ASV users: is there a "good" leak rate?

[new-to-BiPAP]

I had my first night with a new mask, mask liners and a CPAP pillow and had a horrible night. Much more leaks than with my old mask. So I was wondering if there is a "good" leak rate? "They" keep telling me (DME and sleep tech) that the machine can compensate for small leaks. I think they wake me up and give me a restless night. Is a constant leak better than ups and downs? Is below a certain number considered "good" for an ASV machine? A bit confused and sleep deprived this morning.

ETA: I read somewhere else in this forum that you can swap out masks in the first 30 days. Is there a number of times that you can do that? I swapped out mine once and the sleep tech at the dr's office gave me another Rx for the original mask. Can I swap back to the original mask or not because I have already swapped out masks?

[Denial Dave]

please post your machine type and model and the mask you are using..

With that information, folks can give you a better answer on your leak question

There is a 30 day trial period for masks, some DME's are easier to get them to do it and others are not.

When I asked to swap masks for the 3rd time, my DME balked at doing it, because they felt I have not given the 2nd mask enough time for me to be accustomed to it. After much grumbling, they gave me the 3rd mask. The 3rd mask was the charm for me.

I'm not sure if there is a formal limit on the number of times you can swap a mask.

Hope some of this helps

Dave

[Pugsy]

The mask manufacturers don't have a formal limit on mask swapping during 30 day trial period but often the DMEs make their own in house rules and they can vary widely from abiding by the manufacturer's policy to something a lot more stringent.

Often it is 30 days from the time you started therapy and that isn't what the manufacturer's policy really means. DMEs often limit it so they don't have to do the paperwork involved to get credit from the manufacturer for the tried and failed mask.

Acceptable leak rate depends on the type of machine used (how they report leaks) and the mask's expected vent rate and pressures used.
If using a ResMed machine they report only excess leak so it's pretty easy to figure out if the leaks are excessive or not.
24 L/min is their line in the sand.
Respironics report total leak which includes the vent rate so large leak territory can vary a bit depending on mask, machine and pressures used.

Any leak that wakes a person up is of course unwanted but minor leaks (and on occasion a short lived larger leak) that we can sleep through isn't the end of the world. I sometimes cross over into large leak territory but never for very long nor too far into large leak territory. I sleep right through it though and I don't worry about 10 minutes or so of maybe larger leak because out of 7 or 8 hours of sleep 10 minutes in large leak isn't that big of a deal.

When evaluating leaks I always suggest that people don't go by the numbers alone. Look at the graphs too and if large leaks are seen evaluate just how long they lasted. Sometimes the "numbers" make the leaks look worse than they were.

[JohnBFisher]

Agreed that major leaks cause problems. But so do the famous face fart leaks .. And an ASV unit will leave you crying in an effort to sleep when it start pushing that pressure over about 15cm H2O .. Leaks happen no matter what you try to do. That's why I recommend mask liners for ASV users. It does not eliminate the leaks but it makes them more tolerable.

[Denial Dave]

Higher pressure ASV and Bi-level can be a major pain to get leaks under control.

If it weren't for the occasional face fart awakenings, I'd sleep really awesome.

Mask liners are great!!

http://www.padacheek.com

[new-to-BiPAP]

I'm not even sure if I selected the correct machine to put in my signature. I have the RedMed s9 VPAP Adapt but there is not an 'adapt' option.

Apparently all of my leaks are below that. But they bother me and wake me up. So maybe it's a good leak rate for the machine but not a good leak rate for me? My leak rates were from 1.5 to 9ish so I supposed that is considered "good".

I did use a mask liner last night for the first time. It was a bit easier to tolerate the smaller leaks into my eyes. And it made it more comfortable. I wish I would have tried them on my first mask. The first one was more comfortable (I can't remember the name, it's the one that replaced the ResMed FX I think).

My apnea/hypopnea index was low. But I had probably 10 times more leaks with this mask than the other. Since I still haven't figured out how to do a screen shot to attach stuff (need to ask hubby), does anyone know of or could post their graphics on what a good night of low leaks looks like? I mean, if you have a constant low leak is that better than a leak every few breaths (even if it is small)? Or does it just depend on what bothers you?

[JohnBFisher]

There's a trick to fitting the Quattro FX mask:

http://www.resmed.com/us/assets/documen ... lo_eng.pdf

Essentially it's a balance between too tight (which makes it leak more) and too loose (ditto). Additionally, you need to place the mask onto the bridge of your nose first and "swing" it down onto your face. You will find that with practice you get fewer leaks and it does well. But it takes a lot of practice.

