getting rid of leaks with a full face mask

Wulfman... wrote:If a range of pressures (some of the technology from this century) works.......then why not just leave it "WIDE open"?
Answer: Not everyone has the same breathing characteristics when they sleep.

no, that's not the answer.
the answer is "because the factory low pressure setting is appropriate for very few people." it's better to set the minimum pressure at a point where it cuts off most of the events, look at the chart, and say "well, when pressure gets below 9, you have events, let's set the minimum pressure a little above 9, and see how things go". it IS more complicated than saying "just set the pressure to straight 10"

think of it like being on the highway, your car CAN go between say 0 and 100mph. but it's NOT good for you to use all those speeds in highway traffic... it'll cause more problems. better to let your speeds vary with the needs of the situation, go too slow, and you'll garner fingers, and horn honks, and maybe an accident as someone swerves around you or runs into you.

why not use straight pressure for everybody, as you're quick to suggest?
answer: because peoples pressure needs change during the night, based on sleep phases, and position, and other variables.

I finally found the night with the Amara View to show what I mean about the baseline leak line...I don't have a beard at least not yet but with those damn menopausal hairs I might end up with one.
And I know for sure that there wasn't any excess leak to be showing.
I haven't had time yet to do a quick trial with the Amara View at the correct mask setting to see if it changes that baseline but I will try to do that tonight if I don't forget.

My baseline isn't as great as yours but my starting pressure is lower so that could be part of the difference.
Just look mainly at the first part of the night where no leaks were happening...I was awake and I know that the mask wasn't leaking. Disregard the later in the night...those were probably mask movement leaks because I did wake up a few times with the mask having moved and it was leaking.
Normally my baseline when using my usual nasal pillow mask is right at 0.0. I will let you know what happens with the baseline with correct mask choice. If it is unchanged then perhaps this is just something inherent in this particular mask and I don't know that I would worry about the leak numbers until they got a little higher.

Where in Missouri are you located? I am in Missouri also...down about an hour east of Joplin. We don't hunt though...I feed all the critters instead of eating them.

palerider wrote:

Wulfman... wrote:If a range of pressures (some of the technology from this century) works.......then why not just leave it "WIDE open"?
Answer: Not everyone has the same breathing characteristics when they sleep.

no, that's not the answer.
the answer is "because the factory low pressure setting is appropriate for very few people." it's better to set the minimum pressure at a point where it cuts off most of the events, look at the chart, and say "well, when pressure gets below 9, you have events, let's set the minimum pressure a little above 9, and see how things go". it IS more complicated than saying "just set the pressure to straight 10"

think of it like being on the highway, your car CAN go between say 0 and 100mph. but it's NOT good for you to use all those speeds in highway traffic... it'll cause more problems. better to let your speeds vary with the needs of the situation, go too slow, and you'll garner fingers, and horn honks, and maybe an accident as someone swerves around you or runs into you.

why not use straight pressure for everybody, as you're quick to suggest?
answer: because SOME peoples' pressure needs change during the night, based on sleep phases, and position, and other variables.

Injecting the word "SOME" in there.

I KNOW where the minimum pressure should be set. (Typically where a single-pressure setting should be.)
But shouldn't "the technology from this century" KNOW what the users need? (he asked facetiously)

From seeing the various reports from many folks over the years, I've become even more cynical about the use of APAPs and ranges of pressures. They were not originally designed or intended for all-night, therapeutic use.......but mainly as a way for clinicians to come up with pressures for folks who had problems with in-lab sleep studies and titrations......."Auto-titrating" as opposed to "Auto-adjusting".
From what I've seen, the percentage of folks who they work (properly) for is fairly small. And create about as many problems for those who they don't.

Please note that I'm not including Bi-level or ASV devices in this........just APAPs.


Den

.

Pugsy wrote:I finally found the night with the Amara View to show what I mean about the baseline leak line...I don't have a beard at least not yet but with those damn menopausal hairs I might end up with one.
And I know for sure that there wasn't any excess leak to be showing.
I haven't had time yet to do a quick trial with the Amara View at the correct mask setting to see if it changes that baseline but I will try to do that tonight if I don't forget.

My baseline isn't as great as yours but my starting pressure is lower so that could be part of the difference.
Just look mainly at the first part of the night where no leaks were happening...I was awake and I know that the mask wasn't leaking. Disregard the later in the night...those were probably mask movement leaks because I did wake up a few times with the mask having moved and it was leaking.
Normally my baseline when using my usual nasal pillow mask is right at 0.0. I will let you know what happens with the baseline with correct mask choice. If it is unchanged then perhaps this is just something inherent in this particular mask and I don't know that I would worry about the leak numbers until they got a little higher.

