Large Leaks???? Airfit P10 & AirSense 10 for her

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Grouch
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Large Leaks???? Airfit P10 & AirSense 10 for her

Post by Grouch » Sat Apr 15, 2017 11:38 am

Just got my new Airsense 10 Autoset for her yesterday. I didn't notice any mask problems. This morning my leak rate was through the roof. It had been fine on my old PR1 machine. MyAir app showed a 0 out of 20. Not a great amount of info from this.

Sleepyhead showed: AirSense and (old machine the day before)
Average Leak Rate - 34.35 (4.91)
90% leak rate - 54.00 (12.00)
% time above LR thresh 69.8% (2.51)
AHI was 0.90 (0.32)

Even with the leaks my AHI was still good

I've never seen that high a leak with any mask. Maybe I had a weird night. Or maybe I have something set wrong with the new machine. I left the settings at what the DME did. The pressure is right. The woman's algorithm is set. Defaults for the heated hose and humidifier. The only thing I touched was to turn off ramping.

Is this a fluke? I did begin using a new mask type about 10 days, but leak rates had been fine on the old machine as shown above.

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Re: Large Leaks???? Airfit P10 & AirSense 10 for her

Post by TASmart » Sat Apr 15, 2017 12:52 pm

I would make sure the hoses are installed correctly. I think a leak rate that high could be heard. According to my DME another thing to check is to make sure the humidifier is all the way in. As always its a lot easier to see what's going on with the Sleepyhead output posted.
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Re: Large Leaks???? Airfit P10 & AirSense 10 for her

Post by prodigyplace » Sat Apr 15, 2017 1:39 pm

Leakage with the P10 could be leakage through the mouth.
What mask & type were you using previously? If it is the mouth, you may not see those leaks with a full face mask.

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Re: Large Leaks???? Airfit P10 & AirSense 10 for her

Post by SewTired » Sat Apr 15, 2017 1:45 pm

I would also check what's been recommended, but in my experience, it is mouth open that is causing the large leaks. That said, sometimes people receive hoses that were damaged before they got them, so do a test and check for leaks on that. I went through some of this on and off through the winter - changing the humidity helped reduce the mouth open. Look at Sleepyhead and see if you are hitting the top of your range. If so, increase it a tiny bit, wait a few days and then increase it a bit more. If you don't normally have mouth open issues, then it's fixable, but it takes some time to figure it out.

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Re: Large Leaks???? Airfit P10 & AirSense 10 for her

Post by Grouch » Sat Apr 15, 2017 2:05 pm

Thanks all for your suggestions.

I checked the seating/sealing of the hose and humidifier. It is possible I didn't have the mask tubing fully seated in the hose. I'm very hard of hearing, so I woudln't necessarily hear the leakage from there. I re-plugged both the hose and humidity chamber back into the machine to ensure a good seal.

Mouth breathing? Maybe, but I've only ever worn nasal pillow masks. In 5 1/2 years I've never had a problem with mouth breathing. But this is a new mask. However I've worn it for 9 days without a problem on my old machine. No problem with leaks.

Right now I'm going with the Operator Error theory about inserting the mask tubing into the heated tube. It does fit differently than my old tube and I now see that it goes further into the tube. Thanks so much for mentioning that, as I hadn't yet considered the connections. I should have! I spent years teaching others how to troubleshoot complex laboratory equipment - including the pneumatic systems.

I'm really happy with the new machine. I'm told it's quieter. Certainly the new mask eliminates blowing my partner out of bed with hurricane force wind. Even with the huge air leaks I still had a great AHI.

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Re: Large Leaks???? Airfit P10 & AirSense 10 for her

Post by Slats » Sat Apr 15, 2017 9:16 pm

I too have had the same problem with leakage with the Airsense 10 . I used a Respironics 60 previously with great success and no leaks, After a month of Sleepyhead telling me that I had major leaks ( 30 or more), I went back to the old clunker. Airsense 10 for her is "pretty" , but useless for me.

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Re: Large Leaks???? Airfit P10 & AirSense 10 for her

Post by Slats » Sat Apr 15, 2017 9:20 pm

here is my post from March 2017, on same issue, perhaps some of the responses will help you:
Slats wrote:As a habitual mouth breather, i learnt to tape my mouth and graduated from a full face mask to Resmed p10 , nasal pillows , with great success, all thanks to folks on the message board. Now I have a new resmed air sense 10 for her , with heated tubing.Though my ahi is very low .8,I am leaking terribly each night, and have determined that the humidity is causing the tape to adhere less and that is what is causing the problem. Last night , i replaced the heated hose with a regular hose, but still leaked 50% over redline(according to Sleepyhead.

I need help.

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Re: Large Leaks???? Airfit P10 & AirSense 10 for her

Post by LSAT » Sat Apr 15, 2017 9:33 pm

Slats wrote:I too have had the same problem with leakage with the Airsense 10 . I used a Respironics 60 previously with great success and no leaks, After a month of Sleepyhead telling me that I had major leaks ( 30 or more), I went back to the old clunker. Airsense 10 for her is "pretty" , but useless for me.
I don't see how the machine, using the same pressure as before can be responsible for the leak. Is the actual leak one that you feel and is disturbing your sleep or is it a reported leak on Sleepyhead software? Usually leaks come from an ill fitting mask, a leaking hose or mouth breathing. Respironics may report leaks differently than the ResMed. Can you show some Sleepyhead detail???

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Re: Large Leaks???? Airfit P10 & AirSense 10 for her

Post by Grouch » Sun Apr 16, 2017 8:15 am

Night 2 on the new Resmed AirSense 10 for her - horrible leaks again. Getting better, but still not great.