[xdman911]

I too have a leak question:

What is the leak rate of a Respironics Wisp Nasal Mask?

MODS:: My Machine is not showing up? Any reason why? Please PM Me

[Pugsy]

MODS:: My Machine is not showing up? Any reason why? Please PM Me

We don't have any special moderators here but I suspect that the link to your machine choice is broken...there are a few of them that way.
Just manually type in the model name and number (3 digit number on the bottom of the blower) in the comments line.
That's where we put the machines that either aren't sold by cpap.com so no choice for them or the choice is there but they don't show up because the link is broken.

Your machine reports total leak which is excess leak plus the vent rate.
Expected vent/intentional leaks are normally in the paperwork that came with the mask...did you get the paperwork...there is a graph showing the vent rate at whatever pressure you are using.

I will go see if I can find a chart for the Wisp just in case you tossed the paperwork or didn't get it.

[xdman911]

MODS:: My Machine is not showing up? Any reason why? Please PM Me

We don't have any special moderators here but I suspect that the link to your machine choice is broken...there are a few of them that way.
Just manually type in the model name and number (3 digit number on the bottom of the blower) in the comments line.
That's where we put the machines that either aren't sold by cpap.com so no choice for them or the choice is there but they don't show up because the link is broken.

Your machine reports total leak which is excess leak plus the vent rate.
Expected vent/intentional leaks are normally in the paperwork that came with the mask...did you get the paperwork...there is a graph showing the vent rate at whatever pressure you are using.

I will go see if I can find a chart for the Wisp just in case you tossed the paperwork or didn't get it.

I looked through the paperwork but did not see anything relating to leak rates. I searched the internet and could not find anything. DME Supplier says it is a fairly new mask.

[Pugsy]

I looked through the paperwork but did not see anything relating to leak rates. I searched the internet and could not find anything. DME Supplier says it is a fairly new mask.

I found a brochure but nothing that shows vent rate chart.
Maybe one of the other forum members using the Wisp will have theirs handy.
I don't use that mask so I wouldn't have one.
Normally it's in a little small booklet that comes with the mask or a big folded up piece of paper.

[xdman911]

I looked through the paperwork but did not see anything relating to leak rates. I searched the internet and could not find anything. DME Supplier says it is a fairly new mask.

I found a brochure but nothing that shows vent rate chart.
Maybe one of the other forum members using the Wisp will have theirs handy.
I don't use that mask so I wouldn't have one.
Normally it's in a little small booklet that comes with the mask or a big folded up piece of paper.

The booklet has a pressure flow curve chart. Is that it?

[Pugsy]

The booklet has a pressure flow curve chart. Is that it?

Yep.

Will look like this one for the Swift FX...page 12
http://www.resmed.com/us/assets/documen ... er_eng.pdf

[new-to-BiPAP]

There's a trick to fitting the Quattro FX mask:

http://www.resmed.com/us/assets/documen ... lo_eng.pdf

Essentially it's a balance between too tight (which makes it leak more) and too loose (ditto). Additionally, you need to place the mask onto the bridge of your nose first and "swing" it down onto your face. You will find that with practice you get fewer leaks and it does well. But it takes a lot of practice.

I'll try it again tonight and see if it is any better. I printed off the above fitting guide last night and referred to it while putting on the mask. I *think* that I did the nose then chin when putting it on last night but I can't be certain as I was also putting the mask liners on for the first time as well and was having trouble with things. What's strange is that either the DME or the sleep ted (I don't remember which, maybe the sleep tech) said to try it from the chin up which I thought was strange as it was the opposite from what ResMed says. I'll make sure to do it properly tonight.

A quick question about the liners. I have a sample of them and it says on the sheet that came with it that once you have it on you can pull on the liners on the outside of the mask to get any wrinkles out. Now I can't say that I cared about wrinkles but it was tickling my nose so I did do that. Could that have caused the mask to leak more? Should I not mess with the mask once it is on?

[Sir NoddinOff]

It was a bit easier to tolerate the smaller leaks into my eyes. And it made it more comfortable. I wish I would have tried them on my first mask.

Leaks into the eyes are the worst. I have an old piece of worn thick flannel that I fold over three times and place over my eyes. It's about 10x12 inches total before I fold it over. It's also handy for keeping the morning sun out of my eyes. I use my thumb and forefinger to press the flannel into my eye sockets. It does a great jobs keeping air out of my eyes but sometimes it gets dislodged. If anybody has a better solution, I'd love to hear it.