new user - should I be worried?

Hello everyone, newbie here.

I have server sleep apnea and was told I needed to use a cpap machine.

I'm using the Respironics with humidifier and the Swift FX mask.

It's okay as long as I'm sleeping on my back, which is uncomfortable for me. When I sleep on my side, the mask shifts and starts leaking, usually waking me up.

I took my machine in for a 3 month review and the sleep tech said that my numbers are okay, but didn't really go over what they all meant - and the ones he did, I didn't understand.

Are these numbers okay do you think?

My machine is at 5 cmh2o.
My large leak is 0%, which of course is good.
AHI 7 day is 10.2 and 30 day is 8.6. He said that was okay for now.
Periodic 7 day is 2% and 30 day is also 2%. I don't remember what he said about that, only that we would have to watch it.
90% pressure is 7 day at 8.7 and 30 day is also 8.7. I don't remember what this meant.
For hours, 7 day is 6.54 and 30 day is 6.12.

dallasdave wrote:AHI 7 day is 10.2 and 30 day is 8.6. He said that was okay for now.

Welcome to the forum.

The AHI is higher than I would want to see it.
Do you have the software so you can see the event category breakdown for that AHI?
SleepyHead will work
See my signature line for link for download as well as the threads to explain installing and using.

If you are spending much time awake fiddling with the mask then that might account for some of the AHI and PB because the machine may be recording awake breathing irregularities because it doesn't know if you are asleep or not.

We would need to see the detailed reports to have a better idea what is going on but the first thing I would look at is the AHI event category breakdown...how much is Clear airway...obstructive and hyponea?

Thanks, I will download sleepyhead and load in my data tonight when I'm back from work

worried? Probably not, but the big question - are you feeling better?

If you were having severe apnea, you were most likely having 30+ events an hour - 30AHI. Reducing them to <10 moves it down to mild, so it's certainly a step forward. To reduce it under 5 would be better, of course, but if you're feeling better, I wouldn't be worried at all.

Actually, I feel the same - still yawning during the day at work, still have bags under my eyes, etc. I can't tell the difference.

The wife can however, since I'm no longer snoring like a freight train, gasping for breath, or twitching my legs

dallasdave wrote:It's okay as long as I'm sleeping on my back, which is uncomfortable for me. When I sleep on my side, the mask shifts and starts leaking, usually waking me up.

What kind of leaking? Loud? Large? Small & squeaky? Is the mask getting pushed around by your pillow, or are the straps getting tugged? If the latter, can you tug the strap at the back of your head slightly left or right to compensate?

I know people have suggested using Lansinoh for nasal pillows, but I don't know whether that was to improve the seal or to reduce irritation.

My machine is at 5 cmh2o.
My large leak is 0%, which of course is good.
...
90% pressure is 7 day at 8.7 and 30 day is also 8.7. I don't remember what this meant.
For hours, 7 day is 6.54 and 30 day is 6.12.

I'm impressed you're using it so much so quickly. A lot of people struggle with it!

What exact machine do you have (model #)? I ask because you list two different pressures: 5 and 8.7. I'm guessing you have an auto-titrating machine, which will adjust pressure (no lower than 5 in your case) based on what it detects. The 90% number means that it spend 90% of the time at or below 8.7 cmH2O (and 10% above that).

AHI 7 day is 10.2 and 30 day is 8.6. He said that was okay for now.
Periodic 7 day is 2% and 30 day is also 2%. I don't remember what he said about that, only that we would have to watch it.

What was your diagnosis: was it specifically periodic breathing, or just general apnea? If the latter, you can probably ignore the periodic breathing numbers for the time being, since they probably are artifacts of when you wake up.

The AHI is a bit high, though. Large leak was definitely 0? If you mouth-leak, you won't be achieving therapeutic pressure.

To get a better picture, we generally recommend you download SleepyHead (free) to read the data from your machine. That'll show you a graph of the whole night and let you see when and where the apneas were: evenly spread out, clustered, etc. You might discover that your apneas are much worse (or pressure higher) when you're on your back, but they're OK when you're on your side in spite of the leaking.

Welcome, & good luck!

The leaking is hard to describe.

I have the mask on and I will be on my back. The mask doesn't leak, and I usually have one hand on my stomach or chest, holding the hose. I can sometimes fall asleep like that.

