Leaks

[Pugsy]

Any leak that disturbs sleep is unwanted..even if it is tiny. Anything that disturbs sleep is unwanted.

If the leaks below in my example disturbed my sleep...I would want to fix them but since they don't and I rarely have a leak wake me up...I just shrug my shoulders and move on.

Leaks....and that ResMed 95% number or from a Respironics machine and using Encore 90% number...all that means is that for 95/90 percent of the time the leaks were at OR below that number. People tend to overlook the OR BELOW part of the definition.
It's just a number that gives us a sort of idea how the leaks went that night. If it's low...we know that leaks were minimal but if it is elevated it may or may not be statistically important...remember the OR BELOW part of the definition.
Past experience has shown me that the 95/90 percent numbers are easily skewed by a short time in larger number (either pressure or leak numbers) so the % numbers may not be as significant as first thought.
Now I am not saying they are never significant...I am just saying they aren't always the holy grail of numbers to look at.
It's just a number and a person needs to evaluate how that number might be significant (or might not) by looking at the overall graphs.

Here's an example from last month. 95% number was a whopping 27.6 L/min and one might think the whole night was trash due to leak if looking at that number and forgetting the OR BELOW part of things.



But when I go look at the actual leak graph it isn't nearly as horrible looking. I barely went above 24 L/min for maybe an hour or so and had a short time with some leak spikes. I suspect my mouth was open part of the time. I don't know for sure what happened because I normally sleep through stuff like this. This report is a prime example of how the 95% number could possible cause alarm because on the surface it might point to a horrible leak night when in reality the bulk of the night was really quite acceptable and often zero. If I was mouth breathing....it wasn't enough to cause the entire night to go to hell.

[JohnO]

I've been using the Aloha nasal pillows since September. Here are some suggestions:

1) Try a pillow with different stuffing. When I started on CPAP I was using a memory foam pillow. I found that the pillow was too firm, and whenever I changed from side to side, it would usually knock the headgear around, breaking the seal at my nostrils. Switching to either a standard polyfill foam or latex pillow solved that problem.

2) Try re-adjusting the straps. This can be a trick. You don't want them too tight to give you a pug-nose, nor do you want them so loose that they leak almost all the time.

3) Try to get a sense of where on the nostril they are leaking. Perhaps you can adjust where the pillow connects to the prongs from the headgear to get a more even seal.

As far as hose placement, I don't use the head loop. I usually pull the hose down closer to my chest so the exhaust vent points up and out. In the summer when it is warmer, I sometimes point the exhaust down as as personal fan.

I do wish the exhaust vent area was larger on the Aloha. The exhaust was not as annoying on my PR True Blue mask, primarily (I think) because the surface area of the vent was larger, causing the flow rate of exhaust pressure to be less per square inch.

John

[khauser]

I'm not kaisagram, but yes, there is some downwards draft. It depends where your nose is relative to expose skin ... for me it was only a problem if I slept on my side because it would then blow on my arm...

I want to modify that ... I was especially careful to note this last night. It actually does NOT blow downwards ... it pretty much blows straight away no matter which way the hose is turned. I just happened to be aiming it at my arm, apparently...

[khauser]

It's amazing what can suddenly become a hot topic. I only wish it was a hot topic because everyone had interest in the actual subject. Instead it became a religious discussion on what kind of mask to use. Peppered throughout it are some great ideas, though, which is what I was looking for.

Last night was better, but not perfect. I am pretty sure I just need to keep adjusting it a bit. It always works well at first, and when I wake up all I want to do is go back to sleep ... not the best time to be fidgeting with fit. I'm going to spend some time with it today BEFORE I go to sleep.

Thanks everyone! I appreciate the help. This weeks graphs will be up later (I'll probably keep a running log of my graphs, just for the fun of it)

[Pugsy]

It always works well at first, and when I wake up all I want to do is go back to sleep ... not the best time to be fidgeting with fit.

