HOSE IT GOING?

Last night:
Usage: 7:42hrs
AHI: 0.7
AI: 0.0
Leak: 20L/min
Average pressure: 13.0
EEP: 11 (change from 7)
Min PS: 4
Max PS: 12
VT: 287 - 563

How do I feel: Exhausted.
I changed the EEP at the suggestion of my RT (Her idea: 7 is not enough pressure to keep the airway fully open, hence the hypopneas. It has dropped my AHI but I feel worse - which is why I changed it in the first place.

Last night:
Usage: 7:15hrs
AHI: 0.2
AI: 0.0
Leak: 27L/min
Average pressure: 13.0
EEP: 11
Min PS: 4
Max PS: 12
VT: 312 - 531

How do I feel: Exhausted. Lots of air going into my stomach rather than into my lungs.
I started taking the Requip again - half a tab to start.

Wonder if
1. Leaks are disrupting sleep at all? You may not realize the disruptions. Not all will cause arousal to the point you remember waking.
2. PLMD movement is making leak worse? or of course arousals...will need to give it time to see if any impact with adding Requip

No real idea what to do at the moment, just wondering about potential culprits that might affect restorative sleep quality.
Might as well look down that path since we can't evaluate the central component. Doesn't hurt to look down this path.

Last night:
Usage: 7:12hrs
AHI: 0.9
AI: 0.0
Leak: 14L/min
Average pressure: 13.0
EEP: 11
Min PS: 4
Max PS: 12
VT: 296 - 485

How do I feel: Very tired.
I used the mask strap - I don't think it helps with leaking but it did stop the mask from moving about and irritating my nose.
Half a tab of Requip - lots of tossing and turning.

Last night:
Usage: 6:58hrs
AHI: 0.4
AI: 0.0
Leak: 22L/min
Average pressure: 13.0
EEP: 11
Min PS: 4
Max PS: 12
VT: 331 - 557

How do I feel: Very tired.
The increase in EEP has brought the AHI down but at the expense of comfort. I see no change in how I feel in the morning.
Half a tab of Requip - Woke up several times.

Last night:
Usage: 7:54hrs
AHI: 2.4 (BIG spike)
AI: 0.0
Leak: 22L/min
Average pressure: 11.0
EEP: 9 (Change from 11)
Min PS: 4
Max PS: 12
VT: 301 - 556

How do I feel: Very tired. Not rested.
Half a tab of Requip - A lot of tossing and turning.
It is pretty clear that changing the EEP has a big effect on AHI.

I just read through this thread, and I'm annoyed.

máirtín, YOUR LEAK IS HUGE, SO NONE OF THE AHI DATA IS RELIABLE. (Typed in CAPS 'cause you don't seem to get it.)

Doesn't matter what your reported AHI is if the leak is so big that the machine can't compensate for it (and yours definitely is). You feel like crap every day because you're not getting anywhere near effective therapy. (And you won't, unless/until your leak is much closer to zero.) Reported AHI could be 0.0 every day, but it's not accurate, and you won't feel the benefits of therapy with those leak numbers.

Keep updating this thread every day if it suits you, but LISTEN to the advice you've been given here (several times now): Fix the leak or get another mask that fits you better.

(Pugsy, my hat's off to ya. You've got the patience of a freakin' SAINT!)

máirtín wrote:I changed the EEP at the suggestion of my RT (Her idea: 7 is not enough pressure to keep the airway fully open, hence the hypopneas. It has dropped my AHI but I feel worse - which is why I changed it in the first place.

Did your RT have anything to say about the leak numbers? (I'm guessing she didn't; my sleep doc never mentioned my high leak rate to me, like it didn't matter. )

Thank you for your concern, BB.
I am going to try the Swift with my chinstrap tonight.
For the moment that is the only alternative I have.

This thread is going on vacation. My ASV will be blowing in Ireland and France for the next 8 weeks.
Daily updates will be suspended but I will try to do a weekly summary.

máirtín wrote:Thank you for your concern, BB.
I am going to try the Swift with my chinstrap tonight.
For the moment that is the only alternative I have.