When I turn to the side, and put my head back on the pillow, the pillow pushes the head gear "up" so it shifts on my face, and the nasal pillows aren't aligned with my nose anymore and I get a leak. I then tug the mask back into position. If my head is tilted towards the pillow usually that pressure keeps the mask in position, until a turn in my sleep and it happens again.

I tried making the mask tighter, but it becomes very uncomfortable and when the leak happens, it's not as easy to reposition the mask.

I talked to my sleep consultant (if that's the right title) and he said I have the right headgear, but it might not be a perfect fit since I shave my head.

Hello again,

So I've loaded my data into sleepyhead, but I'm not sure what to do next. I guess I need to take time and read through the online help. These values do not seem right to me - an average of 25 leaks a night? Am I reading that right?




Details Most Recent Last 7 Days Last 30 Days
AHI 12.68 10.49 8.69
RERA Index 1.26 1.67 2.02
Flow Limit Index 0.63 0.83 0.89
Hours per Night 7:57 7:02 6:19
Average Pressure 6 7.01 6.82
95% Pressure 9 10 10
Average Total Leaks 23.14 25.78 24.69
95% Total Leaks 41 45 43


argh, the website is taking away my formatting. Here's the overview info:
AHIApnea / Hypopnea Index 12.68
HypopneaHypopnea 5.02
ObstructiveObstructive Apnea 0.25
Clear AirwayClear Airway Apnea 7.41
RERAResp. Effort Related Arousal 1.26
Flow LimitFlow Limitation 0.63
VSnoreVibratory Snore 0.13
PB/CSRPeriodic Breathing 3.21%

What version of SleepHead does it show in the upper left corner of SleepyHead when opened?
Should be 0.9.3 as the latest.
What is the model of your machine...3 digit number on the bottom of the blower unit.

When you tell SleepyHead to go find the SD card stop at the drive letter where the SD card is sitting. If you try to go into the SD card and select any folders you have gone too far.
Only the drive letter where the SD card sits should be in the directory box line to choose.
Are you going into the SD card itself? That's too far.

I use the Swift FX. I sleep on my side or half on my side/half on my stomach. And I sort of hang my nose off the edge of the pillow. I have the top strap just to the back of the top of my head and the back fabric-covered strap towards the bottom of the back curve of my skull. Maybe try playing around with adjustments between the two straps.

You also might consider using a hose hanger; it made a huge difference to me in my ability to move around without dragging the pillows out of my nose. I use http://www.amazon.com/North-American-He ... B0034CHMRU, but there are lots of suggestions at viewtopic/t89813/viewtopic.php?f=1&t=89 ... 60#p824146.

dallasdave wrote:The leaking is hard to describe.

I have the mask on and I will be on my back. The mask doesn't leak, and I usually have one hand on my stomach or chest, holding the hose. I can sometimes fall asleep like that.

When I turn to the side, and put my head back on the pillow, the pillow pushes the head gear "up" so it shifts on my face, and the nasal pillows aren't aligned with my nose anymore and I get a leak. I then tug the mask back into position. If my head is tilted towards the pillow usually that pressure keeps the mask in position, until a turn in my sleep and it happens again.

I tried making the mask tighter, but it becomes very uncomfortable and when the leak happens, it's not as easy to reposition the mask.

I talked to my sleep consultant (if that's the right title) and he said I have the right headgear, but it might not be a perfect fit since I shave my head.

Dallasdave---just a thought but have you given any consideration to changing your bedpillow to one which has "space" for your mask when you turn on your side? Made a difference for me.

Some people have reported that putting a chinstrap on over the Swift FX helps prevent it sliding around; even if just adjusted loosely. Also, NateS reports have success with a specific CPAP pillow (he used a Swift FX for a long time): https://www.cpap.com/productpage/cpapma ... QgodQisArA

I haven't tried this pillow but it looks like a good idea. I personally use a hose hanger plus over the head routing. That helps keep things organized nicely.

dallasdave wrote: I have the mask on and I will be on my back. The mask doesn't leak, and I usually have one hand on my stomach or chest, holding the hose. I can sometimes fall asleep like that.

When I turn to the side, and put my head back on the pillow, the pillow pushes the head gear "up" so it shifts on my face, and the nasal pillows aren't aligned with my nose anymore and I get a leak. I then tug the mask back into position. If my head is tilted towards the pillow usually that pressure keeps the mask in position, until a turn in my sleep and it happens again.

