Leaks trail AIs

Last night I slept 8.5 hours, had AIs of 8.6, HI of 19.5 and AHIs of 28.1. This is with he vpap auto 25 and the FP Forma mask (L). I did get up a few times and I don't feel wrecked because of the number of hours but I don't have that great oxygenated feel of a great night's sleep. How could I with an AHI over 28.

What s so interesting is that if you look at the graphs, first come the AIs & then the leaks trail. HI seem to be happening the same time as the AIs except for once & when that happened the leaks were simultaneous with the HIs. When the HIs accompany the AIs, the leaks trail. Note the leaks are substantial at a median of 6, 95% at 31.2 & a maximum of 42. I seem to be averaging HIs between 8 and 9 on good nights and AIs between .4 and 4 with the Mirage Activa and a chin strap. I changed my setting from 6/14 to 7/15 with no help. It looks like I am going to have to tape my mouth, which I hate, and use the Mirage Activa.

allend,

Can you show the PRESSURE along with the LEAK and EVENTS?

I suspect that the leaks may be trailing the large clusters of apneas because the (possibly rather steep) increase in pressure caused the smallish 6 L/min leaks to become very, very large > 24L/min leaks. Then once the extra pressure started to eliminate the apneas, the pressure maybe started to drop a bit, but not enough to really help with the leaks, but it was enough of a pressure drop to let some hypopneas sneak through. Sometime around 1:00 it looks like either you fiddled with the mask some (to partially eliminate the leaks) or the pressure had dropped enough to reduce some of the leaking, and by 2:00 the pressure was clearly not enough to prevent that second really large cluster of events. So the VPAP started ramping up the pressure again, which cleared the apneas but also triggered the leaks and the cycle started again.

But the only way to confirm or eliminate my hypothesis is to look at the PRESSURE data along LEAK and EVENT data.

I think Photobucket is down or having problems with login.

That's a lot of apneas! I've read often to ignore the events that occur within 30 mins or so of falling asleep as centrals are common as we fall asleep -- scary as that sounds. Still that's a lot of events and your reported leak is way high. Might need to switch to a FFM to control the high leak. I was losing precious therapy air via little escaping puffs via loose lips and hadda graduate to the RespCare Hybrid...no touching the nose or forehead & no losing air, 3 sizes of oral cushion, 3 sizes of pillows that can be set to 2 heights...very comfy mask.