Where in Missouri are you located? I am in Missouri also...down about an hour east of Joplin. We don't hunt though...I feed all the critters instead of eating them.

ok i see what your saying. thank you for taking the time to look into that for me. im from around the belton area,just south of kc 20 miles.

well, i shaved my beard last night. looks as if that was the issue. id assume this would be a acceptable leak rate if the resmed can adjust to 24l/m. i was well under that all night.

Well....crap.
I wore the Amara View last night with the correct mask setting....all night but some dumb ass left her SD card in the computer and that means she gets no detailed graphs for last night.
Normally I would shrug my shoulders as I don't really need the detailed graphs but last night was kinda important. Can't believe I forgot to put the SD card back in the S9.

I will do some awake time with SD card in the machine and using the mask later today and get that leak line graph. I don't want to wear the Amara View all night again tonight. It's an okay mask for me to use in a dire emergency but it isn't without some annoyances and I just want to use my nothing mask.

Crap...the one time I really, really wanted the detailed data.

Pugsy wrote:Well....crap.
I wore the Amara View last night with the correct mask setting....all night but some dumb ass left her SD card in the computer and that means she gets no detailed graphs for last night.
Normally I would shrug my shoulders as I don't really need the detailed graphs but last night was kinda important. Can't believe I forgot to put the SD card back in the S9.

I will do some awake time with SD card in the machine and using the mask later today and get that leak line graph. I don't want to wear the Amara View all night again tonight. It's an okay mask for me to use in a dire emergency but it isn't without some annoyances and I just want to use my nothing mask.

Crap...the one time I really, really wanted the detailed data.

oh no!! sounds like something i would do! i hope that mask didn't bother you to much, i'd hate for you to have had to deal with a bothersome mask on account of tryin to help me figure this out!! anyway's, thank you again for your help. have a great new year's day!! thanks again!

Well...I have no one to blame but myself.
I will test my theory later today while awake.
I told my husband what I did...he's still laughing at me.
He also reported...more mask vent noise than usual and cold air blowing on him when he used to not have that happen with my other mask. My normal mask is the ResMed AirFit P10 nasal pillow mask...it's essentially silent in terms of mask vent noise and the vented air is so diffused that it can't be felt at all beyond one inch from the vent holes.

I will do the awake testing because I am really curious about that baseline leak thing and when I am curious I won't stop till I scratch that curiosity itch until it is sated.

I will report later once I get that little chore done. All I need is 10 or 15 minutes of detailed graph to see what I need to see.

Okay...I got a few minutes with the Amara View and the correct full face mask setting.
The baseline leak still is elevated a bit.

Here's what it looks like with full face mask selected


and here is the old one with nasal pillow mask selected


Both baseline numbers seem to be around 3 to 5 L/min and that's with pressures of 6 EPAP and 9 IPAP on the today's short test so I wouldn't be surprised to see the baseline be a bit higher at higher pressures.

I don't know how conclusive this is but it might mean that with this particular mask the large leak line might really be slightly higher than 24 L/min so the % of time in large leak might not be quite as much as initially thought.
Also bear in mind that even if the AHI is not accurate during the time of big leak that it doesn't mean that the other part of the night the AHI is suspect. The suspect AHI only relates to the time in big leak and if you only spend 30 minutes in big leak out of 8 hours of sleep it isn't going to impact the overall AHI that much at all.
At this point though...if someone is sleeping well and leaks aren't waking them up and they are feeling decently I don't know that I would worry so much about 5 to 8 % of the time in large leak especially with this particular mask. Heck, I don't even worry about it with my nasal pillow mask because I know that trying to achieve perfection often causes me more issues than it fixes.
My sleep quality is fragile enough from other issues so I don't want to add more potential for sleep disturbance when trying to fix a short lived leak in large leak territory that I sleep right through anyway.
I sometimes get near perfection now anyway and the times I don't I just don't worry about unless I start seeing a consistent pattern of large leak. I could get perfection all the time if I wanted to go to extraordinary measures but I know from my own past experience that those measures come with their own baggage that can affect my sleep quality. Chin straps slide around and are annoying and tend to wake me often...taping is less annoying but again it can be annoying when/if it gets loose and in general its annoying to have to do and sometimes it did wake me up....and those measures just affect mouth leaks and do nothing for mask movement leaks which are going to happen from time to time anyway. I don't always have mouth leaks and I don't always have mask movement leaks that venture into large leak territory so I choose to accept less than "perfection" because I am sleeping decently and more importantly feeling decently.

It's up to each cpap user to determine what makes them happy and what they will maybe accept in terms of less than perfection. If it bugs someone a lot to not see perfection and let a little large leak slide..that's their choice but perfect numbers don't guarantee squat in terms of sleep quality and how they feel each day.

I do know that early in my therapy I was a lot more anal about such things as a little bit of less than perfect but I long ago learned that while the perfect numbers are nice to see that they don't mean much if I feel like crap from fiddling with something all night long.

