Questions about leakage rate

I've been using my CPAP machine for almost 3 months and will be seeing my doctor on September 3 for my 90-day compliance appointment. Before this appointment, I'd like to get some things straight in my mind. This way, I can be sure that the Dr. and Resp. Therapist are leveling with me. Basically, the only problem I've had has been with finding a mask which doesn't leak. The mask I started with and use 99% of the time is the Swift FX Nano for Her. My only problem is that it leaks. I wake up a few times each night with the awful sound of air leaking out the side. My AHI is consistently under 5 but my leak number is in the 30's. I remember reading it should be under 15 which I've never achieved. As an experiment, I tried using the Mirage Liberty Full Face Mask (small) but the nasal pillows kept leaking . The AHI number was 7 and the leakage was 43. I only used that one night because it was not comfortable. Then I tried the AirFit F 10 for a couple of nights. Again lots of noisy leaks waking me up during the night. I even tried taping the sides of the mask to my face with surgical tape but by early morning I was leaking. I was considering using staples but figured the cure might be worse than the cause:-) Again, AHI under 5 but leakage was 63! Before you ask, I've tried adjusting the straps on all three of the masks to see if I had it too tight or too lose, but that didn't make a difference. Also, I wash the mask each morning. I change the silicone mask liner every two weeks, I've tried the Pad-a-cheek liner without seeing any difference.

My maximum pressure is 15. If that number was lowered, would that help with the leaks?

Basically, what I'm wondering is this: If my AHI in under 5 (with the Swift FX Nano) and the leakage is 33-38, will the doctor say everything is fine. Obviously, I need a better fitting mask and I don't want the doctor/resp.therapist to brush off my concern about leakage by saying my AHI's are low and that's what is important.

Since I started using the CPAP machine, I am feeling better in the morning once I can clear my head and wake up. My problem is that I lay in bed for 30-45 minutes trying to rouse myself and that's after 8 plus hours of sleep. Thank goodness I'm retired. Once I'm up, most days I'm fine. No longer do I have foggy brain and headaches in the morning. Palpitations are gone as is the jittery, anxiety feeling. I'm thinking that I am waking up 5 to 8 times a night because of the leaky sounds and that's why I have trouble waking up at a reasonable time. Of course, I could be wrong about this. I also am able to remember my dreams each time I wake up so I know I've been dreaming, but then I fall back to sleep and don't remember them in the morning. Not quite sure what this means, either.

I'm sure you are going to suggest that I download the SleepyHead software and use that. Here's my problem. I'm not that computer proficient and don't know how to download the program let alone how to transfer the information to this Discussion Group for your help in interpreting it. Some days I feel like a dinosaur.

So basically, my question is what should I ask/tell the doctor on the 3rd especially if they say the leakage rate isn't important?

One other question. After my 90 day Medicare compliance period is up (Sept 9th) can I insist that the DME remove the transmitter which is on my machine? I understand why it is necessary for compliance reasons, but I just don't like the idea of my information being gathered for no reason after the 90 days. I guess it's the whole NSA thing that's got me bugged (pardon the pun.)

Thanks for any suggestions/help you can offer me. Hope everyone has a wonderful Labor Day Weekend.

I started 6 months with Quattro Air, and now use the AirFit F10. These masks use the same cushion, and it is a very leaky noisy cushion. I had constant noisy face farts.

Like you, I tried Pad-A-Cheeks but for me they were uncomfortable. I looked for other liners, and found a product called RemZzzzs; available at most DMEs, also from our forum hosts at https://www.cpap.com and from places like Amazon. You could also make your own liners out of old t-shirts or buy one at Goodwill, which is what I do now, using them intermittently with the RemZzzzs. You can google "DIY cpap mask liner" to find a pattern for these and print it out... I'm not certain what the address. All you have to do is trace it onto your fabric and cut it out. I wash both RemZzzs and homemade ones in with my other laundry in a mesh bag, using each only one night at a time. They are all curled up when they come out of the washer, and I straighten them and lay them flat to dry then iron them to help them retain their shape.

I have not found anything that works better to solve the leak noise... some leakage is acceptable with any mask, but the important thing is to reach a point where they are not waking you up. I don't even remember when I last had a leak that woke me or kept me awake. My Sleepyhead reports show that my leaks rarely go over the red line, which is the projected level to be expected for the mask. I suggest that you try a different liner... in addition to helping with the leaks, liners are good for protecting your face from irritation or contact dermatitis.

You should be able to use your cushions longer than 2 weeks, mine last about 2 months before I have to change them out... also, make sure you are washing your face really well before you put the mask on; facial oils, makeup, moisturizer, etc. can interfere with the seal.

With leaks over 30 L/min on the S9 machine it's possible that the machine could be missing flagging the events (if some are happening) especially when you go over 35 L/min. So that nice low AHI might not really be so low....at least during the periods where the leak is excessive.
ResMed says large leak territory begins at 24 L/min. Up to around 30 L/min the machine can still pretty much sense any apnea events that might be occurring. It might call them Unknown apneas if it couldn't tell what they are. Over 30 L/min and it starts getting real iffy as to how good a job sensing the events it does.