Understanding leaks with Encore

[Paul Van Dyk]

Hi. What do I need to know about leaks when reading my Encore data? I don't really know what I'm looking at so what data do I look at and monitor? Thanks.

[Pugsy]

Encore Pro I assume? Encore Pro software default for leak is unintentional or excess leak.
Look for level or stable leak line without large and prolonged spikes. Eyeball what the leak line starts out at (not always zero because it depends on pressure used) and use that line or number as a baseline to gauge leaks. When using unintentional leak reporting I would try to stay below 65 to 70 L/min and the machine should be able to compensate for leak well enough and not impact therapy. We are never told at what number they define "Large Leak" but I have seen it flagged at 90 L/min and not flagged at 80 L/min so that gives you sort of an idea.

If you change the reporting default to total leak then your reports will show a higher leak because the vent rate is included. So main thing again..eyeball starting line and use it as a guide line.

If any leaks wake you up no matter how small the report might show them to be....they are unwanted because anything that wakes you up is unwanted.

A few leak spikes and a not so pretty leak line is not a big deal if you sleep well and don't have a large amount of time with a Large leak.

[Paul Van Dyk]

Yes, I have Encore Pro 2.4. I should leave it on unintentional and not change it to total, right?

So this was a bad night for me then?

[Pugsy]

From hour 1 to roughly a little past hour 3 the leak was horrible. So horrible for 2 hours out of 7.

Rest of the time it was near perfect. It doesn't matter which you use (Unintentional or Total leak) as long as you know what you are seeing. I personally prefer Unintentional because it is easier to see leak spikes on the baseline.
Your baseline with your mask at your pressure is going to be around 15 L/min (give or take a bit as we can't see that close)

[Paul Van Dyk]

How bout this night?

[Pugsy]

Technically much less time in large leak. 16 minutes instead of 2 hours with the other report.
Respironics says that they can compensate up to the "Large Leak" flag which on this Unintentional leak report seems to be around 80 L/min. So while not pretty, overall most of the night the therapy was probably adequate. I would probably accept the data as being overall valid. During large leaks, that are prolonged, the sensors may not score events and give the impression that nothing happened (as in hyponeas or apneas) when in fact all sorts of bad things can happen and you not see them.

So the 2 hour large prolonged leaks..would likely seriously impact therapy and data but these 2 short large leaks won't severely impact therapy (at least on paper).

If the leaks disturb your sleep (even if they are just ugly and not large leaks) they will impact how you feel though because anything that messes with sleep can potentially really mess with how you feel. Even a leak line with minimal leak spikes is unwanted if you wake up 20 times fiddling with minor leaks.

[Paul Van Dyk]

Thanks for the great info!

How about this night??