevating the AHI.

Roughly 12 hours in bed asleep vs roughly 8 hours.

Also, did your sleep study mention any time where your events are maybe worse. Like on your back on in REM sleep?

I don't think the leak is a factor though.

[jbn3boys]

...

It seems to me that when I have a low number day I should be feeling better! Wouldn't that be what you'd expect?

Yes, in theory, that is how it should work.

You may just need to give your therapy more time to work. 3 weeks is still pretty new.

Or maybe you are so "used to" the way that you used to sleep, that your body just isn't adjusted to how you sleep with cpap.

Or maybe there were other things effecting your sleep, anything from stress, to what you ate,to your activities during the day, to your state of mind just before falling asleep.

I guess I'm really not a lot of help, if the leak rate is acceptable, which pugsy says it is. (And she's a lot more knowledgeable than I am!)