This happens to me pretty much every night. Almost always perfect flat line for 90 minutes or so then things seem to go whacko.
I see it in the reports but they don't wake me up. I always laugh at the reports showing spikes in leaks at 90 to 120 minutes in to sleep. I call it my witching hour. From the pattern...to me looks like maybe associated with time frame where REM sleep would likely be happening. Don't know why leaks would be more likely to be worse in REM sleep though. Sometimes I see pressure increases at that time but sometimes a pure flat line on the pressure. Usually I just like to blame it on aliens. It's more fun than saying that I don't know.

With time and experience you will get the leaks down where there will only be minimal annoying awakenings from the leaks.
Part of it is that you will fine tune the mask and learn what little things help keep it sealed better.
The other part is that your brain won't be so hyper vigilant (hopefully) so that very minor leaks won't disturb your sleep so much.
When I first started therapy...the least little thing would cause me to wake up. Now I can sleep through stuff that 4 years ago would keep me awake nearly all night.

[khauser]

It always works well at first, and when I wake up all I want to do is go back to sleep ... not the best time to be fidgeting with fit.

This happens to me pretty much every night. Almost always perfect flat line for 90 minutes or so then things seem to go whacko.
I see it in the reports but they don't wake me up. I always laugh at the reports showing spikes in leaks at 90 to 120 minutes in to sleep. I call it my witching hour. From the pattern...to me looks like maybe associated with time frame where REM sleep would likely be happening. Don't know why leaks would be more likely to be worse in REM sleep though. Sometimes I see pressure increases at that time but sometimes a pure flat line on the pressure. Usually I just like to blame it on aliens. It's more fun than saying that I don't know.

With time and experience you will get the leaks down where there will only be minimal annoying awakenings from the leaks.
Part of it is that you will fine tune the mask and learn what little things help keep it sealed better.
The other part is that your brain won't be so hyper vigilant (hopefully) so that very minor leaks won't disturb your sleep so much.
When I first started therapy...the least little thing would cause me to wake up. Now I can sleep through stuff that 4 years ago would keep me awake nearly all night.

I'm not new to therapy ... just this mask. All my years on xPAP minor leaks are the biggest issue (and snoring, but I'm less aware of that).

[Pugsy]

I'm not new to therapy ... just this mask. All my years on xPAP minor leaks are the biggest issue (and snoring, but I'm less aware of that).

Ahh, then you likely are just sensitive to the leaks. We all have things that we are more sensitive to than others.
Maybe with time and experience you can get the Aloha tweaked so leaks (even those tiny ones) are no longer an issue.

I have other things that wake me up. Though leaks have to be really, really bad before they will wake me so at least I don't have that disruption often.
It's always something.

[Denial Dave]

Because of my higher pressures and bipap, I occassionally get little bird chirps from my seal.... it happens when the bipap reaches my IPAP pressure.... it used to wake me up, but recently I apparently slept through them.... my wife complained about the chirps, but I never heard them...

Sometime, I do get leaks blowing straight down from my Quattro and I can feel it on my arm... it comes from minor leaks around my mouth.... A slight tug on the straps and it goes away.

Dave

[Chuck Connors]

I finally found a mask that worked for me through trial and error. Lots of good advice on this site, but you just have to keep trying different masks until you find the one that works for you. Two things I'm religious about doing each night. Cleaning the silicone part of the mask is one of them. One poster had recommended using Pantene Fine Hair Solutions shampoo and that has been working well for me for over one year. Just a little dab goes a long way. For washing my face, I use a Clarisonic Mia and the cleanser I use is Cetaphil. The nights I haven't cleaned my face are usually the nights I'm going to wake up in the middle of the night with a leak. -Chuck-

[mths]

Hello,

I´m new here.

I apreciate to get resscan.

Could you help me?

Thks!

[Julie]

Please start a new thread instead of using this old (and not related) one...