I tried making the mask tighter, but it becomes very uncomfortable and when the leak happens, it's not as easy to reposition the mask.

As you've noticed, tightening the headgear does NOT solve the problem and, in fact, makes it worse.

You might try loosening the headgear even further, even though that sounds counterintuitive.

I use a Swift FX and when the headgear is appropriately tightened it's actually ridiculously loose. As in I can get four of my (not very big) fingers under the top strap without it being stretched at all and I can easily get a couple of fingers under the bottom strap with the smallest amount of stretching of the bottom strap. When the machine is NOT on, the pillows are so loose that they'll fall just a smidge off my nostrils. But once I turn the machine on, the pillows properly inflate and rest snugly against my nostrils. And if the mask does get dislodged, a simple tiny tug and release settles them back snugly against my nostrils.

You will eventually get to where you can readjust the mask in your sleep when a small leak occurs. But it also helps to try to minimize those leaks. Here's what I tend to do as a side sleeper by preference: I start by fitting the mask sitting up (which is technically a "no-no") because it works for me. I sometimes still need the light on when I'm getting ready for bed---rearranging pillows, locating the hanky that I use as an eyeshield, making sure the alarm is set (if it needs to be), and tugging the mask onto my head and quickly checking the straps for their rough location, and turning the machine on and fixing any horrible leaks (which are real rare). After turning the light off and the machine on, I lie down on my side and do any fine tuning to get rid of any leaks that started once my head is where I want it to be. Fixing the leak is almost always as simple as "tug the pillows slightly away from the nose and let them resettle." Tugging the pillows also tends to fix the annoying feeling when the pillows are not at the right angle in the nose. And then it's easy enough to get to sleep in my preferred position. I typically sleep with one hand gently grasping the top of the small hose and so if I turn over and a small leak starts, that hand is already in position for a small tug to fix the leaks.

Another thing that I've found that helps is this: I have a tendency to prefer sleeping on my left side. I've noticed that the mask is more comfortable if the back strap is tightened in a lopsided way instead of being symmetrically tightened. For me, it seems to work best if I have the backstrap of the Swift FX a bit tighter on the right (upper) side of my head than it is on the left (lower) side of my head. I think that tightening the backstrap on the upper side of my head helps keep the mask from sliding down away from the upper nostril.

Oddly enough, this lopsided strap tightening doesn't seem to cause too many problems when I do turn over and sleep on my right side.

Finally someone mentioned Lansinoh lanolin cream. It definitely helps soothe sore nostrils. For many people it also helps improve the seal of nasal pillows because it has a slightly tacky feel to it. So that's also an idea for you to try.

Thanks everyone. Robysue I will try your suggestion.

What do you people think about my numbers? Are they within what you could call an okay range?

I'm really disappointed in my sleep technician, because instead of going into much detail, he just said they were okay.

I haven't had time to read the sleepyhead documentation yet, but I think it's funny I can identify the days where the cat woke me up at 3am

Your machine reports Total Leaks and total leaks are the mask's intentional vent rate at your pressure plus any excess leaks

dallasdave wrote:Average Total Leaks 23.14 25.78 24.69

These are quite acceptable.
The 95% leak numbers just mean that for 95% of the time your leak was at OR below that number. The unit of value is Liters per min.
So the average of 25 L/min is quite acceptable.
On your machine at your pressures large leak doesn't come into the picture until you reach 75 L/min or more (it sort of varies a little) and based on the 95% number where you were at or below around 40 L/min....you spent very little time above that 40ish mark...you would have to look at the leak graph to see about how long and how high.

dallasdave wrote: an average of 25 leaks a night? Am I reading that right?

25 L/min...not number of leaks.

Your AHI is higher than I would want to see and you are having more Clear Airway events than I would want to see but I would want to evaluate the actual graphs before getting all worried.

dallasdave wrote:AHIApnea / Hypopnea Index 12.68
HypopneaHypopnea 5.02
ObstructiveObstructive Apnea 0.25
Clear AirwayClear Airway Apnea 7.41

Do you know how to post an image of your graphs so that we can see what you are seeing? It would help us help you much easier and better. How to post images explained in this thread along with examples.
viewtopic.php?f=1&t=81072&p=737779#p737779