I don't know if this is terribly significant, but my apnea and hypopnea numbers have been extremely low (close to zero) for 3 months which is about how long I've been using the xPAP, but today I found that my numbers were quite a bit higher.  The hypoapneas measured 5 or 6, still low, but I know that my sleep was very restless (and I only slept 5 hours and I must have 7 to feel half way decent).  My apnea score was increased but was still rather low.

So, given this information, is there anything I should know?  Could it be stress related by any chance?  Should I be concerned?

Thanks

Musica

<I>...but today I found that my numbers were quite a bit higher.  The hypoapneas measured 5 or 6, still low...

Musica, might you be coming down with a cold?  (Or sinus, or flu?) That can do it.  So can a drink or two, as can a higher leak rate.

I just started a machine w data capabilities a bit over a month ago.  Interestingly, I developed a cold after about a week (tis the season), and for a while, my hypos were up, in a few cases well over 1/hr.  (As with you, I'm having relatively few events w my new machine and optimized settings.)

Also, you apparently describe just one evening's worth of data.  I would gather several day's worth before I worried too much about stress.  Sounds as if you are "in the zone" therapy-wise.

Hope this is useful.

Regards all - - Woof

In addition to what Woof_man has written, check your leak numbers, if your mask is leaking or air is getting out through your lips your AHI score may rise if the machine is unable to compensate.

Blessings,
--pseudonym

Thanks for your reply.  No cold (thank goodness) and I'm in Florida where the weather's been quite warm, but I'll keep it in mind next time my numbers go up.  
M-

Woof_man wrote:

<I>...but today I found that my numbers were quite a bit higher.  The hypoapneas measured 5 or 6, still low...

Musica, might you be coming down with a cold?  (Or sinus, or flu?) That can do it.  So can a drink or two, as can a higher leak rate.

I just started a machine w data capabilities a bit over a month ago.  Interestingly, I developed a cold after about a week (tis the season), and for a while, my hypos were up, in a few cases well over 1/hr.  (As with you, I'm having relatively few events w my new machine and optimized settings.)

Also, you apparently describe just one evening's worth of data.  I would gather several day's worth before I worried too much about stress.  Sounds as if you are "in the zone" therapy-wise.

Hope this is useful.

Regards all - - Woof

Thanks Pseudonym, I had forgotten that I've been trying a different pillow size for my Opus.  Went from a medium to a lare because I lost the medium!! Some air does pass my lips.   Is there a score to show me that the leak is beyond what it should be? Thanks.

pseudonym wrote:

In addition to what Woof_man has written, check your leak numbers, if your mask is leaking or air is getting out through your lips your AHI score may rise if the machine is unable to compensate.

Blessings,
--pseudonym

I think we talked somewhat about this in another thread... or maybe that wasn't you   I honestly can't recall (chalk that up to brain fog!  LOL)

Which Opus is yours, a 360, a 482?  You need to look up the expected leak rate at your pressure, it should be contained in one of the product literature or details on the F&P site.

Do I recall you have a ResMed machine?  You need to set the mask type to standard when using the Opus.  But this still does not give you the true picture of leak, if I recall CrohnieToo's posts on the subject.  Even at 'standard' setting ResMed subtracts a certain minimum expected leak rate, then still only shows you 95th percentile for the night.  

I believe CrohnieToo had to call or email ResMed to find out what the machine assumes as leak at her pressure.

Once you know the expected leak of the Opus at your pressure, and know what amount of leak the ResMed is assuming (so it shows you what is left), you can see how much leak you're experiencing above and beyond what is expected from your mask.

For an example (and I am making these figures up!  This is just to illustrate the math).  

1.  Let's pretend your model Opus is expected to exhaust at .5 liters per second at a pressure of 15.  

2.  Let's pretend your ResMed on Standard Mask setting expects .2 liters per second exhaust from any mask, so it subtracts that amount from whatever it will display to you on the screen at 95th percentile.

3.  Let's pretend your ResMed on Standard Mask setting displays .6 liters per second at 95th percentile.

The math is this:  ResMed assumption + ResMed display = 95th percentile of mask leak.  In the pretend example we have .2 + .6 for a figure of .8 liters per second recorded by the machine at 95% or less for the night.

Since we had pretended the Opus is expected to leak at .5 liters per second, we see that you are .3 liters per second over and above what is expected from the mask.  That would be a significant leak and probably the cause for the increase in restless sleep and higher AHI.

Of course I must reiterate these are pretend figures, I do not know what the actual figures are for your machine's assumption, your mask, or what your display shows.  You need to find out the real figures so you can do the math.  

(I don't use a ResMed, I have a Respironics and they handle this differently, so if I have mis-remembered about ResMed someone PLEASE CORRECT ME and provide the right information!  Thanks!)

