First post: mask leaks & sleepyhead data

[chairmango]

Hi all,

I've been reading this forum for months now, and absolutely love this place. I have a question that I am hoping this community can help me with. Before I start, I should mention that my girlfriend even posted on this forum before I did: viewtopic/t63966/Trouble-Sleeping-Next- ... -CPAP.html.

Based on everyone's recommendations here, I uploaded my data using ResScan and Sleepyhead for the first time last night. The data is so interesting, and I wanted some help interpreting it. I use a pressure setting of 12cm, which according to the ResMed Mirage Swift II manual, results in a flow rate of 37 L/min. When I look at the leak data, it's all over the place. My baseline seems to be 0 (which means that my CPAP machine doesn't include regular air flow is a leak), but it can go as high as 50. Does this mean my mask is coming off a lot? My girlfriend has complained about mask leaks waking her up in the past.

A little bit of background on me: I've been using CPAP for the past 3.5 years. I started using it at the end of my senior year and it made such a difference - the ability to stay up past midnight and awake in lecture is quite crucial to being a successful student . I'm 6'0, 200 lbs with a 17' neck, but I'd say I'm pretty fit and slim. From what I'm told, I tend to move a lot when I sleep - I sleep on my side and back. I also use SleepZeo, and I find I have about 12 wake ups per night, which often occur during my REM cycles.

Please let me know if I can provide any more information. Any insights you can glean from the screenshot would be much appreciated!

[jules]

resmed machines report "excess" leak over what is expected not the actual flow rate; respironics machines report the actual flow rate as leak

[Pugsy]

I would think your mask is coming dislodged a bit during those leak spikes. Probably not completely off but maybe out of one nostril a bit. Probably what girlfriend is hearing. Worst seems to last 20 minutes or so. Sometimes very brief spiky leaks. You do spend some time above the 24 L/min line which is where ResMed says therapy and data can be impacted but not a huge amount of time above that line. Apparently the leaks are waking up your girlfriend and not you. Which would normally be the case. If nothing else they are disturbing her sleep.

Leaks are a never ending battle. Otherwise your report looks very good and while not the prettiest of leak line (yes, your baseline will be zero because ResMed reports only excess leak) and does warrant some work...it is far from a complete mess. For the bulk of the night the leak was within acceptable limits with just a few excursions above 24 L/min for up to 20 minutes or so.

[chairmango]

Thanks for the info and encouragement, Jules and Pugsy. I will go ahead and buy myself some lasinoh this evening and get down to business on those leaks!

[robysue]

chairmango,

How old are your nasal pillows? Could be that they need replaced. When my Swift FX pillows start to age, I tend to start getting random leaks, some of which are "bad" and they do seem to be more prone to moving around too.

[Breathe Jimbo]

Leaks up to 27 are within normal limits, according to ResMed. Your numbers rarely reach that level, and then only barely cross it. Sure, your leaks could be better, but I would not worry much about what you are seeing.

[chairmango]

I used Lansinoh (on my nose) last night and my leaks didn't exceed 24 L/min. Wohoo! What a difference that makes.

Robysue - great tip. My pillows are rather old. Probably over a year old. I'll probably just go ahead and buy some new pillows because I don't want to wait for my doctor and DME provider. Is this a decent deal? https://www.cpap.com/productpage/resmed ... ft-II.html

[b360155]

Can be found for slightly less on eBay.

[NateS]

When you say:

Leaks up to 27 are within normal limits, according to ResMed. Your numbers rarely reach that level, and then only barely cross it. Sure, your leaks could be better, but I would not worry much about what you are seeing.

which of the three numbers on Sleepyhead are you referring to? Min Med 95% or Max?

Thanks.

Nate

[Pugsy]

which of the three numbers on Sleepyhead are you referring to? Min Med 95% or Max?

Generally maximum.
ResMed says they can compensate for leaks up to 24 L/min and above that they say the machine may lose ability to score data and effectively deal with any apnea events. Obviously a leak around 27 L/min isn't hugely beyond the 24 L/min line. Now if the leak was say 47 L/min...way too much.

Maximum leaks that go to 24 or above and are short lived probably aren't going to impact things hugely.
If the 95% number is around 24 L/min this means a person spent 95% of the time at or below this number and likely spent more time near that 24 L/min and above than we would want to see. I would be nervous if I consistently saw a 95% number hovering around 24L/min.

If the median average is 24 or higher L/min....huge problem with leaks.

Any leak that disturbs sleep..even if a small leak...needs to be worked on because anything that disturbs sleep can mess with how we feel.

[jedimark]

which of the three numbers on Sleepyhead are you referring to? Min Med 95% or Max?

Generally maximum.
ResMed says they can compensate for leaks up to 24 L/min and above that they say the machine may lose ability to score data and effectively deal with any apnea events. Obviously a leak around 27 L/min isn't hugely beyond the 24 L/min line. Now if the leak was say 47 L/min...way too much.

Maximum leaks that go to 24 or above and are short lived probably aren't going to impact things hugely.
If the 95% number is around 24 L/min this means a person spent 95% of the time at or below this number and likely spent more time near that 24 L/min and above than we would want to see. I would be nervous if I consistently saw a 95% number hovering around 24L/min.

If the median average is 24 or higher L/min....huge problem with leaks.

Any leak that disturbs sleep..even if a small leak...needs to be worked on because anything that disturbs sleep can mess with how we feel.

90%/95% measurements are just "crud filters" to filter out the spikes, giving a cleaner "peak" value. It gives no indication of how long the leak was at that value, just that 90/95% of the leaks were under or at it..

The average (or weighted average) is probably a more important gauge for leaks, as it gives a better picture of where most of the time was spent.. Median comes a close second.. If the average (or median) always comes close to the upper percentile, then it's a sign you've got problems..

Same goes with pressure in APAP mode.. if the average (or median) pressure is closer to the 90%/etc than the minimum, it's a sign the lower pressure range is incorrectly set, and probably a sign the upper pressure is set too low as well.. (I'm not encouraging tinkering, I'm just speaking according to the numbers)