Huge Jump in Leak Rate - New Machine/Mask

[CollegeGirl]

Okay, I've been using the Respironics "tank" auto for a few years now, along with a Headrest. My average leak has hovered around 25. Here's a pic of a usual leak line for me (It's a short one, but this is what it generally looks like even over 8 hours):



I just recently got an M-Series Auto and a newer version of the Headrest. Suddenly, my average leak rate is around 40 for the past two nights. This is what it looks like now:



As you can see, hugely different.

The lack of spikiness in the leak (other than my bathroom break...lol) makes me think it's not just a mask that's leaky because it's new, nor mouth-breathing.

Did the vent rate for the Headrest double with this newer version? I somehow doubt that.
Does this have to do with the fact the filters on the M-series models no longer have anything covering them (this was really strange to me - was anyone else weirded out by this?)? I wouldn't think that would affect leak rate, but maybe it does?
Does it have to do with the fact I had to take the humidifier off and put the blower cover back on - maybe I reassembled it improperly? I'm going to go through the owner's manual one more time and see if I can make sure that's not the case.
Are the M-Series more leak sensitive?

If anyone has ANY insight I'd appreciate it - a little rise in leak wouldn't worry me, but to go from 25 lpm to 40 seems fairly significant to me.

[kteague]

Hi CG! I've got a newer model of the Headrest too, and the first thing I noticed was how much more forceful the vented air seemed to be. While my vent rate is not in the 40's, I have a hard time getting it below the low 30s (should be about 26 or 27 at my fixed pressure). I was wondering if there's any chance new expected vent rates were issued with the newer masks and I missed it. I had just pushed it to the back of my mind after someone told me my machine has leak compensation so it shouldn't affect my treatment. Glad you brought it up.

Kathy

P.S. I think of you from time to time. Always puts a smile on my face when I see you've posted.

[CollegeGirl]

Okay, my auto stays at either 11 or 12, which means my VFR would be around 25-27 with this mask. So...there's definitely some leakage going on.

Also, I checked, and the blower port is situated correctly, so I don't think that's the issue. Hmmm

Thanks so much for the response Kathy! I'm hoping ozij or RG or someone will chime in and tell us both what's going on. LOL.

[ozij]

Sorry, CG -- I have no idea -
I did have one seal that wouldn't seat properly at the top if I pushed it too much - I learned to pull it back down after twisting it in - making sure it didn't leak above the top rim.

Question is why don't you have a zipper pattern, but hihger on the new machine. Maybe what we're seeing is the result of the Respironic firmware change?

How does you old maks look on the new machine?
Is it possible the old machine had lost its callibration - and was supplying lower pressure?
O.

[birdshell]

Ginny, my friend! 'Tis really YOU?

Not to be old school, or anything, but have you tried securing the Headrest with tights leg(s)? I cannot remember, but *think* you may be a deconstructor of our beloved Headrest/Aura/Twilight NP/Headrest. I use 2 tights legs and have a nearly perfect leak rate of zero most nights on my ResMed Vantage.

I wonder if the new mask is a bit more stiff, having not been as 'seasoned' and...could be allowing more air into the nostrils and thus a higher leak rate? Couldn't that effect cause the rainout, as well? Hmm, maybe not.

Another thought on your rainout problem: if an a/c is too large for the space (BTU's per cubic foot, I think) it will not work as efficiently at removing humidity. I worked summers in a school that had installed a large--r a/c unit to accommodate future additions and the computers in the lab would be wacky, not to mention the teacher would be sweaty. The a/c just did not cycle enough to remove the moisture in the air.

Love ya, CG,thanks for coming back!

Karen,
Who was helped immensely by CG in the beginning

[jdm2857]

The A/C comments are accurate as too large a unit reduces the temperature so quickly that it does not stay on long enough to drop the humidity.

However, rainout is caused by warm humid air inside the hose and mask, and colder air outside the hose. The humidity outside the hose is not a factor for rainout.

[CollegeGirl]

Sorry, CG -- I have no idea -
I did have one seal that wouldn't seat properly at the top if I pushed it too much - I learned to pull it back down after twisting it in - making sure it didn't leak above the top rim.

