Large Leaks

[AcedDublB]

I am on Auto BiPAP with a DreamStation and relatively high pressures.

I have tried 6-7 masks and can't find anything that doesn't leak.

I use RemZzzs mask liners and a cervical collar.

I am using Amara View and find it comfortable and it never leaks when I am going to sleep but the screen results in the morning are very discouraging.

I go to sleep fairly easily, don't wake up and feel good, very little yawning or tiredness.

I have zero issues with mask or pressures.

6 months on CPAP then Auto BiPAP

Last night is fairly typical:

AHI 10
Usage 8:31 hrs
Mask Fit 40%
CA 0
OA 1
Hypopnea 84
Disconnects 2
Large Leaks 5:09 hours
Large Leak 65%

I just bought a new Quattro Air FFM which was very comfortable and light but leaked even before I got to sleep. $115 wasted.

DME gave me multiple masks to try with no success and The Amara View is the best but obviously not working well once I go to sleep.

I sleep mostly on my back and try not to move.

Apart from gluing a mask to my face what can I do to get a better fit when I don't know what the issue is.

Getting to be very frustrating so any advice is welcomed.

[lilly747]

Yes you do have some problems. Leaks look bad and so does your AHI. I would suggest you take some screenshots of your data and pot it.

Here is how to do it and get your manual for your machine.

This will help...step by step To Organize Graphs, To Take Sceen Shots, and Post to Imgur and post them here to Cpaptalk:

https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/resources/sleepy ... screenshot
https://sleep.tnet.com/reference/tips/imgur

When posting Daily Detailed Data, the most important things to include in the screenshot are:

1) The Left Sidebar with all the summary data.
(Turn off the Pie Chart so that we can see the statistical data for the leak rate and the pressure. .....To turn the Pie Chart off: Click on File- Preferences- Appearance then uncheck Show event breakdown pie chart. ALSO: Turn off the right sidebar. To do this: Click on view then uncheck the Right sidebar. )
2) The event table at the top if the graphs.
3) The flow rate graph
4) The pressure graph when you use Auto
5) The leak graph
6) Flow Limitation graph - Myself, I like to see this one. But don't squish the graphs so much that the scale on the left of the graph is useless....

Clinician. manual
keep following the links and then Scroll down to Section Three your machine is there just follow instructions and they will email it to you.

https://sleep.tnet.com/reference/docs

Someone else will have to chime in about your leaks..........WHAT is your pressure/s. You say they are high??? What is HIGH??

[grayghost4]

I use an Amara view mask and my pressure ranges up to 20 .... and have few leaks.
that mask is tricky to adjust the straps

Here is a discussion of the mask:

viewtopic.php?f=1&t=111550&view=unread#unread

[AcedDublB]

Thank you, I just loaded SD data into the new Sleepyhead updated for the DreamStation.

The AHI numbers are shockingly different than what the DreamStation screen shows me.

My AHI on Sleepyhead is 0.67 while the DreamStation says 19, the same situation on adjacent days.

How can this be.

Thank you for the instructions, Sleepyhead data will be posted shortly.

[AcedDublB]

[AcedDublB]

Sure hope someone can explain the huge discrepancy in the AHI numbers between DreamStation and Sleepyhead.

I will download same info to Encore Pro and see what happens.\

[AcedDublB]

This is the same day info as Sleepyhead image above.

Note huge difference in AHI number.

[lilly747]

Sure hope someone can explain the huge discrepancy in the AHI numbers between DreamStation and Sleepyhead.

I will download same info to Encore Pro and see what happens.\

BUMP

EDIT other than your leaks being so bad you can not trust your data, I don't know why the data is different.

[cathyf]

Sure hope someone can explain the huge discrepancy in the AHI numbers between DreamStation and Sleepyhead.

This is ONLY a guess, but perhaps the machine records hypopneas differently in the data files when there is large leak going on? Just from what I know, hypopneas are somewhat harder for the machine to detect, and it's got to be pretty tricky when the mask is shooting jets of air out the edges! If you notice, both softwares are telling you that you are having lots of hypopneas, but they agree that your not having many of the other events. If you look at the sleepyhead graphs, they show 3 hypopneas during non-leak periods, and only one in large leak. You should zoom in right around midnight and see if there is a break in the large leak right where the hypopnea was measured. That would make we awfully suspicious that the machine is not logging hypops during large leak out to the breath-by-breath data, but was counting them in the summary statistics.

Another thought is that you may have found a bug in sleepyhead, as the dreamstation is a very recent addition to the software, and so we don't have a gazillion nights of history to say that it always works in every situation. For the same reasons, it could be that you've found a bug in Encore.