Blessings,
--pseudonym

Thanks so much for your reply.  I do have the Resmed 8s so you have a good memory.  You mention having brain fog but my brain won't even register what you wrote in your message but I'll give it a shot:

I just looked at the data for the week and the pressure was high (averaged 6 when I went to the doc's office) and now it's an 8.   The leak rate for the week was .74 and the AHI was 4 (four is still below the "not to worry" number, yes?).  I think I'll have to go back to the medium pillow or reset the headbands tighter when I use the larger pillows.  

Problem is that there are SO many variables when using the cpap gear that it's a bit cumbersome.  Frustrating!

Thanks for your help!  Does the information I wrote explain things a bit better?

Musica

pseudonym wrote:

I think we talked somewhat about this in another thread... or maybe that wasn't you   I honestly can't recall (chalk that up to brain fog!  LOL)

Which Opus is yours, a 360, a 482?  You need to look up the expected leak rate at your pressure, it should be contained in one of the product literature or details on the F&P site.

Do I recall you have a ResMed machine?  You need to set the mask type to standard when using the Opus.  But this still does not give you the true picture of leak, if I recall CrohnieToo's posts on the subject.  Even at 'standard' setting ResMed subtracts a certain minimum expected leak rate, then still only shows you 95th percentile for the night.  

I believe CrohnieToo had to call or email ResMed to find out what the machine assumes as leak at her pressure.

Once you know the expected leak of the Opus at your pressure, and know what amount of leak the ResMed is assuming (so it shows you what is left), you can see how much leak you're experiencing above and beyond what is expected from your mask.

For an example (and I am making these figures up!  This is just to illustrate the math).  

1.  Let's pretend your model Opus is expected to exhaust at .5 liters per second at a pressure of 15.  

2.  Let's pretend your ResMed on Standard Mask setting expects .2 liters per second exhaust from any mask, so it subtracts that amount from whatever it will display to you on the screen at 95th percentile.

3.  Let's pretend your ResMed on Standard Mask setting displays .6 liters per second at 95th percentile.

The math is this:  ResMed assumption + ResMed display = 95th percentile of mask leak.  In the pretend example we have .2 + .6 for a figure of .8 liters per second recorded by the machine at 95% or less for the night.

Since we had pretended the Opus is expected to leak at .5 liters per second, we see that you are .3 liters per second over and above what is expected from the mask.  That would be a significant leak and probably the cause for the increase in restless sleep and higher AHI.

Of course I must reiterate these are pretend figures, I do not know what the actual figures are for your machine's assumption, your mask, or what your display shows.  You need to find out the real figures so you can do the math.  

(I don't use a ResMed, I have a Respironics and they handle this differently, so if I have mis-remembered about ResMed someone PLEASE CORRECT ME and provide the right information!  Thanks!)

Blessings,
--pseudonym

Without knowing the exact figure for what your mask is supposed to exhaust at at your current pressure, and the exact figure of what the machine is subtracting from the displayed figure, no -- your explanation doesn't help as we still can't calculate the actual leak rate you've been experiencing.  

Can you do some checking and find out what those two figures are?  Or, you could just rely on your DME to tell you if your leak rate is too high.

Blessings,
--pseudonym

I've talked with my DME about the numbers and she said I shouldn't even look at them.  I guess she thought I was making too much of an issue. She struggled to find me the right head gear so I don't think I should push her on the numbers. Who knows, maybe I should?  Do you think the numbers were out of line or is it still too iffy to even venture a guess?
Musica

pseudonym wrote:

Without knowing the exact figure for what your mask is supposed to exhaust at at your current pressure, and the exact figure of what the machine is subtracting from the displayed figure, no -- your explanation doesn't help as we still can't calculate the actual leak rate you've been experiencing.  

Can you do some checking and find out what those two figures are?  Or, you could just rely on your DME to tell you if your leak rate is too high.

Blessings,
--pseudonym

I have no way of knowing if that leak rate is high or not, without those two figures.  The machine is just displaying 'some number' but we have absolutely no reference as to what that number represents.

You can find the figures out from the manufacturer's if you're so inclined, as I did in that other post I remember (that may or may not have been to you).  Or you can just forget it and move on.  (Personally I like to know if my leak rate is out of line but that is just me.)

Blessings,
--pseudonym

Strangely enough, one of my DME techs called for an appointment to check "the pressure" on my machine which she said is done regularly.  I'll ask her about it.  Thanks for the info!  I'll let her read what you wrote so nothing will get lost in translation. Again, thanks!
Musica

pseudonym wrote:

I have no way of knowing if that leak rate is high or not, without those two figures.  The machine is just displaying 'some number' but we have absolutely no reference as to what that number represents.

You can find the figures out from the manufacturer's if you're so inclined, as I did in that other post I remember (that may or may not have been to you).  Or you can just forget it and move on.  (Personally I like to know if my leak rate is out of line but that is just me.)

Blessings,
--pseudonym