Higher pressures, more apnea???

Hi,

Noticed an odd thing. With higher pressures on my Auto-PAP range, I am actually getting more events! Here's last nites data.



And here's the summary data for the last week...



When the pressure goes up from 9cm, my AHI rises from 2.8 to 7.1 at 11cm. Now I am wondering if a fixed 9cm would be better. Why would the auto mode give me worse numbers?

PS Edited to include the whole chart from last night. The big spike leak was when I got up for a few minutes, and wasn't wearing the mask.

I don't have much in the way of mask leaks. Mouth leaks I don't know about.

My bet is......you're leaking so much....that your machine is ineffective.

Get rid of mouth leaks...and mask leaks.....then, you can find the "sweet spot".....the most comfort, the greatest effectiveness, at the lowest pressure.

Gerald

The way I read your report, your pressure isn't starting out high enough or able to respond high enough. Your apneas are sudden ("frank") and with no (or few) precursor events like flow limitations or snoring.

I think straight pressure would be a good idea, too, but I think you need more than 9 cm. I'm guessing 12 cm. would get the biggest percentage of your events.


Den

Gerald wrote:My bet is......you're leaking so much....that your machine is ineffective.

Get rid of mouth leaks...and mask leaks.....then, you can find the "sweet spot".....the most comfort, the greatest effectiveness, at the lowest pressure.

Gerald

if the mask has an intrinsic leak rate of 35, why would a rate of 50 make it ineffective. I think people really underestimate the ability of the machine to delivery therapy with these leaks.

I agree with Den but first you need to take care of the mouth leaks. For the mask you have listed, leaks are too high. adjusting pressure without fixing leaks first will do no good.

Tape your mouth shut or find a comfortable leak-free FF mask ... then do as Den suggested and try CPAP mode at about 12 cm.

Well, I didn't see the leakage as a huge problem.....just a couple of times during the night and still not that bad. If it was mouth-leaking, then you probably need to seal the "pie-hole".......if it was the nasal pillows slipping out of place.......better luck next time. "Sh*t happens". I could show you a week's worth of my own leak lines that you'd swear didn't come from the same setup or person. (one extreme to the other)


Den