Also I tend to think that the ResMed large leak line in the sand is a bit on the conservative side. I often will see large leak flags with my S9 but I never had them with my Respironics machine which has a little more generous leak allowance. That's why I tend to use the 30 to 35 L/min leak range for ResMed reporting as my own spot where I might start worrying a bit should I see much time spent in that area or above.
Brief episodes won't hurt anything and prolonged episodes aren't the end of the world unless someone starts seeing them often and they are extremely prolonged....and I don't give any single digit % of time in large leak more than a secondary glance.

But that's me and what I am comfortable accepting...and each person has to come up with their own "acceptable". Just bear in mind that ResMed won't give you a Mr Frowny face for leak management until you hit 30% or more of the time in large leak territory and it takes a lot of big leak to get Mr Frowny.

Pugsy wrote:Okay...I got a few minutes with the Amara View and the correct full face mask setting.
The baseline leak still is elevated a bit.

Here's what it looks like with full face mask selected


and here is the old one with nasal pillow mask selected


Both baseline numbers seem to be around 3 to 5 L/min and that's with pressures of 6 EPAP and 9 IPAP on the today's short test so I wouldn't be surprised to see the baseline be a bit higher at higher pressures.

I don't know how conclusive this is but it might mean that with this particular mask the large leak line might really be slightly higher than 24 L/min so the % of time in large leak might not be quite as much as initially thought.
Also bear in mind that even if the AHI is not accurate during the time of big leak that it doesn't mean that the other part of the night the AHI is suspect. The suspect AHI only relates to the time in big leak and if you only spend 30 minutes in big leak out of 8 hours of sleep it isn't going to impact the overall AHI that much at all.
At this point though...if someone is sleeping well and leaks aren't waking them up and they are feeling decently I don't know that I would worry so much about 5 to 8 % of the time in large leak especially with this particular mask. Heck, I don't even worry about it with my nasal pillow mask because I know that trying to achieve perfection often causes me more issues than it fixes.
My sleep quality is fragile enough from other issues so I don't want to add more potential for sleep disturbance when trying to fix a short lived leak in large leak territory that I sleep right through anyway.
I sometimes get near perfection now anyway and the times I don't I just don't worry about unless I start seeing a consistent pattern of large leak. I could get perfection all the time if I wanted to go to extraordinary measures but I know from my own past experience that those measures come with their own baggage that can affect my sleep quality. Chin straps slide around and are annoying and tend to wake me often...taping is less annoying but again it can be annoying when/if it gets loose and in general its annoying to have to do and sometimes it did wake me up....and those measures just affect mouth leaks and do nothing for mask movement leaks which are going to happen from time to time anyway. I don't always have mouth leaks and I don't always have mask movement leaks that venture into large leak territory so I choose to accept less than "perfection" because I am sleeping decently and more importantly feeling decently.

It's up to each cpap user to determine what makes them happy and what they will maybe accept in terms of less than perfection. If it bugs someone a lot to not see perfection and let a little large leak slide..that's their choice but perfect numbers don't guarantee squat in terms of sleep quality and how they feel each day.

I do know that early in my therapy I was a lot more anal about such things as a little bit of less than perfect but I long ago learned that while the perfect numbers are nice to see that they don't mean much if I feel like crap from fiddling with something all night long.

Also I tend to think that the ResMed large leak line in the sand is a bit on the conservative side. I often will see large leak flags with my S9 but I never had them with my Respironics machine which has a little more generous leak allowance. That's why I tend to use the 30 to 35 L/min leak range for ResMed reporting as my own spot where I might start worrying a bit should I see much time spent in that area or above.
Brief episodes won't hurt anything and prolonged episodes aren't the end of the world unless someone starts seeing them often and they are extremely prolonged....and I don't give any single digit % of time in large leak more than a secondary glance.

But that's me and what I am comfortable accepting...and each person has to come up with their own "acceptable". Just bear in mind that ResMed won't give you a Mr Frowny face for leak management until you hit 30% or more of the time in large leak territory and it takes a lot of big leak to get Mr Frowny.

ok. thanks for taking the time to do that. i guess that mask just may show a bit more leak.

Those before and after beard shots are pretty impressive, jt1.
Maybe you should post them back to back in another thread for others with beards to have a look. It seems to me there have been a few bearded people here struggling with leaks, but discounted their beards because they couldn't feel any leakage around them.

Jay Aitchsee wrote:Those before and after beard shots are pretty impressive, jt1.
Maybe you should post them back to back in another thread for others with beards to have a look. It seems to me there have been a few bearded people here struggling with leaks, but discounted their beards because they couldn't feel any leakage around them.

sure thing... i'll start a new thread so others can see.