Questions about leak rates

I've been using APAP for about a month and it seems like I am having very good results (my AHI is consistently less than 1). After going through multiple masks I've settled on the Airfit P10.

These graphs show how large leaks often occur near a ramp up in pressure. Sometimes (infrequent) I will remember a dry mouth in the middle of the night. I've never woken up with a dry mouth. Is there a way to determine if this is a mouth leak? Should I even worry about this?

I assume the non-zero minimum leak is an artifact of how the machine separates intentional from unintentional leaks.

What I'm really trying to do here is get a feel for leak rates and how to interpret with SleepyHead. My sense of the P10 is that it doesn't leak at all unless tugged on but when I'm sleeping all bets are off.

Last night


I had a bit more trouble with leaks this night

Some years ago I did some experimenting with taping my mouth to make sure I wasn't mouth breathing because it's darn near impossible to know for sure what is causing those leaks that sort of give us a "plateau" appearance.

So I taped...and made sure the tape was still in place in the morning and you know what....I would still get some very brief large leaks with this same "plateau" appearance. So I know for sure that mask movement can give the same appearance as probable mouth breathing.

So the only real way to know for sure if those large leaks are mask movement or mouth opening is to tape your lips shut to totally eliminate the mouth opening chance and see if you still get those leaks or not.

That said...assuming that I have slept through those large leak time periods and if I feel quite decent during the day...I don't worry about those rather brief periods of time in large leak.
ResMed will still give you a Mr Smiley face for leak control until you hit 30% or more of the night spent in large leak.
Even your "bad" night was less than 10%.
My own personal line in the sand is 10%...as long as it is below 10% I really don't give it much of a second look at all.
Whatever these are...mask movement or open mouth...I sleep right through them so I don't really care.

I gave up taping long ago (after maybe 2 or 3 months) because I figured out that large leaks were minimal and didn't disturb my sleep ...and taping sort of did disturb my sleep a little. And getting good sleep has always been my primary goal...not getting perfect math scores on the the report.
I compromised...let a little big leak happen on occasion and sleep good.
Besides...taping won't help mask movement big leaks and I would still get some of those even with lips taped.

It's rare that I don't hit large leak territory at least briefly...as long as it is brief and I don't go over 35 L/min for very long...I don't care.
But I sleep through all of it and that's what is important to me.

If you want to know for sure with absolute certainty what those plateau leaks are....you will need to tape and see if they still happen or not. Do they warrant taping all the time....not in my opinion. Not bad enough in terms of where it goes and doesn't last long enough....even your "bad" night.

Thanks Pugsy. I really appreciate your lengthy reply!

Your take of not worrying about large leaks for less than 10% of the time gives me a good way to look at this data. I was hoping there was a trick way of looking at the leak data that would indicate a mouth leak. Oh well.

I'll consider taping my mouth but as it is right now I just keep trucking with the current setup. Maybe it is mouth breathing and I'll eventually learn to keep my mouth shut.

I'm still getting accustomed to the treatment and so I can't tell if my sleep is any better. I wake up far too much in the night and I'm still tired during the day. But as I understand it's not unusual for it to take three to six months to start feeling better.

lawr1000 wrote:These graphs show how large leaks often occur near a ramp up in pressure.

you'll note that in the 'last night' pic, there are several other times when your pressure went up to the same level as the first leak, and there was no concurrent increase in leaks at all. more likely you turned and dislodged the mask at around the same time.

lawr1000 wrote:I assume the non-zero minimum leak is an artifact of how the machine separates intentional from unintentional leaks.

no.
here's what mine looked like shortly after I got my first P10:

and, you note, your leak line does occasionally drop down to or near to zero.

palerider wrote:

lawr1000 wrote:These graphs show how large leaks often occur near a ramp up in pressure.

you'll note that in the 'last night' pic, there are several other times when your pressure went up to the same level as the first leak, and there was no concurrent increase in leaks at all. more likely you turned and dislodged the mask at around the same time.

That makes me less concerned about mouth leaks. Thanks. Taping at this point seems like adding another thing to get used to in an already difficult adjustment period. I'm going to stick with Pugsy's advice and not worry about these leaks as long as they stay short and represent a small portion to time spent using the machine.

palerider wrote:

lawr1000 wrote:I assume the non-zero minimum leak is an artifact of how the machine separates intentional from unintentional leaks.

no.
here's what mine looked like shortly after I got my first P10:

I'm envious of your leak rate graph.
I have been using a small amount of Lanolin to help with mask comfort. Last night I didn't apply it and my average leak rate dropped a bit to 2.4 L/min as compared to the previous night's 3.6 L/min (one night's data isn't much evidence of improvement). From my point of view the P10 is the most comfortable mask I have tried and it feels like it doesn't leak which if very helpful when first falling asleep. I'll keep truckin' with the P10. Hopefully over time using APAP will become second nature and I will get better at managing leaks in my sleep.

Thanks for the help.

lawr1000 wrote: I'm going to stick with Pugsy's advice

that's always a good plan.

Pugsy and I may not always agree on things 100%, but it's usually only on nitpicky details that don't matter too much... point is, she gives excellent advice. I've learned a lot from her.

lawr1000 wrote:I have been using a small amount of Lanolin to help with mask comfort. Last night I didn't apply it and my average leak rate dropped a bit to 2.4 L/min as compared to the previous night's 3.6 L/min (one night's data isn't much evidence of improvement).

I used the lanolin (about a bb sized dollop) when I was first starting, because the P10 hurt my nose terribly. however, that only lasted a week or two, and I think that I'd stopped by the time that screenshot was taken.

btw, I'm still using the same p10, same pillows, though I have gotten new headgear... I'm just curious how long this one will last before I have to switch to a spare. (yes, this is a subtle dig at people that think they have to change the pillows every 2 weeks) (note date on screenshot)

palerider wrote:btw, I'm still using the same p10, same pillows, though I have gotten new headgear... I'm just curious how long this one will last before I have to switch to a spare. (yes, this is a subtle dig at people that think they have to change the pillows every 2 weeks) (note date on screenshot)

I have HDHP insurance and never meet my deductible. So I pay for all my CPAP equipment/supplies and never intended on replacing pillows twice a month but 2 years seems a very long time.

lawr1000 wrote:

palerider wrote:btw, I'm still using the same p10, same pillows, though I have gotten new headgear... I'm just curious how long this one will last before I have to switch to a spare. (yes, this is a subtle dig at people that think they have to change the pillows every 2 weeks) (note date on screenshot)

I have HDHP insurance and never meet my deductible. So I pay for all my CPAP equipment/supplies and never intended on replacing pillows twice a month but 2 years seems a very long time.

all depends on whether you're the kind of person that replaces things all the time just to have a 'new' one, or the kind of person that uses things till they *NEED* replacing, I suppose.