After 2 weeks of using CPAP - understanding SH results

[overshoot]

It has now been about 2 weeks of using my CPAP machine. Thanks to this forum I have been able to tweak my settings and get some encouragement to keep going - but I have reached a point where I think I could use some help looking at my results in SleepyHead again, to see where I should be focusing.

I started out with an AHI before CPAP of 55 or so. My first week on the machine ranged from 8-14 or so,and recently I've been able to get it down to 4-6 each night. While that is great, I think there is still a major leak problem (hopefully you can see that in the SH screenshots and tell me how big of a problem that is.

My settings are now Auto 9-15. At the higher levels it seems tougher to keep the mask seal on. I have a dreamwear full face, under the nose mask, which compared to the other ones feels great.
https://www.sleepapnea.com/products/mas ... rview.html

However, I think it leaks easily in the bottom right/left corners mostly, and sometimes right to the left/right of my nose (although easier to fix that one by just sliding the mask up a bit. I also find that it is harder to have a good fit towards the end of the night/morning.

I love my AHI being under 5 (if it is accurate), but I think I could do better if I could just get this dang mask to stay on better. I have a recessed jaw (probably some of the reason for the apnea in the first place) - so perhaps that makes a great seal tougher? Any help would be welcome.

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[Pugsy]

Oh man, you are using the F & P Icon and the SleepHead statistics for % of time over the red line is defaulting for ResMed red line threshold.
So that statistic is wrong...you need to change it from 24 to probably around 50 L/min....Preferences/cpap and on the right side you will see that 24 L/min. I don't know exactly because that statistic is red line for excess leak and the Icon reports total leak.
Might be best to turn off that statistic because I don't know the numbers needed to give SH a good guide line to follow.

I think that 60 is where F & P has the line in the sand for large leak territory or it used to be. The gray areas you see on the graph flagged as large leak...that's the machine doing the flagging and not SleepyHead. So you have some significant leaking going on and I don't know where the cut off line might be for "the data is no longer accurate above this much large leak" on a F & P machine.
I suspect that the leaks are so bad they are allowing the events that you do see flagged happen. Are there more events happening that we don't see flagged??? It appears to still be flagging stuff when leaks are over 80 or 90 total leak (the top line) so I would say the AHI is probably accurate but I can't say with a lot of confidence since I don't know for sure.

The mask can obtain a good seal as evidenced by the time with no large leak flag happening. Unfortunately not nearly enough time spent in no large leak and I don't know what is happening to cause the leak. It was ugly....got cleared up and got ugly again.
Did you do anything different at about 1:20???? There is some time where the leak might be from the pressure going up and other times when the pressure is still nice and low there is a large leak. So I don't know that we can totally blame the higher pressures.
You are having significant problems at the beginning of the night too...not just at the end of the night.

[OkyDoky]

Are you checking the seal at 15cm when you put it on? Just raise the pressure then after you get it sealed put the pressure back to your settings. Looks like when your pressure was elevated it leaked but when it was lower it maintained a seal. Worth a try.

[overshoot]

It has now been about a month, and I've improved the leak rating considerably by getting the right fit of my mask (medium frame, with large cushion), but most importantly, the addition of the somnifix sleep strips that tape your mouth when you close, with a little vent in the middle to allow for air flow. This has been a game changer for me.

That being said, I still have an AHI of 4-6 (HUGE improvement from 55 on my sleep study test). I'm curious what my AHI would be w/o CPAP but using the sleep strips, but that is some of that false hope.

So - I've increased my pressure range to 9-17.5 now. Looking at the results, it seems I may need to go higher still, but I'll give it a few days - but I would really appreciate any help interpreting my results and seeing if there is something I'm missing. I didn't change the leak/min threshold yet (although I think that is correct), just to give apples to apples results.

thank you for any advice as I continue down this path and try and make it sustainable! I already feel MUCH MUCH better every day so this has pleasantly surprised me.

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