Question is why don't you have a zipper pattern, but hihger on the new machine. Maybe what we're seeing is the result of the Respironic firmware change?

How does you old maks look on the new machine?
Is it possible the old machine had lost its callibration - and was supplying lower pressure?
O.

I'm going to try the old mask with the new machine tonight and see what I get. Good thought.

I did have them test the old machine when I went in with the manometer - it was actually blowing 10.4 when it was supposed to be blowing 11 - so it's a little off, but not by much.

I'll try pulling the seal back down a bit - but I'm not feeling any leaks there with the mask on, so I dunno.

You may be right about the firmware change - who knows. Thanks O!

[CollegeGirl]

Ginny, my friend! 'Tis really YOU?

Not to be old school, or anything, but have you tried securing the Headrest with tights leg(s)? I cannot remember, but *think* you may be a deconstructor of our beloved Headrest/Aura/Twilight NP/Headrest. I use 2 tights legs and have a nearly perfect leak rate of zero most nights on my ResMed Vantage.

I wonder if the new mask is a bit more stiff, having not been as 'seasoned' and...could be allowing more air into the nostrils and thus a higher leak rate? Couldn't that effect cause the rainout, as well? Hmm, maybe not.

Another thought on your rainout problem: if an a/c is too large for the space (BTU's per cubic foot, I think) it will not work as efficiently at removing humidity. I worked summers in a school that had installed a large--r a/c unit to accommodate future additions and the computers in the lab would be wacky, not to mention the teacher would be sweaty. The a/c just did not cycle enough to remove the moisture in the air.

Love ya, CG,thanks for coming back!

Karen,
Who was helped immensely by CG in the beginning

I really, really don't think it's just a leaky mask, because you would expect there to be all kinds of peaks and valleys with that, and irregular patterns. There's not. I actually am NOT a deconstructor - I like it better with the headgear, and I actually don't use tights anymore, as my nostrils seem to have conformed to the shape of the large Headrest seal over time and I now get a perfectly good seal without them.

The a/c could very well be too large for my tiny room - that may be what it is. Oh well. I'm ordering a hose cover from our other good friend Karen, so hoping that will solve the problem. I just love my cold air - I'm going to miss it if it's not as cold. lol

And I've been here off and on, Karen - I post every now and then when I think someone really needs a certain bit of info and hasn't gotten it yet. Doesn't happen often, though, as there are so many knowledgeable people posting here!

[CollegeGirl]

The A/C comments are accurate as too large a unit reduces the temperature so quickly that it does not stay on long enough to drop the humidity.

However, rainout is caused by warm humid air inside the hose and mask, and colder air outside the hose. The humidity outside the hose is not a factor for rainout.

See, this is what I find so weird, because I don't use a humidifier at all, much less a heated one. lol. It's got to just be my breath warming it up and making it humid, but unless I've had a fever for six months, it seems strange for it to start suddenly and not go away.

[CollegeGirl]

Well, last night was my first night to sleep as long as I wanted with my new machine - I'm waking up a lot more than I usually do. Got up to pee three times - I generally don't get up at all. Also, I set my thermostat to 70 last night, much higher than I enjoy, and I *still* got rainout. Looked at my data, and increases in leak rate did precede each time I woke up. My AHI, though, is only 0.1, and I never got into Large Leak or anything - my average leak is 36. Maybe it is just a matter of adjusting. I meant to use my old mask last night, but forgot. I'll try tonight.

[CollegeGirl]

Well, even though it feels like I'm largely talking to myself now (lol), I'm going to update this thread again.

I got up three times last night... very unlike me. Slept with my old mask last night on my new machine, as some suggested. Leakier than its "usual" on my old machine, but not as bad an "average" leak as the new mask. Screenshot of last night's data:



As you can see, my AHI is still excellent, I'm just feeling like an absolute wreck this week. Ugh.

ETA: This is going to sound weird, but I'm going to try turning C-Flex down to 1. I really don't know what else to try at this point.

[grandmma]

Well, even though it feels like I'm largely talking to myself now (lol), I'm going to update this thread again.

Just so you know CG, you''re not talking to yourself - keep updating, I'm watching, reading and interested! