Yet another leak question

[Pugsy]

So, Is the large leak line on the top of the sleepyhead leak graph and the bottom line the one I should be comparing to it?

You have a Respironics machine and are seeing dual leak lines.
Top line is the total leak line (mask vent rate plus excess leak) and the bottom line is excess leak only.
We don't have a set value to keep an eye on when looking at excess leak only line but we do have a value for the top line which is total leak....keep that line under 80 to 90 L/min and your leak won't be a problem.
If you get into the 100 L/min range the machine can't work properly....it won't/can't sense events properly and it won't respond properly.
Mask vent rates will vary with type of mask used and the pressures used...more pressure the greater the vent rate.
If you are using APAP varying pressures your leak line will vary and that is entirely normal.
Full face masks have a higher vent rate than nasal pillow masks even at the same pressure.
If you look in your mask paperwork there should be a graph that shows the intentional leak/vent rate for your mask ....just look for your pressure on the graph. If using varying pressures it can't be exact but you can use the average to get you close. It doesn't have to perfect. There's always a little plus or minus variation anyway.

[birdygirl38]

So i L/min - liters per minute? And does the leak graph show L/min? None of my graphs go over 35 so is that good?
I seem to be having so few problems adjusting to CPAP, occasionally I wake up and take of the mask but that tends to happen when I am congested as I have a nasal mask (not pillows).
My AHI has never been higher than 6 and most of the time is 3 or lower. I am feeling so much more alert, I knew I was tired before CPAP but I am just shocked at how little I was functioning like I used to.
I must be an easy success story.
Thanks for the help in understanding the leak information.

[Pugsy]

So i L/min - liters per minute? And does the leak graph show L/min? None of my graphs go over 35 so is that good?

Respironics machines...L/min ..yes liters per minute and that is what the graphs show and if you never reach 35 L/min that is excellent when reporting total leak. Probably indicates minimal to none leak above vent rate most of the time.
Sounds like you are one of the lucky ones who adjusted fairly easily and quickly and even lucky enough to feel better fairly quickly.

[birdygirl38]

Thanks Pugsy this clears it up. My total leak line has never gone above 40l/m. So I must have a good fit. I did try a pad a cheek mask liner and it seemed to make me feel more claustrophobic though it did blunt the Darth Vader effect I hear as I breathe. I had trouble sleeping when my husband was snoring and sometimes with my mask it takes a long time to get to get to sleep. I hear myself breathing and not matching when the machine wants me to breathe. I feel like it is forcing me to breathe differently even when awake - I don't like not being in control. I started sleeping with soft foam ear plugs and that seems to help. Any comments on ear plugs - are they a bad thing?

[Pugsy]

I started sleeping with soft foam ear plugs and that seems to help. Any comments on ear plugs - are they a bad thing?

If they help you sleep then I would say go for it. I think there are a lot of forum members here who use some sort of ear plugs.
I don't know of any drawbacks unless it might relate to wax formation in the ear canal. Even that is easily controlled though.

[Always tired]

If you look in your mask paperwork there should be a graph that shows the intentional leak/vent rate for your mask ....just look for your pressure on the graph. If using varying pressures it can't be exact but you can use the average to get you close. It doesn't have to perfect. There's always a little plus or minus variation anyway.

Could someone post the intentional leak/vent rate for the Mirage Quattro? I have never seen any graphs for my Mirage or my True Blue nasal either. Now I see why on nights that I change masks from the Quattro about 1:00 A.M. to the True Blue, the Total leak rate is so much different on SH in the morning. So much to learn.
A T

[cosmo]

Mirage Quattro


Found it on page 7 of the user guide.

http://www.resmed.com/us/products/mirag ... c=patients#

User Guide (1MB)

[Pugsy]

Link to a quick reference guide for vent rates for all ResMed masks.
http://www.resmed.com/us/assets/documen ... sa_eng.pdf
Not in minute detail but enough detail to get you in the ball park.

[Always tired]

Thanks Pugsy and Cosmo
A T

[Chronicle Cat]

How to stop a leak? Stop looking at your data every day!!! It's how you feel that's important. I ignore the data and just sleep. After 3 years on cpap I've never felt better and I only look at my data once a year during my doctor's check up.

[Becky at RemZzzs]

Because of mouth breathing with my nasal mask with chin strap I tried out a FF Mirage Quattro last night and noticed on SH this morning that my leak rate was way above normal. Leaks did not significantly bother my sleep and AhI was about 1.5.
Here is the question-- If your AHI is good, but you have a lot of leaks, and it does not significantly bother your sleep does it really matter from a medical viewpoint?

I imagine this question has probably been asked 1000 times before, but searching under "leak" reveals a ton.

Thanks in advance
A T

Hi, Always Tired.

I work for the company that makes RemZzzs CPAP Mask Liners. I am sorry that you are struggling with leaks. If you would like, I would love to share a complimentary samples of our liners with you. I honestly feel that our liners could really help cut down your leak rate. If you are interested, please feel free to PM me.
Thanks.

Becky Bennett

[Always tired]

Pugsy and others,
Sorry it took so long to respond but I wanted to try and figure out a lot of this on my own and have a graph that represents material we are talking about.
In the SH chart shown I used my Mirage Quattro until about 3:00 and then switched to the True Blue nasal mask. My APAP setting is 5-8 and the intentional vent rate for the Mirage is about 24-32 for 5-8 pressures.
The intentional leak or vent rate for the True Blue nasal mask is 18-24 for a 5-8 pressure. Since Total leak is vent + mouth or mask leak the Mirage Total numbers are much higher that the True Blue. I think this is correct so far--please correct me if it is not.
So in my original post I was looking at Total Leak for the Mirage as opposed to Total for my True Blue--Apples and oranges.
A couple of conclusions and a question.
In a nearly perfect world with a mask leak of 5, I would want my Mirage total leak to be about 30-37, depending on pressure and for the True Blue I would want the total to be about 23-29?
OR just ignore total and keep the leaks,lower line, to below 5 if possible?

What is the number for Average Leak in the chart above? Pugsy you asked this question earlier and I did not know where to look.

Last question...and perhaps I'm misreading the PR leak chart. Notice leaks about 5:00 A.M. How can Total Leak be below 10 at pressure of 5 when the Intentional vent for 5 is 18 for the True Blue mask?

For what it's worth...I'm keeping notes in SH and am finding out that even with low AHI numbers, prolonged leaks above 5 usually mean a crappy day. Perhaps the leaks are fracturing my sleep and I am not aware?

[Pugsy]

What is the number for Average Leak in the chart above? Pugsy you asked this question earlier and I did not know where to look.

Look at the numbers under the pie chart on the left. Median column..that is median leak average.

Total leak numbers that you will see don't always match up exactly with what the vent charts might show. In little bitty letters in the mask literature there is a + or - 5 or 6 L/min for all masks. My mask at 12 cm pressure shows a 37 L/min vent rate and it is rare that I ever get above 30 L/min on my reports..sometimes barely above 25. It's a ball park number to go by and not always exactly matching.

Perhaps the leaks are fracturing my sleep and I am not aware?

It's very possible that leaks are disturbing sleep at some low level that you don't remember. Might be that one mask is more comfortable than another one and you just sleep a little better.

[cosmo]

Here is what mine looks like for a comparison. But I'm using nasal pillows.

[Always tired]

Here is what mine looks like for a comparison. But I'm using nasal pillows.

Cosmo,
Those leak numbers (lower graph) look fantastic, are you like that every night? How do you feel in the morning?
A T