AHI Lower now that I stopped wearing my chin strap?

[wyosleepyhead]

So things were going awesome with the new Swift FX mask for her (switched from Wisp), by I was still removing the mask some nights and AHIs were 9-12. I really love the pillows so something told me to take off the chin strap and see how that goes (chin strap still making me claustrophobic). AHI that first night 1.5!! Every night since I have been well below 5.0. My mask is leaking worse now because the chin strap helped hold the headgear on, but the noise wakes me and I adjust. I have a PR SystemOne Cpap with Cflex+ and I check the large leak and periodic breathing every day and it says 0%.

Does this even make sense? Am I opening my mouth in my sleep and losing pressure so the machine isn't reading apneas?

[kteague]

If you are opening your mouth your leak numbers should show it. I'm not the authority on this but I don't think your large leak number is the only one to watch. The overall leak numbers will give you an overview in case your leaks are higher than they were with the chin strap, even if not in the large leak range. Your machine would compensate for some leaking, but if that air goes out your mouth instead of down your throat, it's not helping you. If you determine you don't really need the chin strap (I used to need one but at some point learned to keep my big mouth shut) you can find tips on here to help stabilize almost any mask. Of the 4 pillows style masks I've used in the past, I found an added strap to be helpful for every one. Just have to be careful any added straps or wraps positively cannot slip and block the air vents.

[Sheriff Buford]

Pugs can probably answer this question better than me, but here's my 2 cents... How do you feel? Your lower AHI reflects proper therapy, but the bottom line is how do you feel during the day and do you noticed small, (maybe slow) improvements in your overall health? I often find myself getting caught up chasing numbers and I need to remind myself my goal is improving my health and feeling better as I slap around a few bad guys, and feeling better in doing so. The "numbers" do indicate patterns, to the good or bad, and they do support/verify my treatment, and my efforts to provide good treatment. As my leak rates shoot up, so does my AHI, but there are days when my AHI is zero and I feel worse than if my AHI were higher. As long as your leak rates are not thru the roof, don't worry about the chinstrap and enjoy the therapy.

Sheriff

[Pugsy]

Yes, it makes sense. It is possible that leaks (from any cause not just mouth breathing) can impact a machines ability to even record apnea events.
Those leaks have to be fairly substantial though...for your machine which is going to report total leak...up around 90 L/min is where large leak territory begins...above 100 L/min and the data can't be trusted at all.
You need to look at the leak line graph itself to see if you hit large leak territory..and for how long and how far you might have gone to really determine if leaks were that much of a problem.

Any leak that wakes you up though...needs fixing...even if it is a tiny leak because it is disturbing your sleep.

15 to 30 minutes in large leak out of 7 or 8 hours isn't the end of the world though.

So my criteria for leak evaluation....how big or bad is it, how long does it last and does it wake me up or not.
I am okay with less than perfection if I sleep well and feel well. I can sleep through some pretty big leaks though.

Some people wake up with the least little leak and wake up often...those people are likely going to need to see more "perfect" leak graphs than I do but it's because of wakeups and not so much impact to therapy.