Less Leaks Higher AHI???

OK, I tightened down the mask and have the leaks under control. But my AHI went from 2 something to 4 something. I've felt I slept well the last few nights and I know under 5 is great, but I really want lower numbers. I'm going to keep it at the pressure settings for a few more days (9-9.5) since it seems as if I have less events at the lower pressure (9). Then if AHI doesn't improve I'll bump it up a little and see what happens.

Here's a link to the last 2 days: http://urastarbooks.net/lpady0502.pdf

Thanks for taking a look and for any suggestions you might have. BTW, the RLS has been fairly calm the last few days as well (phew!).

Linda

Most of your events were hypopneas and not apneas. Is it possible that the leaks were making it harder for the machine to detect the hypopneas?

Check your earlier reports to see if your hypopneas seemed less frequent when your leak rate was larger.

Congrats on getting the leaks under control. What pressures are you running at. I see your low pressure and your working pressure but I don't see the top limit.

Also the bad news is,I couldn't get my AHI down where I wanted it with the F & P 431 mask, the hated ComfortFull, gave me much lower AHI. The 431 seemed to be cooler, and I liked that, but I wanted the lowest numbers more. Jim

Hi Jim,

I'm using a range of 9.0 to 9.5 to keep it from ramping up too much with the snores. I would have set it at straight 9 since that's where I got my best numbers from, but then it doesn't calculate any of the rest of the data .

I'm seriously thinking of giving up and getting a nasal mask even though I usually have terrible congestion. Either that or I was thinking of the 432 with the foam insert.

Another option I was looking at was waiting for the Quattro since it sounds so good.

I did have my numbers down a couple times to 1.7 with the 431 and that would be quite acceptable to me. But, I was also doing the snore/pressure/leak/event cycle all night. I'm just going to stick with the 9.0 to 9.5 for a while (at least a week LOL) and see how it goes. If it doesn't get better, I'll bump it up gradually.

Linda

leaks do seem to follow event cycles. During those cycles your jaw muscles relax where the mandible drops and causes the leak.

Depending on the mask, sometimes tightening up on the mask to stop the leaks can make your AHI worse. it does that because it can pull the mandible back narrowing the airway at the back of the throat. Same thing can happen with a chin strap that pulls the mandible back instead of up.

Try it while awake with the mask on, relax the lower jaw and allow the mandible to drop, you do the same thing during REM sleep.

Then if you are using a Full Face or hybrid mask the air will begin to treat via the mouth instead of the nares, that can be seen in your reports with the higher snore rate, those are most likely palatal snores and probably inaudible but the machine is sensitive and can pick up those vibrations.

I think you should try letting your machine go up above 9.5 for a week or so since now you've got the leaks under control. Maybe up to 10.5 or so just to see what's up there?