leak rate -- Respironics vs. Resmed

[lindsayschach]

I got a new Resmed CPAP a few months ago. I've had a hell of a time with leaking since then. I didn't have that problem with the Respironics. I tape my mouth and use a nasal mask.

I decided to do an experiment and go back to my Respironics with the same mask and see how much leaking there was. The Respironics displays "Large Leak" in %. For the past two nights it has been 0%. OTOH, with the Resmed device I was seeing leak rates of 30 - 50%, according to sleepyhead.

What's up with this? Does anybody have any wisdom to impart? I don't have another SD card I can put in the Respironics, so I only have sleepyhead data for the Resmed. Do I have a to get another SD card?

Thanks,

Lindsay

[palerider]

I got a new Resmed CPAP a few months ago. I've had a hell of a time with leaking since then. I didn't have that problem with the Respironics. I tape my mouth and use a nasal mask.

I decided to do an experiment and go back to my Respironics with the same mask and see how much leaking there was. The Respironics displays "Large Leak" in %. For the past two nights it has been 0%. OTOH, with the Resmed device I was seeing leak rates of 30 - 50%, according to sleepyhead.

What's up with this? Does anybody have any wisdom to impart? I don't have another SD card I can put in the Respironics, so I only have sleepyhead data for the Resmed. Do I have a to get another SD card?

Thanks,

Lindsay

First, you need to figure out what you're talking about, or at least, *I* need to figure out what you're talking about, in order to offer anything other than a wild guess.

Sleepyhead doesn't report leaks in percentage, it reports leaks in liters per minute. It does report "time over leak redline (24lpm) in percentages.

Respironics "large leaks" are, given that it's a different manufacturer, and they do things completely different.... they're different.

Post a representative screenshot from Sleepyhead for each machine.

[Pugsy]

Exactly which model ResMed machine did you get?
You are showing the AirStart 10 CPAP in your profile. Is that what is on the front of the machine?

Resmed has a much more conservative line in the sand for large leak territory than the Respironics machine.
I never got a large leak flag of any kind when I was using the Respironics machines but it's rare that I don't hit large leak territory at least briefly with the ResMed machine.

Post an image of the detailed report for a night from your ResMed machine.

[greatunclebill]

you can use any sd card. they are sold almost everywhere.

[lindsayschach]

Pugsy, first of all, my version of sleepyhead does post a leak %. It's in the list on the upper left.

Good to know about the differences in leak reporting, pugsy.

Yes, it is an AirSense 10 Autoset.

[Pugsy]

The time over red line statistic in percent is a SleepyHead calculation. If you were to use ResScan you wouldn't have that particular statistic given to you.
ResMed machines actually post excess only leak and it is indeed L/min. The red line threshold that ResMed uses for the beginning of large leak territory is 24 L/min.

Respironics doesn't really have a set red line threshold because large leak territory red line actually varies a bit with the mask used and the pressure used. It's usually somewhere up around 80 to 90 L/min when reporting total leak.

In terms of leak reporting...there's total leak which includes the mask's expected vent/intentional leak rate plus any excess leak.
and there's excess only leak reporting.
Respironics report total leak and ResMed reports excess leak only.

I would need to see the Respironics leak graph but I suspect that if this is a typical ResMed night for you then on a Respironics machine you were likely getting a leak line up fairly close to large leak territory but you just never went over.
Respironics has a very generous red line threshold and ResMed has an ultra conservative red line threshold.
Different brands and different thresholds for the beginning of large leak territory.

I think you can just take your existing SD card and stick it in your Respironics machine and let it write your data to that SD card and then run it through SleepyHead....then just put it back in the AirSense 10 machine....it won't care if the Respironics P series file folder is on that SD card. I just did this very same step the other day and my AirSense 10 machine didn't squawk and didn't erase the P Series folder either. In fact I even have another folder on that SD card that I can't seem to remove and have even named it "can't remove this folder" and the AirSense 10 machine doesn't care.
Now if we were talking about the ResMed S9 machine...it would care and wouldn't let us do that.

All that said...your mask is leaking a lot in the wee hours of the morning. For some reason maybe it is moving around some or maybe some mouth breathing is going on. The 95% leak number is roughly 35 L/min though...this means that for 95% of the night the leaks were at OR BELOW 35 L/min. Your AHI is probably accurate though. It is having trouble distinguishing what kind of apnea even though...that's why you see the UA flag...unknown apnea.

Are you sleeping through all those leaks and feeling decent during the day???
Having any dry mouth? Or are you taping?

When you have time update your equipment profile to the correct machine to avoid confusion later.
Scroll down and look in the Rs for the AirSense 10 AutoSet...for some reason it got put in the list as ResMed AirSense 10 AutoSet where the other machines got put in the As under AirSense 10.

[palerider]

Pugsy, first of all, my version of sleepyhead does post a leak %. It's in the list on the upper left.

Good to know about the differences in leak reporting, pugsy.

Yes, it is an AirSense 10 Autoset.

That's the "time over leak redline".

Your leaks are good for the first half of the night, then ... not good.

[lindsayschach]

Here's the sleepyhead data for last night with the Respironics machine.

As you all said, there is, indeed, leaking, but it's not reported as a "large leak." In fact, it's about the same as it was with the Resmed. I suppose it could be mouth breathing, though I do tape my mouth. The paper tape I use (CVS) is not terribly sticky, but I switched to it after ripping a piece of my lip off with the stronger stuff (NexCare). Maybe that's the next thing to try?

Any other comments or ideas?

Thanks,

Lindsay

[palerider]

Here's the sleepyhead data for last night with the Respironics machine.

As you all said, there is, indeed, leaking, but it's not reported as a "large leak." In fact, it's about the same as it was with the Resmed. I suppose it could be mouth breathing, though I do tape my mouth. The paper tape I use (CVS) is not terribly sticky, but I switched to it after ripping a piece of my lip off with the stronger stuff (NexCare). Maybe that's the next thing to try?

Any other comments or ideas?

At your pressure, your mask normally vents around 35lpm. So, in the latest chart, you're doing good for the first 45 minutes or so, then leaks start getting bad. They're never bad *enough* that the respironics starts to complain, but for most of that period, they're in excess of 24liters *extra* leak.. and that's enough for the Resmed to not like it.

Your leaks are bad on either machine, one just complains more about them than the other one does, and the reason it complains is that when leaks are bad, the machine can't tell what *type* apnea you're having, and so it reports Unknown/Unclassified Apneas.

Use the 'mask fit' feature of the machine, and do the mask fitting while laying down, turning over, etc, try and get it as leak free as possible.