From Sleepyhead:
Airsense Day 2 Airsense Day 1 Resmed
Average Leak Rate - 19.01 34.35 (4.91)
90% leak rate - 40.80 54.00 (12.00)
% time above LR thresh 36.42 69.8% (2.51)
AHI was .13 0.90 (0.32)

From the Sleep Report reading on the machine itself Leak = 54L/min. However, this value is 28L/min in the MyAir app. Not sure why they aren't the same. Maybe they are different measurements?

Here's the weird part. I can turn on the machine and immediately do a mask fit test and get the green happy face. If I then turn the machine off right away, I get the Mask Seal frowny face. I tried this a number of times and got the same results every time.

My pressure is pretty steady between 13 and 13.25 cm/H2O

I'm a side sleeper if that makes a difference. I didn't sleep well last night and woke up a number of times. Never did I feel like the mask was leaking. No air blowing from random places. I checked the pillow position on the P10 mask and they looked fine. I got up in the middle of the night and tried the mask I've been using the old machine for over a year - the Nuance. Same thing. I could turn the machine on, do a quick mask fit test and get a green icon. Turning the machine off, it would show a red icon for mask seal.

Yesterday I checked and rechecked all the connections. They seem fine. I felt along the heated hose, but couldn't fell any leaks, though there easily could be a very small one. The humidifier seems to be sealing. I get a green happy face on it. However there's no click when I push it into the machine. Don't know if there's supposed to be one. I do get a click on the heated hose.

Slats - I did go back and read the thread you mentioned. Good info there, but I really don't think this is a mouth leak. I'm not a mouth breather. Never have been. And I've never had a leak problem until I started using the new machine 2 days ago.

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Re: Large Leaks???? Airfit P10 & AirSense 10 for her

Post by Grouch » Sun Apr 16, 2017 8:21 am

TASmart wrote:I would make sure the hoses are installed correctly. I think a leak rate that high could be heard.
I'm severely hard of hearing and don't wear my aids when using CPAP, so I might not hear it. However, I can't feel leaking air along the hose.
TASmart wrote: According to my DME another thing to check is to make sure the humidifier is all the way in.
I've tried reseating it 4 or 5 times. It doesn't click into place, but maybe it isn't supposed to. I do get a green smiley on the humidifier in the sleep report.
TASmart wrote:As always its a lot easier to see what's going on with the Sleepyhead output posted.
What part do you need to see? I've already posted this, but could show other info if it would help.

From Sleepyhead:
Airsense Day 2 Airsense Day 1 Resmed
Average Leak Rate - 19.01 34.35 (4.91)
90% leak rate - 40.80 54.00 (12.00)
% time above LR thresh 36.42 69.8% (2.51)
AHI was .13 0.90 (0.32)

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Re: Large Leaks???? Airfit P10 & AirSense 10 for her

Post by Grouch » Sun Apr 16, 2017 8:23 am

SewTired wrote: That said, sometimes people receive hoses that were damaged before they got them, so do a test and check for leaks on that. .
How would I do that? A bit of diluted soap on the outside of the tube to look for bubbles? Or is there a way to do this via the machine?

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Re: Large Leaks???? Airfit P10 & AirSense 10 for her

Post by Pugsy » Sun Apr 16, 2017 8:27 am

Do an awake experiment to see what the graph with the leak line is showing for a baseline pressure.
Wear the mask while awake (reading a book or watching TV) for about 30 minutes and then download the data to SleepyHead and look to see where the leak graph line is running while awake and you know for sure no leaks and no mouth breathing is going on.

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Re: Large Leaks???? Airfit P10 & AirSense 10 for her

Post by edfreeman » Sun Apr 16, 2017 8:27 am

Looks like you've done well in checking all the seal points. One thing I would do since you've had hearing loss is get someone who hasn't to listen around the machine for leaks while you operate it normally. A leak that large can be heard.

One other thing to check: Make sure the machine is set to "nasal pillows" as your mask. I found this on the intentional leak for the P10:

viewtopic/t103392/Acceptable-leak-rate- ... t-P10.html

And looked at this for a general view of FFM intentional leaks:

https://www.continuedcare.com/wp-conten ... -ports.pdf

From that, it appears the P10 has an intentional leak rate that is higher than that of at least the line of masks on that second link. If you're set to FFM on your machine, it's gonna think you're leaking.

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Re: Large Leaks???? Airfit P10 & AirSense 10 for her

Post by Grouch » Sun Apr 16, 2017 9:32 am

Pugsy wrote:Do an awake experiment to see what the graph with the leak line is showing for a baseline pressure.
Wear the mask while awake (reading a book or watching TV) for about 30 minutes and then download the data to SleepyHead and look to see where the leak graph line is running while awake and you know for sure no leaks and no mouth breathing is going on.
Thanks! I'll give that a try. I dug around in my CPAP supplies and found a Quatro full face mask when I was having severe allergies. I may give that a try.

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Re: Large Leaks???? Airfit P10 & AirSense 10 for her

Post by Grouch » Sun Apr 16, 2017 9:41 am

edfreeman wrote:Looks like you've done well in checking all the seal points. One thing I would do since you've had hearing loss is get someone who hasn't to listen around the machine for leaks while you operate it normally. A leak that large can be heard.

One other thing to check: Make sure the machine is set to "nasal pillows" as your mask. I found this on the intentional leak for the P10:

viewtopic/t103392/Acceptable-leak-rate- ... t-P10.html

And looked at this for a general view of FFM intentional leaks:

https://www.continuedcare.com/wp-conten ... -ports.pdf

From that, it appears the P10 has an intentional leak rate that is higher than that of at least the line of masks on that second link. If you're set to FFM on your machine, it's gonna think you're leaking.
Thanks for this. I do have my machine set to pillow, not FFM.

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