AHI and Leaks

[Recoil]

I am currently working through some mouth leaks that I have been having. Some nights good, some night eh... I was wondering though, is the AHI we receive in the morning at the end of a session accurate considering the leaks? Does the AHI take the leaks into account? I was wondering how the machine is still able to detect an event even though some of the pressurized air is seeping out. Does it account for that in its AHI calculation? Last night I had 12L/min leak but my AHI was 0.0 (a first for me) over a 9hr session. This made me question if I truly had 0 events while having 12L/min leak. My AHI is usually between 0.1-1.0.

[Pugsy]

Some excess leak is expected and in fact ResMed says that if you keep the excess leak below 24 L/min the accuracy of the data is in good shape and accurate. Once we start going over 30 L/min things can start getting a bit iffy in terms of accuracy and above 35 L/min then the machine can run into trouble accurately sensing, recording and responding to any event it senses. Now understand....this period of questionable accuracy ONLY affects the time during the really big leak.
It doesn't make the other parts of the night not accurate.....only the time in really big leak. So if you only had big leak for say 1 hour total...that one hour might be questionable but the other hours not in big leak are accurate....and usually the machine will start flagging UAs (unclassified apneas) when we are in big leak and then above 40 L/min the machine might not even sense anything.

Last night I had 12L/min leak

Where did you get this leak number? Off the machine LCD screen or software detailed reports like OSCAR or SleepHQ?
Do you know the difference between what the machine shows as leak on the LCD screen and the software???

12 L/min....well below any large leak threshold and you can pat yourself on the back because that AHI of 0.0 is accurate.

[Recoil]

I got the 12L leak from the Resmed MyAir app that gets the download from the machine around 8am every morning. When I go to the sleep report setting on my machine it just gives me a 1 month summary.

[Pugsy]

I think that the MyAir App reports what the machine is reporting or would be reporting if you were getting a 1 day report and the machine itself reports a 95% number and all that means is that for 95% of the night the leak was AT OR BELOW. It's just a number and I would imagine that if you did an OSCAR report that you most likely spent the bulk of the night below that 12 L/min.

Your leak line probably looks pretty darn good. Hopefully that few/less leaks meant you didn't have leaks waking you up.
BUT...sometimes even teeny tiny leaks disturb our sleep and when that happens we have to do something because anything that disturbs our sleep is unwanted.

So....pat yourself on the back. I haven't looked at my report from last night but I am reasonably sure that my leak numbers are higher than yours.

[Recoil]

Haha! I’ll post my sleephq report in the morning for last nights results

[Recoil]

Here is a link to the other night with 0.0 AHI and 12 Leak https://sleephq.com/public/beda04f5-87c ... 2634800820

Last night's results were not so good https://sleephq.com/public/27833806-b43 ... ae0c16ee75

[Pugsy]

Did those leaks last night wake you up at all?
It's a not so pretty report for sure but the time spent above 24 L/min is actually fairly short.
And the time spent above 30 L/min was really short where the machine might have had some trouble sensing stuff.
All of those 4 flagged CA/centrals are arousal related and not asleep related.

[Recoil]

Did those leaks last night wake you up at all?
It's a not so pretty report for sure but the time spent above 24 L/min is actually fairly short.
And the time spent above 30 L/min was really short where the machine might have had some trouble sensing stuff.
All of those 4 flagged CA/centrals are arousal related and not asleep related.

I woke up a couple of time last night but overall feel like I slept really well last night. It's odd how I can have a good night and then the next night my mouth leaks go out of control lol. That's the frustrating part that I'm going through. I really love the nasal pillows and the Dreamware headgear and don't want to switch to a Full Face mask. So I'm taping but sometimes when I wake up I notice I am letting air out just at one or both corners of my mouth. The front is still solidly taped.

Also, how can you tell the 4 CA's are arousal related and not sleep related?

[Pugsy]

how can you tell the 4 CA's are arousal related and not sleep related?

I zoomed in on each flagged event and looked at the breathing just immediately prior to the flag and you took some big gulps of air right prior to the flag. We don't take big breaths (or have uneven breathing which you also had on a couple of them) while asleep. You may not remember the arousal because it was so very brief but your breathing shows otherwise.

I have some examples in this thread.
viewtopic.php?f=1&t=187767&p=1451526#p1451526
I have other examples all over the place but no time to go hunting them....this one I had handy.

[Recoil]

how can you tell the 4 CA's are arousal related and not sleep related?

I have some examples in this thread.
viewtopic.php?f=1&t=187767&p=1451526#p1451526
I have other examples all over the place but no time to go hunting them....this one I had handy.

That example was perfect. I got the general idea and that will help me try to self analyze. Thanks Pugsy! Still got homework to do on the mouth leaks...

[Pugsy]

Still got homework to do on the mouth leaks...

As do I some nights but for the most part leaks don't wake me up so I don't worry too much about them.
It's a war you won't ever totally win but there will be nights where you win a few battles.

I have not so pretty leak nights too...see below.
Slept right through those leaks....
I don't tape either...

[Recoil]

Hey Pugsy. I decided to turn my humidifier off (it was set to max by default) because when I mouth tape, I'm either drooling or the humid air is causing the tape to moisten and loosen during the night. I live in Tampa, FL and my Home AC is set at 75 degrees. With the humidifier off, how should I go about setting the Heated Air Tube? Do I set it as the same temp as the house?

Also, last night I had a lot of leaks. I also just used a new type of mouth tape and no chin strap. Are you able to tell if I pretty much slept through the large leaks? According to SleepHQ, the large leaks were only 34min out of a 6hr 45min session. I feel like I slept great last night. I remember you saying something in your "tips" sticky post that if the amount of time in large leak territory is very small compared to the total session, I shouldn't be concerned. Is that right?

https://sleephq.com/public/1e78d8bb-877 ... 81900d3e52

[Pugsy]

how should I go about setting the Heated Air Tube? Do I set it as the same temp as the house?

The heated hose is heated either for comfort or to whatever temp is needed for rain out prevention.
If you aren't having rain out....you won't be needing the rain out prevention temp and you can use whatever temp is comfortable for you....be it whatever. You don't have to use the heating part of the heated hose if you don't want.
You can turn off the heating part of the hose as well.

Are you able to tell if I pretty much slept through the large leaks?

The problem with large leak data (say over 30 L/min leak) is that we don't know for sure how it might impact the data recorded. Does it distort the breathing/flow rate so it's hard to evaluate for arousal vs asleep? I don't know for sure.

if the amount of time in large leak territory is very small compared to the total session, I shouldn't be concerned. Is that right?

If I was sleeping good and feeling good then I don't worry about short lived times in large leak.

Your leak is significantly ugly but the amount of time deep into large leak territory (over 30-35 L/min) isn't all that much and if I was sleeping good and feeling good then I don't know that I would do much worrying about it if that were my report.

My own reports are rarely pretty either but I have slept through worse and felt fine (for me anyway) so I shrug my shoulders and move on.

BTW....that leak could be mask movement leak as well.

[Recoil]

Thank you!

[Recoil]

Pugsy - How would I try and determine the cause of the apnea at 12:42am and the apneas between 1:16am - 1:18am? I am still trying to learn how to interpret the charts. https://sleephq.com/public/64f714ce-7b5 ... 053c0d1d47