Zero AHI but large leaks

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Golf016
Posts: 40
Joined: Mon Mar 27, 2017 7:18 pm

Zero AHI but large leaks

Post by Golf016 » Mon Sep 19, 2022 4:49 am

I recently switch from a Wisp mask to a AirFit P10 Nasal Pillow mask due to a sore on the bridge of my nose. After a few days of getting comfortable with it I notice that I only have large leak events and no AHI events. Is this a false positive reading?
Meaning, the leaks are so large that it does not register any AHI events. I am using a ResMed 11 CPAP machine. The past 2 days show 0 AHI events. I have been using a CPAP machine for over 5 years and before my average AHI reading was ( .5 )
I find the P10 Nasal Pillow very comfortable but is it as effective as the Wisp which reports
Oscar Screen.JPG
Oscar Screen.JPG (243.82 KiB) Viewed 159 times
Oscar Screen.JPG
Oscar Screen.JPG (243.82 KiB) Viewed 159 times
very low leaks.

_________________
Machine: AirSense 11 Autoset
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: PR System One 60 Series Heated Tube Humidifier with Heated Tube
Additional Comments: Humidifier built in ResMed Airsense 11

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Pugsy
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Re: Zero AHI but large leaks

Post by Pugsy » Mon Sep 19, 2022 5:17 am

Up to leaks around 35 L/min the machine is probably not going to miss much and if it was sensing events but didn't know what to call them because of the leaks we would expect to see some UA flagging. Unknown apnea.

Now up around 40 L/min and above leak.....it gets iffy as to how the leaks affect sensing, recording and responding to anything.

You've got a double post of the same image....did you mean to post a different image?
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I may have to RISE but I refuse to SHINE.

Golf016
Posts: 40
Joined: Mon Mar 27, 2017 7:18 pm

Re: Zero AHI but large leaks

Post by Golf016 » Mon Sep 19, 2022 5:29 am

My mistake, but the images from both days are very similiar.

_________________
Machine: AirSense 11 Autoset
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: PR System One 60 Series Heated Tube Humidifier with Heated Tube
Additional Comments: Humidifier built in ResMed Airsense 11

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robysue1
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Location: Buffalo, NY

Re: Zero AHI but large leaks

Post by robysue1 » Mon Sep 19, 2022 7:38 am

I recently switch from a Wisp mask to a AirFit P10 Nasal Pillow mask due to a sore on the bridge of my nose. After a few days of getting comfortable with it I notice that I only have large leak events and no AHI events. Is this a false positive reading?
Meaning, the leaks are so large that it does not register any AHI events.
Could be. But as Pugsy points out, if the leak is under about 30 or 35, the machine still does a pretty good job of tracking events. Above 40, though, things get dicier in terms of accuracy.

One thing you can sometimes do is zoom in on the problem leaks to the point where you can see the individual breaths in the flow rate. If the machine is having trouble tracking your breaths, it usually shows up in the zoomed in flow rate. So you need to compare what the flow rate breaths look like in a bad leak area to an area where the leak is well controlled and the breathing is normal---i.e. no events. If there's not much difference in size and shape of the typical breaths, then the machine is probably doing ok in terms of tracking and flagging events. But if the size or shapes of the individual breaths is quite a bit different, that could be a sign the leaks are large enough to interfere with the machine's ability to detect and record events.
I find the P10 Nasal Pillow very comfortable but is it as effective as the Wisp which reports
The P10 can be just as effective as any other mask, but if you want to make the P10 your goto mask, you may want to work on the leaks a bit. The P10 doesn't have much to adjust---just the opening between the two parts of the strap on the back of your head and way you actually set the pillows against your nostrils. If you think you may just be knocking one or both pillows slightly off your nostril, you might try the old lanolin trick: Get some Lasinoh nipple cream (sold to breastfeeding mothers with sore nipples) and put just a tiny dab around each nostril. That can help keep the pillows in place as well as soothe any irritation in the nostrils, which you don't seem to have.

Or you could consider using the Swift FX mask. It's a bit older than the P10, but the pillows are just as comfortable and its pillows are easier to keep seated on the nostrils, at least in my experience. But the downside is that the FX has an exhaust flow that can feel like a jet stream on your chest.

_________________
Machine: DreamStation BiPAP® Auto Machine
Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Also use a P10 mask
First joined as robysue on September 18, 2010. Forgot my password and the email account I used to sign up was on a machine that has long since died and gone to computer heaven.

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Golf016
Posts: 40
Joined: Mon Mar 27, 2017 7:18 pm

Re: Zero AHI but large leaks

Post by Golf016 » Tue Sep 20, 2022 3:45 am

Thanks for the input, I will try the Swift FX Mask

_________________
Machine: AirSense 11 Autoset
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: PR System One 60 Series Heated Tube Humidifier with Heated Tube
Additional Comments: Humidifier built in ResMed Airsense 11

Golf016
Posts: 40
Joined: Mon Mar 27, 2017 7:18 pm

Re: Zero AHI but large leaks

Post by Golf016 » Tue Sep 20, 2022 3:53 am

The shape of the typical breaths is in what panel? Flow Rate?

_________________
Machine: AirSense 11 Autoset
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: PR System One 60 Series Heated Tube Humidifier with Heated Tube
Additional Comments: Humidifier built in ResMed Airsense 11

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robysue1
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Location: Buffalo, NY

Re: Zero AHI but large leaks

Post by robysue1 » Tue Sep 20, 2022 9:38 am

Golf016 wrote:
Tue Sep 20, 2022 3:53 am
The shape of the typical breaths is in what panel? Flow Rate?
Yes. If you zoom in sufficiently far on the Flow Rate graph, you will see a visual representation of every breath you took through the night while using the machine when you scroll from the beginning of the night to the end of one.

Here's a zoomed in snippet (from a long, long, long time ago) of some really nice regular sleep breathing from my own data to show you what I mean:
Image

_________________
Machine: DreamStation BiPAP® Auto Machine
Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Also use a P10 mask
First joined as robysue on September 18, 2010. Forgot my password and the email account I used to sign up was on a machine that has long since died and gone to computer heaven.

Correct number of my posts is 7250 as robysue + whatever I have as robysue1