Understanding my leak rate?

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stcrim
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Understanding my leak rate?

Post by stcrim » Fri Jun 26, 2015 8:10 am

I am using SleepyHead to follow my sleep on a RemStar Pro with C-Flex+ (460P) with either an AirFit P10 or FX Nano. My leak rate is very consistent on the graph running between 23 and 45 most of the time. Occasionally will drop to 20 or bump to 60. My average leak rate is 6.58 putting me above the 3.98 threshold.

If I understand correctly this is a completely unacceptable leak rate!!! I'm assuming this is all about mouth breathing or rather mouth leaking. Chin straps don't work, my lips can flap like a sheet in the wind. I have taped leaving a small opening on each side but vent through it like a Dolphin.

Maybe nose masks and nose pillows aren't for me - where do I go from here?

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Julie
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Re: Understanding my leak rate?

Post by Julie » Fri Jun 26, 2015 8:18 am

Just curious why you leave open space when you're taping - the idea is to make sure you don't leak air at all.

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ChicagoGranny
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Re: Understanding my leak rate?

Post by ChicagoGranny » Fri Jun 26, 2015 8:31 am

stcrim wrote:Maybe nose masks and nose pillows aren't for me - where do I go from here?
FFMs - https://www.cpap.com/cpap-masks/full-face-cpap-mask.php

Don't let the nasty nasal interface forum members scare you of FFMs. lol

stcrim
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Re: Understanding my leak rate?

Post by stcrim » Fri Jun 26, 2015 9:59 am

The openings in the tape are just to drink a little water through a straw every now and then. I'm not opposed to a FFM other than I don't enjoy sleeping on my back all the time. I'm a side sleeper which probably helps in obstructives.

What are people doing to get those leak rates down?

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Julie
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Re: Understanding my leak rate?

Post by Julie » Fri Jun 26, 2015 10:17 am

Why sleep on your back at all? It provokes a lot more apneas, which could be impacting your sleep. If you have trouble side sleeping with the mask, why not look into e.g. a Pap Pillow (.com) and/or your own version of it? Maybe try other FFM's.

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OkyDoky
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Re: Understanding my leak rate?

Post by OkyDoky » Fri Jun 26, 2015 10:26 am

Respironics machines include mask venting rates in their leak rates and depending on your pressures this could be from 20 to 40 L/min. Here is a link to the mask manual, look on page 7 for the graph. http://www.resmed.com/us/dam/documents/ ... er_eng.pdf What was left above that amount is your actual leak. Resmed machines do not include the mask venting.
I usually don't worry until my total rates are above 60L/min and then it also depends on the length of time to determine if it is a problem.
ResMed Aircurve 10 VAUTO EPAP 11 IPAP 15 / P10 pillows mask / Sleepyhead Software / Back up & travel machine Respironics 760

stcrim
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Re: Understanding my leak rate?

Post by stcrim » Fri Jun 26, 2015 11:00 am

This is an example of a typical night for me. Sometimes my AHI is below 5 and sometimes it's above. Does the leak rate there appear to be a problem??? The images are night before last and last night - both are with AirFit P10
Image

Image

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ChicagoGranny
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Re: Understanding my leak rate?

Post by ChicagoGranny » Fri Jun 26, 2015 11:22 am

stcrim wrote:I'm not opposed to a FFM other than I don't enjoy sleeping on my back all the time.
Who told you that you have to sleep on your back when wearing a FFM?

It's comfortable for me to sleep on my side while wearing my FFM and my leak rate is near-zero.

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OkyDoky
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Re: Understanding my leak rate?

Post by OkyDoky » Fri Jun 26, 2015 11:28 am

Your leaks look pretty well controlled. The spikes look like where you took your mask off before you shut your machine off. Also if you look at the graph, it shows 2 lines and the bottom one is your actual leak with the top one including the venting. If the leaks are disturbing your sleep then you may want to investigate a FF mask but I don't think the amount you are having is affecting your therapy.
It looks like you mostly have centrals and hypopneas, have you always had centrals? If your sleep is fragmented some could be SWJ and better sleep may help those.
ResMed Aircurve 10 VAUTO EPAP 11 IPAP 15 / P10 pillows mask / Sleepyhead Software / Back up & travel machine Respironics 760

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SockPuppet
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Re: Understanding my leak rate?

