meaning of wildy fluxuating AHI numbers

[DavidE]

I'm puzzled by my AHI numbers since a titration on Jan. 26 during which it was found that my AHI was brought down to 0 with a pressure increase from the previous 10 up to 13. Since then, the numbers on successive nights have looked like 23.8; 7.6; 45.8; 27.7; 9.7; 3.6; 5.4; 14.4; 27.6; 20.6; 1.5.
Only looking at the last 2 nights: Feb. 6--AHI=20.6; Total AI=15.8; Central=2.0 with a Mask leak of 13L/min. compared to last night (Feb. 7) AHI=1.5; Total AI=0.2 and mask 103 L/min. and Central of 0.0.
I don't believe the fluxuations are related to mask leaks in an important way. As one example, the AHI on Feb. 5 was 32.5, yet mask leak that night was 1L/min. Also, I was aware of noisy mask leaks during the recent titration night when a pressure of 13 brought my AHI down to zero, and the technician doing that titration showed no concern for the mask leak level.
Any thoughts would be appreciated.
P.S. I have just installed SleepyHead and have yet to figure out how to create and attach screen shots to a posting. So, the numbers I quoted are from the machine--written down each morning. I'm using a new ResMed S9 Elite CPAP with climateline tubing and the H5i humidifier along with a FitLife mask by Respironics.

[Pugsy]

(Feb. 7) AHI=1.5; Total AI=0.2 and mask 103 L/min. and Central of 0.0.

Mask leak is indeed very important. ResMed says that leaks up to 24 L/min that the machine can compensate for. Above 24 L/min and all bets are off and therapy as well as scoring of events can be impacted. I suspect with a huge leak like 103 L/min....your machine's sensors had no idea what events were occurring because the leak was so large it couldn't sense anything. So don't be fooled by a low AHI when the leak was high. The machine just couldn't sense them.

Now as to why the high AHI? I have no idea but obviously something is not working well. Posting a report may help spot something.

BTW are you using EPR? If so at what setting?

For posting images most of use use simple screen shots.
This is how I do it.

Open the image to full size so it is easily read.
I use Vista snipping tool to create a screen shot and crop the image at the same time.
Prt/scr key will also take a screen shot if using XP. If laptop is used sometimes the Fn key has to be pushed at the same time as the prt/scr key
I think windows 7 Home Premium has the snipping tool, Basic may not.
Once the screen shot is created save it in jpg format.

Upload the image to a host site. I use Photobucket it is free, there are others.
Once the image is uploaded then copy the ENTIRE IMG address. Be sure to include the opening and closing IMG in brackets. Paste that copied address into a post here.
Use the preview button. If you can't see the image try again because if you can't see it we can't.

[Pugsy]

Also could you please add your equipment to your profile so members can see it at a glance and won't have to ask you each time you post something and don't mention which machine.
Please use text option.
wiki/index.php/Registering_Equipment_in_User_Profile

[Bobber2]

I am still at the evaluation stage to determine what works best for me CPAP or APAP, what levels etc. I am a side sleeper, use a full face mask, and have small nasal passages. As part of the evaluation, I was getting AHI's all over the map, which didn't settle down completely even with pressure increases. AHI's can go up during rapid eye movement sleep (REM) or when you sleep on your back. The sleeping on the back portion relates to obstructive apnea and physics. When you are on your back the obstruction has to be lifted vertically, rather than just pushed sideways as is the case when you are on your side, in both cases to remove the obstruction. Lifting vertically takes good flow and a higher pressure (physics/gravity). By using a pillow against my back to prevent rolling and to force me to spend the whole night on my side, I was able to bring the AHI under control at a reduced pressure. This was good for me because, as for many others, increasing pressure for me reduces obstructive but increases central. However, outside the apnea I don't like the forced to my side sleep experience, so the next step is to see if there is an APAP setting that allows me movement with manageable obstructive and central.

Two things are true, each case is inindividual, and determining the best individual solution is through experimentation. Perhaps some of my experimentation relates to your situation.