Maskleaks and AHI score

Can mask leaks increase AHI events, in particular obstructive apnea ? Last night my AHI score reached an all-time high of 4 , with an O.A. of 2.38. Even though the overall AHI score of 4 is well within the normal range it is still unusually high. The large leak score was 2.08. I wonder if the leaks have a bearing on the AHI score. Usually my AHI score is well below 1.

TKS

Ittiandro

No I don't think so. If anything large leaks may suppress the reporting of obstructive events. If you have a ResMed the machine reports the event during a large leak period as UA or Unclassified, as it can't tell the difference between a CA and OA when the leak rate is high. So, what you should see is an increase in UA events. . That said one theory is that there may be an increase in OA events right after a high leak rate because the machine does not increase pressure during a high high leak rate event and it may be too low right after the event. This applies only if the machine is in Auto and there is a significant difference between minimum and maximum pressure.

Thanks, what is the high leaks threshold, roughly? Is 2.00 pc low?

Tks

Ittiandro

Sometimes you are better off using a nasal mask with a chin strap than trying to eliminate leakage on a full face mask. Many people have to experiment with a large number of masks.

Also, when I went from the gen 8 to gen 10 RESMED machines, my residual AHI went from 3.0 to 0.3, and I could feel a huge improvement in my general alertness and physical well being. Net/net, I am quite unconvinced that an AHI of 5.0 is remotely “normal” or acceptable. Even one apnea, if it lasts long enough, can kill you… 5.0 and above is just the level that the insurance companies and the medical system are willing to pay to treat…..

Thanks for your comment Two points

1. Yes, sleep apnea could kill you, if left untreated, for a number of pathologies it spawns (diabetes, obesity, heart diseases, etc.) but not, I believe, for a single long lasting episode., as you seem to imply.
   A breathing interruption must be 10 seconds or more to be classified as apnea. Since apneas are rated on an hourly scale, one single episode can kill either if it lasts one hour, which doesn't make sense, or, if you have 360 events of 10 secs over an hour's period, because this wouldn't leave you time to breathe, which is theoretically possible, but equally nonsensical, in addition to the fact that there is no clinical evidence.

2. Zero AHI is perhaps best, but an AHI score of 5 or less is normal in the sense that statistical studies and clinical evidence indicate that most adults do experience brief periods of breathing interruptions. What I find somewhat intriguing is that, judging retroactively from certain episodes way back in my young days ( I am 82 now) I must have had sleep apnea for my whole life without being aware and with no impact on my mental and physical conditions, except for snoring, which bothered others more than me.... When I finally decided four years ago (more out of curiosity than anything else) .to see a sleep doctor, the Sleep Apnea titration process revealed a stunning AHI score of 40 AHI's! Now they are down to under 1. To be honest, I don't feel much of a difference. If I have never been affected by 40 AHI/hr I don't think I should worry about 5, even less about dying, which will certainly happen before not too long for other causes ( natural, I hope) .

Ittiandro