Post by SockPuppet » Fri Jun 26, 2015 11:43 am

OkyDoky wrote:Your leaks look pretty well controlled.
The leak line is not a good indicator to use to declare that there is no significant loss of air out the mouth.

If you want to try to do this, you should look at the individual breath waveforms during the time when the unintentional leak peaks on his graphs.

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OkyDoky
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Re: Understanding my leak rate?

Post by OkyDoky » Fri Jun 26, 2015 11:55 am

SockPuppet wrote:
OkyDoky wrote:Your leaks look pretty well controlled.
The leak line is not a good indicator to use to declare that there is no significant loss of air out the mouth.

If you want to try to do this, you should look at the individual breath waveforms during the time when the unintentional leak peaks on his graphs.
Agreed, especially if he's not intentionally taking the mask off without turning the machine off. And with his flapping lips comments it is likely a better tape job or FF mask would help.
ResMed Aircurve 10 VAUTO EPAP 11 IPAP 15 / P10 pillows mask / Sleepyhead Software / Back up & travel machine Respironics 760

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SockPuppet
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Re: Understanding my leak rate?

Post by SockPuppet » Fri Jun 26, 2015 12:05 pm

OkyDoky wrote:And with his flapping lips comments it is likely a better tape job or FF mask would help.
+1

I've used taped lips with nasal pillows, but in the long run I just feel better with a FFM. It seems there are times during the night when I need to breathe through my nose and mouth.

I'm not sure why this is. It is likened to walking on the street for a mile, all the while breathing exclusively through the nose. Then coming to a hill and the additional exertion requires that air is taken in through both the nose and mouth. IDK.

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Pugsy
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Re: Understanding my leak rate?

Post by Pugsy » Fri Jun 26, 2015 8:51 pm

Mouth leaks will show up on the leak graph if they are big enough and last long enough.
To the machine a leak is a leak no matter where it is coming from.
Large leak territory with your machine is probably up around 75 L/min total leak (vent rate plus excess leak) so except for the spikes you see...your leak is well within the machine's ability to compensate.
If you were trying to compare your leak number with the 24 L/min that you read about for ResMed machines...don't.
Those machine report only excess leak so their large leak territory begins up around 24 L/min.

Look at the SleepyHead events graph up on the top right...See where it says CSR and right below it you see LL....
LL is large leak....your machine fill flag a large leak if it thinks you have one.
This includes mouth leaking/breathing leaks. I see no evidence of mouth breathing or leaking that is seriously impacting therapy. The big spikes...mask removal and brief. I wouldn't worry about them.

So in terms of leak control your overall leak line is actually quite decent..some of the little bumps upward are to be expected because the pressure also increased. Vent rate is tied to pressure and more pressure means more vent rate and thus the leak line will go up because the vent rate went up and it does this even if there is 0 excess leak.
Look at the leak graph and right above it in little letters...leak rate 0.00 (that's excess leak) and total leak rate 0.00 and that is excess leak plus vent rate....Leaks are NOT a problem and neither is mouth breathing. Mouth breathing leaks are easy to spot on the leak graphs.

Leaks aren't a problem unless they are waking you up...but they aren't big enough to negative impact the therapy itself.
The overall appearance of your events graph point to probably needing a little more minimum pressure than the 8 that is currently the starting point. The airway needs a little more baseline pressure to hold it open a little better.

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BIGELI
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Re: Understanding my leak rate?

Post by BIGELI » Wed Jul 01, 2015 3:53 am

For over 7 years I had a machine that gave me no feedback except for my IPAP/EPAP levels. I am 100% compliant. My AHI is 1.7. But now I have a Aircurve that spits out data including MASK LEAKAGE. Sometimes this number is high and its freaks me out. On the other hand I get 6 to 8 hours of sleep. If you're sleeping through the night your treatment is working.

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palerider
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Re: Understanding my leak rate?

Post by palerider » Wed Jul 01, 2015 9:29 am

BIGELI wrote:But now I have a Aircurve that spits out data including MASK LEAKAGE. Sometimes this number is high and its freaks me out. On the other hand I get 6 to 8 hours of sleep. If you're sleeping through the night your treatment is working.
nope, that's NOT correct... apples and oranges.

people were "sleeping" through the night before they got treatment.

"sleeping through the night" means nothing at all about how well the treatment is working.

please stop spreading BAD information.

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