Amara view airleaks/Hard time in falling asleep

[Michandola]

This is my 11th night with Amara View ff mask. It worked well for 4-5 nights. Now, my biggest challenge is to figure out whether it is the airleaks or normal venting out of the air from the mask. I hear this air rattling sounds. No doubt that is the air from the vents but sometimes I feel that it is coming out of the gaps forming between my nose and silicon mask cushions. Has anybody have similar issue with Amara View? No matter how much I adjust the mask, those gel part of the mask never seems to snug tight my nose.

Machine shows mask fit - 100%
AHI 1.2
Pressure of 5.0

First couple of mornings I felt great and had bust of energy in the mornings. Thought it will stay that way. But, now I feel that 70% of night I feel awake or at least know about surroundings. Do I need to crank up the pressure? It is auto-cpap so I guess it adjust the pressure accordingly. Not sure what to do.

[Pugsy]

Mask fit at 100% just means no large leaks...no leaks that made it to large leak territory.
Doesn't mean there weren't any leaks that might have disturbed your sleep...just means you didn't hit large leak territory.

Can you try a different size cushion? Maybe the size you are using isn't just right for you?
Did you measure for size with the little sizing guide that should have been included in the mask package?

I don't know that more pressure is the answer or not. It isn't needed in terms of AHi but maybe a little more pressure (thinking maybe 6) might allow the mask to inflate better. It needs to inflate to be able to seal....maybe it isn't getting a good enough inflation.

And yes, I know what you mean about the air feeling like it is leaking around the nostrils. Especially noticeable for me because I have always used a nasal pillow mask and any air felt around the nose means the pillows aren't sealing so great.
Even without it being a real leak the air movement on my nostrils would cause me to wake up because it is something that I am not used to.

If you are waking often (for whatever reason) then you aren't going to feel those good AHI numbers.
If it is the mask and air movement (leaks or whatever) that is causing you to wake up....it needs to be fixed even if it isn't large leak territory leaking. Any leak that disturbs sleep needs to be fixed no matter how small.

[NadiaK]

I also just started using the Amara View a little over a week ago. I also had the little air leaks around the nose at first. You have to be sure that your nostrils are directly over the nose opening. Once you have it correct it will feel like the mask has disappeared. I found that the best thing that worked for me was to put the mask on in the bathroom. I have one of those magnified mirrors that pulls away from the wall. Once I put the mask on, I then take a little flashlight and shine it at the nostril area to see if everything is lined up correctly. I also use one of the RemZzz liners with my mask which for me makes the seal perfect.

[Okie bipap]

I have used the Amara View for several months. I have found that if I push up slightly on the upper straps, I get a better seal around my nose. If you really want to check your leaks, use sleepyhead software and see when you actually have leaks, and how bad they are. My leak rate with this mask is very seldom goes higher than 10 l. per minute.

[Jimmycrackhorn]

I hated Amara View after having high hopes at first.

It's the only mask so far that freaked me out making my hands fall asleep when I wore it. I was afraid I was having a stroke.

Also with Auto pap it would end up blowing off my face so to speak when the pressure would amp up. Then if seemed like I'd have to crank it down super tight just to get it to almost stop leaking but still it would be a pain in the butt and shoot out the side of my face.

[sleepychar]

I use the Amara View mask and I have found that it can be a bit touchy to get it to fit correctly. Some nights I put it on and no leaks, or at least no major leaks. Other nights I just can't seem to find that fit that prevents leaks. I have discovered that, for me at least, it needs to be worn lower on my face than I would have thought. As another member said already, nostrils should sit right over the opening, but the mask doesn't need to be pressed very tightly against my nose. I can almost tell it is right when I put the mask on and I can kind of breathe freely through the nasal opening before connecting to the machine. It's hard to describe what that feels like. There is a little pressure on my face between my mouth and nose from the mask. If you feel air blowing into your eyes, then you do have a leak around your nose and you need to keep adjusting the mask until that stops. Sometimes it takes me three tries to get the mask to sit right on my face. Not a big issue most nights but when I am tired, it's very frustrating. Once that is done, mask works great. I have also found that wearing the top head strap just a little bit further toward the back of my head helps sometimes.

[Michandola]

Mask fit at 100% just means no large leaks...no leaks that made it to large leak territory.
Doesn't mean there weren't any leaks that might have disturbed your sleep...just means you didn't hit large leak territory.
.....

Since I got this whole cpap thing I am aware about my surroundings not all the time but most of the time. Even if the mask is fitting properly the air from the vents + swooshing sound of air making me paranoid that some leaks are there. I kept on running my finger through the nasal rim of the mask. I think that I have to take it easy and trust that there are no leaks. I was under impression that machine reading for mask-fit is accurate to the point. Good (sad) to know that its not the case. I think amara view has bad reputation about the airleaks or at least the paranoia with it.

[Michandola]

I use the Amara View mask and I have found that it can be a bit touchy to get it to fit correctly. Some nights I put it on and no leaks, or at least no major leaks. Other nights I ......

Yes it is easy to detect the leak if the your eyes are open. I was having an issue for this too. But, I soon discovered that AV masks' soft gel nasal part is very easy to distort with few adjustments or if you move it around a lot. It is frustrating esp. the nasal side of the mask.

