AHI 131 !! - Help me understand my SleepStudy & CPAP results

[Kenwood]

I have my appt with my Sleep Study doctor on Monday (I requested it)...so hopefully when he reviews my stats...he will agree that I need an Auto adjusting BiPAP machine and have the DME company switch it out.

The wifey would love for me to stop stealing her pillows. After about 7-10 years of her breaking in a pillow, I'll steal it. My pillows are soooo old....I have hair ties around all the edges as they have ripped open and spilled out the pillow guts.

[Kenwood]

On Friday, I received the Amara FF mask in the mail from my DME company. I just did NOT like the way it fit and I was playing with it all night it seemed. I finally ripped it off at 6am (leak spike) and went back to sleep with my ComfortBlue FF mask. The 2nd leak spike and gap at 8am was a work phone call.

[Kenwood]

On Friday, I had a normal doctor visit with my family doctor and got a copy of the DME printouts from my SD card:

Average Vibratory Snore Index = 138.2
Average % of Night in Large Leak = 26.6%
Average Large Leak = 1 hr 33 mins
Average AHI = 5.1

I have an appt on Monday night with my Sleep Study Dr to go over these results and see if I can switch machines to an auto BiPap machine. I'll also bring my mask and see if they have any ideas for my large leaks

[Pugsy]

Average Vibratory Snore Index = 138.2
Average % of Night in Large Leak = 26.6%
Average Large Leak = 1 hr 33 mins
Average AHI = 5.1

Yep, pretty much what we already knew.
Snores are through the roof.
Leaks are through the roof for roughly 1/4 of the night.
AHI is borderline okay but that is overall and with the massive leaks we can't get real excited about it being borderline okay.

We really can't look at last night's data all that closely for accurate evaluation. Your sleep was messed up all night messing with leaks and fit.
If you had said you slept great till that first wake up and changed mask...we would get more excited about last night.

[Kenwood]

Here is Saturday night - back with ComfortBlue FF mask.....but that T-Shirt liner is streatched out now and I was fighting leaks all night again. Can't wait to get those real mask liners in the mail in the next couple days.

[Pugsy]

You know the really only time where leaks weren't likely hugely compromising therapy was that little short segment starting around 8:30.

Early on in the night the leaks were so big that the machine doesn't record much because it doesn't know much is going on.

If the new mask liners don't produce some huge improvement...maybe start thinking of another mask. There comes a time when we have to realized that sometimes nothing we can do will make the mask work.
This therapy the way, it is now, is far from optimal. If it was sub optimal for maybe an hour...maybe not so bad but the therapy is marginal only for about an hour and the rest of the time very sub optimal.

[Kenwood]

Pugsy,

I had my appt with my Sleep Study Doctor tonight. The doctor was very impressed with my knowledge of everything for only being on CPAP for 2 weeks - so that's a big compliment to your help/advise and also this forum. Mission Accomplished - She will put in a new RX to have my machine switched out to an Auto BiLevel machine. She will increase my IPAP setting from 18 to 20. She wants to see me back in 5 weeks.

As to my mask leak issues - I brought my ComportBlue FF mask with me and she confirmed I have it adjusted proper and correct size. She did agree its really close to my eyes - as I've had puffy lower eyes issues on many mornings. She loved the temp mask liner I made out of a T-Shirt to see if a mask liner would help (she said she never saw that idea before). The Sleep Study place will do a mask fitting at their Center and try out all the various masks they have to see which one fits best for me - very, very happy about this - as this beats dealing with the mail and my DME company. (They will call me back tomorrow for an appt for a mask fitting).

When I got home my Pad-a-Cheek was in the mail - so I'll try that tonight and see if how that works out with my leaks.

[Pugsy]

Good job. Glad the doc's on board.
Hope the new Padacheek liner helps but if it doesn't...you know sometimes no matter how well a mask is supposedly fitting when you sit in a doctor's office or a DME office...it just isn't the same as at home...laying down...with a hurricane blowing in it. Facial muscles relax and all that.
So don't give up on the mask. I think once you get that down and with the new machine being able to adjust as needed you will be on the home stretch.
I think the mask part is probably the hardest thing to sort out. There are just so many variables to deal with.

[Kenwood]

Here's Monday nights data with using Pad-a-cheek mask liner. It's my lowest AHI number at 1.89

[Pugsy]

See that 100 L/min line on the leak graph???? See how many times you were there or above it???
When you hit 100 L/min the machine can't sense things accurately...so we can't trust that nice low AHI.
That nice blank spot from 3:40 to 4:20...you leak was at 140 L/min...the machine might as well have been off for all the good it was doing you.....it simply couldn't sense anything...I am betting a whole bunch of stuff was missed.

You need a different mask....this one is obviously not going to work for you.
Large leak territory begins at 90 L/min....you spent a minimal amount of time below that line.

So sorry to burst your bubble about that nice low AHI....it can't be trusted to be accurate with leaks in this magnitude.

[Kenwood]

I know and agree Pugsy....that's just the fantasy football stats geek in me trying to find a positive. Plus my Sleep Doc wants to increase my pressure from 18 to 20...so its only going get worse.

[Pugsy]

Plus my Sleep Doc wants to increase my pressure from 18 to 20...so its only going get worse.

Geez....like that is going to do any good if you can't keep a seal now...sometimes these docs just don't have any common sense. Is he raising the EPAP too? That's what's needed right now more than 20 cm...13 EPAP isn't getting the job done.

[Kenwood]

Plus my Sleep Doc wants to increase my pressure from 18 to 20...so its only going get worse.

Geez....like that is going to do any good if you can't keep a seal now...sometimes these docs just don't have any common sense. Is he raising the EPAP too? That's what's needed right now more than 20 cm...13 EPAP isn't getting the job done.

I'm not sure....I'll leave a message for my doc and ask if she is/will also increase my EPAP.

[Kenwood]

I think I can see WHY I have some leaks with my mask..... I noticed creases have formed one on each side in only 3 weeks of use:

[Kenwood]

Have not posted an update in a while. On Monday, I had an appt with the mask lady at my Sleep Study doctors office. They fitted me with a Mirage Quattro which tested with very low leaks at 20 pressure on their machine. So that specific mask RX got sent to my insurance company. But its been over 2 weeks and I still haven't heard anything on my machine swap to a BiLevel Auto. The DME company hasn't received any requests from my Insurance company. Just a bit frustrating. Plus my back has been killing me since I've been on CPAP, as I've had to learn to sleep on my side. I so miss sleeping on my stomach with my face buried into my pillow. Been going to the chiro and had a back massage earlier in the week.