This thread is going on vacation. My ASV will be blowing in Ireland and France for the next 8 weeks.
Daily updates will be suspended but I will try to do a weekly summary.

Good to hear you have another mask to try. I hope the Swift + chinstrap works well for you. (Chinstraps work for some, not for others. Even if the jaws are together and you're not inhaling through the mouth, you can still lose air through your lips on exhale, which is considered a leak.) Some people who love their nasal or pillows mask but still tend to mouth-breathe will opt to tape their mouth shut. That's another option to try (provided you're ok with it) if the Swift works well for you but you're still experiencing high leaks with the chinstrap.

Many of us go through several different masks before we find the one that gives us the best fit, but a comfortable and relatively leak-free mask makes ALL the difference. You're making a solid effort to use the machine; now put that kind of effort into finding the right mask.

Sounds like an awesome vacation, and I hope you're able to enjoy it (rather than sleepwalking through it). Have fun.

Last night:
Usage: 6:02hrs (Up early for 7:25 flight)
AHI: 0.1
AI: 0.0
Leak: 13L/min
Average pressure: 13.0
EEP: 11
Min PS: 4
Max PS: 12
VT: 301 - 556
Mask: Swift with chinstrap.

How do I feel: Tired. Less sleep than normal.
No Requip.

Enjoy the vacation. I envy you.

Continue to work on the leak as best you can. If it were me I would not be happy unless it was less than 10 consistently.
Mainly to take that potential variable out of the equation just in case... Your obstructive AHI has always been the least of your problems though. The one piece of data on screen that is missing, centrals, is what I am most concerned with.

If we had the software report graphs we could see for sure if that leak number was just maybe elevated because of large leak for just part of the night (like maybe one hour) and thus maybe not as much of a factor with the overall AHI as it initially appears to be. We just can't tell for sure from the on screen numbers. So all we can do right now is wonder "what if" minimal leak results might give a person.

Even if the AHI numbers aren't impacted hugely by the leaks, the leaks themselves can potentially mess with sleep quality.

Last night:
Usage: 8:07hrs (4 hours in the afternoon and 4 hours at night)
AHI: 1.1
AI: 0.0
Leak: 24L/min
Average pressure: 13.0
EEP: 11
Min PS: 4
Max PS: 12
VT: 331 - 580
Mask: Quattro with mask cover and strap.

How do I feel: Tired. Still dealing with jetlag. Today, I'm going to try to stay up for the whole day and go to bed at a regular bedtime.
No Requip.

Last night:
Usage: 5:54hrs
AHI: 0.1 (Lowest it has ever been)
AI: 0.0
Leak: 7L/min
Average pressure: 13.0
EEP: 11
Min PS: 4
Max PS: 12
VT: 314 - 503
Mask: Quattro with mask cover and strap. Mask fit: Excellent

How do I feel: Tired. I managed to stay up all day yesterday and went to bed close to the regular time.
No Requip.

Last night:
Usage: 6:26hrs
AHI: 1.0
AI: 0.0
Leak: 33L/min
Average pressure: 13.4
EEP: 11
Min PS: 4
Max PS: 12
VT: 346 - 570
Mask: Quattro with mask cover and strap.
Mask fit: Poor

How do I feel: Tired but glad to be "home" in France.
Mask leaked all night. I had to turn off the leak warning alarm so everybody could get some sleep. I guess things got loose with all the travelling. This morning I gave the mask a good cleaning in hopes that will improve the seal tonight.
I'm using French bottled water until I can get some "eau demineralisée".
Another problem was adjusting the time and date: I have lost all my summary data. I suspect it is still there for download but no longer available on-screen.
No Requip.

Last night:
Usage: 9:37hrs (includes afternoon nap)
AHI: 0.2
AI: 0.0
Leak: 17L/min
Average pressure: 12.6
EEP: 11
Min PS: 3 (change from 4)
Max PS: 13 (change from 12)
VT: 304 - 596
Mask: Quattro with mask cover.
Mask fit: Good

How do I feel: Tired.
I have the machine on a nightstand at roughly the level of my head. This has improved the seal a little, I think. Now, the weight of the hose is not dragging on the mask so much.
I woke up one time to go to the bathroom but went straight back to sleep.