[palerider]

I was under impression that machine reading for mask-fit is accurate to the point. Good (sad) to know that its not the case.

it's accurate, as long as you understand what the machine reading actually *means*

[Michandola]

I was under impression that machine reading for mask-fit is accurate to the point. Good (sad) to know that its not the case.

it's accurate, as long as you understand what the machine reading actually *means*

Like I said, it read 100% mask fit doesn't do a thing for me. The air was leaking while numbers in disguise. So, was it reading no airleaks?

[Pugsy]

The air was leaking while numbers in disguise. So, was it reading no airleaks?

No....it was reading no "large leaks". It's not saying it wasn't leaking...only that whatever leak was present didn't make it to large leak territory.
The machine can compensate for quite a bit of excess leak (above the vent rate) and the LCD screen mask fit numbers are only meant for large leak evaluation.
If you want to see the real excess leak and/or vent rate...you need to use the software and evaluate the total leak graph.

[prodigyplace]

I am not sure about the Dreamstation, but you can get a good leak / mask fit on my device and still have large leaks.

I has several large leaks last night, I think mainly due to my jaw moving to mouth breathe. The online software shows Good mask seal but I know, and Sleepyhead shows otherwise.I am working at changing behavior and adjusting things. I am trying to avoid adding a chin strap to the mix.

[Pugsy]

I am not sure about the Dreamstation, but you can get a good leak / mask fit on my device and still have large leaks.

People need to understand what the machines are reporting on the LCD screens or the website app software reporting.
Respironics 100% mask fit means that there were 0% of leaks qualifying for large leak territory flagging. That's all it means.
Doesn't mean an excess leak didn't happen...just means the excess leak didn't reach large leak territory on that machine at those pressures (large leak territory line in the sand varies with the pressure used).

ResMed machines report leaks a little different on the LCD screen.
You get a Mr Smiley face as long as you didn't spend more than 30% of the night in large leak territory (and for ResMed machines the boundry line is 24 L/min excess leak. You could spend 29% of the night at 40 L/min leak and still get Mr Smiley.
The other reporting number on a ResMed machine in terms of leak is what we call a 95% number and all it is by definition is a number where a person was at OR BELOW for 95% of the night. 95% numbers are easily skewed so sometimes not all that reliable in terms of an indication as to how the whole night might have gone in terms of anything.

A large leak flag from either machine isn't the end of the world. It could simply be a quick mask refit large large leak and pretty obvious on the software detailed reports.
Large leak flags become important when we see large blocks of time spent in large leak territory...AND we also need to evaluate just how far or deep they went into large leak territory before we start worrying about the machines sensing and recording ability being compromised.
With your ResMed machine...large leak territory is 24 L/min and if you go to 26 L/min you are in large leak territory but the machine can still do a decent job sensing and recording up to 30 L/min...between 30 and 35 L/min you might see some unknown flags where the machine senses something is going on but doesn't know what to call it.
Over 35 L/min and it gets a little iffier....from my own personal experience with progressive large leaks which make it easier to quantify results...over 35 L/min I got big blanks for any events so either I didn't have them or the machine was clueless.
Since immediately prior to hitting over 35 L/min I was seeing some unknown flagging I would have to assume that the events still were happening but the machine missed them.

Respironics machines have a more generous line in the sand where large leak territory begins...it's not the same as ResMed's 24 L/min excess only leak.
Plus Respironics machines report total leak which is the mask's expected intentional leak/vent rate plus any excess leak.
Can't compare ResMed leak numbers to Respironics leak numbers because they are 2 different animals.
Respironics never gives us a single line in the sand number like ResMed does. Instead the machine itself determines the line in the sand depending on pressure used at the time. More pressure means more vent rate in that total leak number so as the pressures go up the line in the sand moves up also. We just have to trust the machine that it will flag a large leak when that line in the sand has been crossed and even then the machine doesn't go completely clueless right away...again just like with ResMed machines it depends on how deep into large leak territory a person goes as to how it impacts the machine's sensing and recording abilities.

Other brands of cpap/apap machines have different lines in the sand before flagging large leaks.
F & P Icons seem to use 60 L/min and we are unsure if that is total leak or excess only (they never tell us exactly but it appears to be total leak).
DeVilbiss machines seem to use around 90 L/min total leak.

Resmed machines are the only machines that report only excess leak and use the 24 L/min line in the sand.

[prodigyplace]

Sorry I diverted the discussion.
Thank you for the explanation, Pugsy.

[Pugsy]

Sorry I diverted the discussion.
Thank you for the explanation, Pugsy

No apology needed. I just took the time to compose a little Leak 101 that will be used at a later date in the revised SH tutorial.

Everyone needs to understand whatever leak data they are looking at. You and the OP weren't my primary audience here....there's going to be a lot of other newbies reading this thread. It was a good time to go into more detail and explain how the different machines do what they do with the various leak reporting data points.
Especially for when a ResMed user tells a Respironics user that they are "leaking like crazy" based on what SleepyHead is showing...when in fact there is no excess leak to speak of. There are a couple of cpap veterans here who still tell Respironics users that their leaks are excessive and cause unnecessary alarm because they (even as cpap veterans) don't know how to interpret the leak graphs.