Sleepyhead chart

I've generally been getting AHI's of 1.5 - 0.5. But last night had a slightly higher AHI of 2.5 as noted in the graph (assuming it worked). I tried two methods of posting it. Anyway, it appears I had a large leak between 2am and 3am, with a corresponding increase in pressure and events. I did not wake up at that time but did at 4 am for the bathroom but feel fine today. Could it be that the events recorded are false events due to the leak? Thanks in advance.

<blockquote class="imgur-embed-pub" lang="en" data-id="TEOKYlY"><a href="//imgur.com/TEOKYlY">View post on imgur.com</a></blockquote><script async src="//s.imgur.com/min/embed.js" charset="utf-8"></script>

http://imgur.com/TEOKYlY



http://imgur.com/TEOKYlY

Tdub210 wrote:I've generally been getting AHI's of 1.5 - 0.5. But last night had a slightly higher AHI of 2.5 as noted in the graph (assuming it worked). I tried two methods of posting it. Anyway, it appears I had a large leak between 2am and 3am, with a corresponding increase in pressure and events. I did not wake up at that time but did at 4 am for the bathroom but feel fine today. Could it be that the events recorded are false events due to the leak? Thanks in advance.

Highly unlikely. Typically, in Large Leaks, the machine won't detect the events at all.
However, I think you need a little more minimum pressure.
And, APAPs won't increase "pressure" during large leaks. They'll increase "volume" trying to maintain the last pressure they were at before the leaks.
On the other hand, during significant leakage, the therapy pressure may not be sufficient to prevent events, so they may happen more readily during those times.

I've had a number of lengthy large leaks over the years that I slept through.
Didn't know I'd had them until I looked at my reports. It happens.


Den

.

Those leaks aren't considered to be large. Large leak territory is up around 60 L/min for the F & P Icon.
It's a total leak number meaning that part of it is including the vent rate and the vent rate will increase as the pressure increases and you pressure increased fairly significantly during that rather ugly time frame.

Something changed during the night to cause the previous pressure settings to not be sufficient to prevent the airway from collapsing...usual culprits are REM stage sleep or supine sleeping or maybe a little of both.
With the increase in pressure as the machine is trying to hold the airway open better there is not only the increase vent rate but also the increased chance that the mask may lose its seal.

If this is a rare occurrence it most likely is related to sleep position and it's up to you if you want to try to stay off your back to see if it helps or just use a little more minimum pressure to help give the machine a better head start in situations like this. If it is REM sleep related you can't control REM so might as well just increase the minimum.

How much more minimum? That's an unknown at this time. While the pressure does go up significantly from where it is now often we find that with a little higher minimum that the pressure doesn't need to climb so high to get the job done.

If what you see is an extremely rare occurrence...I don't know that it is critical that you do anything about it. I got clusters like that when I first started cpap therapy. My OSA is worse in REM sleep and I was seeing clusters like that every night and often 2 or 3 times a night. Since it wasn't rare for me to see those clusters I just raised my minimum a couple of cm and that was enough to prevent the bulk of those events and break up the clusters.

Thanks guys. I'll just keep an eye on it for now. I'm guessing I probably rolled onto my back. I haven't seen a number like this so far so unless it shows up again I'll leave well enough alone.