I am a new amara user, and I think that a weakness of the mask is that it only comes in one size in the height/width directions -- the 3 sizes of the cushion are only in the depth of the mask, to adjust for how far your nose sticks out from your face. The mask is definitely too big for me, and the slightest up/down or left/right movement makes it leak like crazy. Especially including the motion of closing my mouth and swallowing -- I can't keep it from leaking if my mouth is closed.

Does the dreamstation have a "mask fit" cycle? This is where the machine takes the pressure all the way up to the highest level, so you can see if you are blowing the mask off at your "asleep pressures" even though it is fine at your awake-level pressures.

My husband calls it the trombone sound. So maybe we should just sign up for a brass band?

[palerider]

Sure hope someone can explain the huge discrepancy in the AHI numbers between DreamStation and Sleepyhead.

This is ONLY a guess, but perhaps the machine records hypopneas differently in the data files when there is large leak going on?

sleepyhead doesn't interpret the flow and assign its own flags, it reports the flags the machine sets.

that said, there's bugs in sleepyhead, and he's using an old beta.

[palerider]

Sure hope someone can explain the huge discrepancy in the AHI numbers between DreamStation and Sleepyhead.

I will download same info to Encore Pro and see what happens.\

you need to get the newest beta, there's still some sizable bugs in the 1.0 beta.

also, please use the f12 button, or in the menu view/take screenshot so that part of the screen isn't covered by the windows menu.

[AcedDublB]

Thank you, I will pursue the most recent SH and also get Encore Pro 2 going.

[cathyf]

Sure hope someone can explain the huge discrepancy in the AHI numbers between DreamStation and Sleepyhead.

This is ONLY a guess, but perhaps the machine records hypopneas differently in the data files when there is large leak going on?

sleepyhead doesn't interpret the flow and assign its own flags, it reports the flags the machine sets.

Right -- what I was trying to say is that the machines themselves appear to be storing some particular pieces of data in multiple places, and that there may be a bug in the machine's software or even the underlying algorithm where the different places that it's storing data are not consistent. What sleepyhead is reporting is 4 hypopneas, and when you look at the graphs, you can see 4 hypopneas, and can easily see the exact time stamp for each one. But encore says that there were 170 hypopneas, while giving no data as to what times those 170 hypopneas happened. What I'm wondering is if there is a "flag this event" function and a separate "log this event" function. The machine thinks it sees a hypopnea, and calls the "flag this event" function which increments a counter, and that counter goes up to 170 during the night. Then the next function called is the "log this event" function, which writes details about the event to the various files, and increments a different hypopnea counter kept in a different part of the software that ends up in a different file on the SD card. But suppose at the top of the "log this event" function there's an "if" that checks to see if the machine is in large leak, and if it does then it returns without logging it. Then encore looks at the one counter and sees 170, while sleepyhead looks at the other one and sees 4. Having two different counters like this is really bad programming practice, but it happens all the time, especially to novice programmers. (In this case, an "experienced" programmer would be one who's screwed himself/herself over this way enough times to stop doing it! LOL)

Ok, this is off topic, but I think that this is why the CPAP manufacturers should charge MORE for the bricks than they charge for full-data machines. You know that when they do the R&D and engineering of these machines, they create the full-data machines FIRST. They have to, as the data would be absolutely necessary to debug the software. Then, after they create the full version, they modify it to create the brain-dead version. It looks like the hardware is exactly the same, but they just go in and rip out the data logging code. But it's still a change to the code, and so it requires a full, rigorous QA cycle of its own. Which ain't free! This being a piece of software that is keeping people alive, it had better be a full and robust QA. This having one counter being kept in two places is the sort of thing that you would have to do in the process of lobotomizing the software to engineer the brick. So having a brick in the product line costs them money by making them develop software that they wouldn't otherwise have to develop, and it also lowers the quality of the software because of having to do cheesy stuff to keep everything working in both a brick and full-data context. It's just insane -- these companies are spending real money to produce an inferior product!

If I were one of these companies, I would say to the DMEs "Ok, here's the full-data machine, it costs $X. If you want a machine without full data, it will be a special order, and it will cost $1,000 MORE."

[AcedDublB]

Here is the Encore Pro 2 Weekly Summary Link.

Confirms that Sleepyhead probably has an issue reading DreamStation Auto BiPAP data but I am certainly not qualified in that area.



I will post additional Encore data later.

[AcedDublB]

I had the beta 1 version.

I uninstalled that and downloaded the beta 2 version and same erroneous result based upon comparison to DreamStation/DreamMapper and Encore Pro 2.

So back to the difficult solution to determining how to stop Large Leaks which I never notice and after weeks of trying various masks.