AHI is up to 6.7 with CPAP? How to fix it?

lakejumper wrote:Thanks Pugsy and everyone! I'm learning a lot about how to manage my own treatment as well. Since this is most likely a lifetime adventure it's worthwhile! I've been using my CPAP for about 9 months and feeling much better but I'm still a newbie with the technology. I've become a believer and have encouraged several friends to get tested and provided support to two family members (severe apnea) to use their machines as they have struggled with the therapy.

Goofproof, I would like to know how you meaure "normal leaks" and vent pressure? I did see a graph on minimal leaks on my friend's report but it was on reports for each individual day and there wasn't any data showing averages or indices.

When you get a new mask the papers that come with it have a chart that tells you the normal leak rate for the pressure you are using. For exhample if it says the leak rate is 32 LPM at 14 CM's of pressure, if you are showing a leak rate of about 35 Lpm you are doing pretty good controlling your leaks. I also won't use ANY MASK that has a normal leak rate of 40 LPM or higher at 15 CM, I find that tends to corrept the data. I use the dailies in Encore Pro or Encoreviewer to check the dailies, I don't care about AVG's at all or 90 % rates just what is going on and when. Once you get everything tined so it's working for you you can just spot check you results to conferm alls still well. Jim

lakejumper wrote: I would like to know how you meaure "normal leaks" and vent pressure? I did see a graph on minimal leaks on my friend's report but it was on reports for each individual day and there wasn't any data showing averages or indices.

Respironics machine report Total Leak...meaning the intentional vent/leak rate for the mask at whatever pressure is being used plus any excess or unwanted leaks. It is the excess leaks that we try to watch.
Vent rate will depend on mask used and at what pressure...it will vary a bit when using APAP because the pressure will vary.

The LCD screen leak data is pretty much useless.. All it reports is the % of the time spent in Large leak and we are never told a definition for "Large Leak" but from my past experience it seems to be around 90 L/Min when reporting Total Leak.

In the mask paperwork there will be a graph showing the vent rate at a certain pressure. If the average leak showing on the daily detailed report in SleepyHead is very close to the vent rate then we assume no prolonged huge leaks. Leaks are easy to spot on the SleepyHead graphs. Respironics says it can compensate for leaks up to their definition of Large Leak (whatever that number really is) so generally if the leak line is well below the 90 L/Min mark the leakage is not excessive and won't impact therapy.

I prefer to look at the leak line itself instead of averages..especially averages over multiple nights.

Here's an example of my leak graph from SleepyHead. Not one of my better nights but I am still well below the 90L/min mark even though it looks huge due to scale. Worst it ever got was around 54 L/min.
My intentional vent rate for my mask at my pressure is around 30 L/min. I suspect the 2 large spikes were when my nasal pillows slipped out just a bit. You can pretty much just eyeball the leak line...see the maximum and if well below 90L/min then the leak is likely not bad enough to impact the therapy.
Even a short lived spike to 90 L/min isn't the end of the world as long as it is very brief and the rest of the night is well within acceptable limits.

URL is http://www.apneaboard.com/ Actually, I probably should download my manual. I fine now and expect to continue to be fine now that I'm sleeping well and have more energy. Started Weight Watchers last week and lost 6 pounds. Wish it would continue that way but most of it was probably just water. But I am starting to feel a bit less helpless in this process of healing.

lakejumper wrote:Wit the help of the Resp. Therapist, she increased the lower pressure to see if it will help.

Kairosgrammy,How do I get to the Apnea board where you can download manuals?


Thanks again for all of your help.

Interesting result last night. I narrowed the range from 4-20cm to 8-14cm.

My average AHI as registered in Sleepyhead went from 3.72 down to 2.09.

Cotay, Good job! Curious, what was your 90% pressure?