Leaks & Acceptable AHI

Hi,
I have been tracking my data via Encore Viewer and am unable to share the graphs to the forum because I don't know how to.
However, my AHI has been consistently well below 5 with a range of 1.8 - 4
I have been using the Swift LT & Mirage Swift II Nasal Pillows. My leaks appear to be better controlled with the Swift II even factoring in the difference in accetable pressure differential for each. For my pressure the LT should be about 36 and the Swift II about 40.
My pressure ranges have been steady 13.5- 15 and my machine is set to 13.5 - 17
Leaks correspond to AI

The problem I have been dealing with is the average leak rates seem to be about 20-25% above the acceptable leaks. Although these leaks are high, they are relatively consistent and my AHI is under 5. The pressure does not apper to be chasing events due to leaks.

An example of data from last last
Swift II AT 14 cm should have a leak rate of 40
Data: Avg leak rate 49; Average large leak 4 minutes; Average Max leak 98; average 90% leak is 67.
Average large leak is 4 minutes which is about 0.5% of the 7 hour sleep.
Average 90% Pressure is 14 and average CPAP Pressure is 13.5
Average Non responsive apnea/hyponea index is 0
Avg Obstructive Apnea Index is 2.0
Average Hypopnea is 1.0
Average AHI IS 3.0
I feel pretty good and have been experimenting with a chin strap and am unwilling to do the polident.
Is the above sufficient or do I need to move up to a an Activa Nasal or Quattro FF? I have both of these masks but wanted to give the Swift LT or Swift II a chance. I believe I am getting some leakage from one nostril but wake up with a dry cottony mouth so I must be mouth breathing when I hit those high leak numbers. I have been experimenting with the these nasal pillows for about 3 weeks and wonder if it's time to move to the next level of mask? Any thoughts? Thanks!

I would try taping a few nights and see if your AHI comes down.

Also, Lansinoh will help seal the pillow-nostril interface, at least for first few hours each night. Enough to give an indication if your AHI is adversely affected by leaks.

For the record, your AHI isn't bad. You ARE getting good therapy. But it's worth trying to improve as long as the cost (in effort and comfort) doesn't outweigh the benefit.

Thanks for the info. I will try the cream.
Since my AHI numbers are OK I was hoping to stick with the nasal pillows. Since I already have an Activa and Quattro, my DME suggested that I request a Liberty when eligible for a new mask (every 3 months). I will continue twaeking the nasal pillows before going to Plan B.

Well done on the good numbers.
Adding Lanoish did help my leaks some , also just to mention that I originally started with the Swift LT for Her Small pillows. But still had a little too much leak from somewhere, so one night I taped. It did help with snores but not as much on the leak as I had hoped (even though leak wasn't all that bad, I checked it at 2 AM when woke up to pee) so then I switched to Extra Small pillows and the rest of the night (taped) the leak rate was about 1/3 less and this put it right at normal for my pressure.

So pillow size might make a difference if you haven't tried that already.

Here is how I do my graphs so they can be posted on the boards.
I used Photobucket free image hosting. Created an album there.
Then I go to my graphs and since trying to save as pdf thing is foreign to me I simply take a screen shot of it. I have Vista so I can crop the screen shot as I do it, XP users can use Paint (it is already on your computer) to crop. Then save as jpeg file. Go to the photobucket account and upload that jpeg file. Then you copy the image location from photobucket and paste it here. Use preview button to see if you have it correct. If this sounds Greek to you let me know and I will try to find some web links with images to explain steps. Once it is done a couple of times it becomes second nature.
Brenda

Thanks for the info Pugsy. I am still classified as a Newbie since this is week 6 of treatment for me.

My first nasal pillow was the Swift LT and to my surprise the small pillows seemed to fit best although my leak rates were too high.
The medium Swift II Pillow seem to be the best all around fit for me which is providing the data I posted above.

I believe my right nostril is slightly larger and may be an additional source of leaking.
Are there other pillow CPAPs that have individual pillows for each nostril? I wonder if this may help.
On the other hand, I 'd rather avoid experiemnting with too many masks.

I am learning that it takes time to find the right mask. My DME and sleep center have initially provided me with; Swift LT, Swift II, Activa & Quattro.
My initial thoughts were that if there was too much concentrated pressure witht he pillows then I could use the Activa.
Secondly, the Quattro could be used for real bad allergy evenings which occur periodically. I am fortunate that my DME has been great to deal with. They will give me reminders every three months for new masks. In addition, they will provide 1 pillow per month. The only problem is that I need to figure out which pillow mask is the optimal one for me. I was thinking of trying one of those enhanced chin strap as opposed to the small cup like one that slides around at night.

I am committed to make the CPAP treatment successful. 10 years ago, my compliance and lack of commitment resulted in giving up with the program.
With better equipment, masks, etc and SUPPORT on cpaptalk.com, I am optimistic this time around and am committed to making the CPAP treatment experience successful!

Try posting the graph pictures if you can. It is entirely possible that your leak rate is well within acceptable limits and no amount of fiddling with the pillows will make any significant difference. I had one night where leak rate was showing maybe tiny bit high but when I looked at the graph it was great except for a short time where I spiked (probably dislodged pillows moving about) and it messed with my averages just a bit.

I toss and turn a lot so I know I am more at risk to dislodge the pillows a bit. I don't have a headboard but sometimes I bring the hose in from over the top to see if it seats better which seems to be a bit more secure. If I could figure out some sort of anchor that would let me still toss and turn and get over on my side I might have a little better results. I am much more of a newbie than you.
My last night's AHI was lowest still 1.5 and my average leak was 35 L/min and my 90% pressure seemed to be at 14 cm so while not perfect, certainly acceptable and I had 9 hours on the machine. This was with Poligrip use and a chin strap.

If you can't figure out how to get the images uploaded send me PM and if you can figure out how to send via email I will upload them for you.

Brenda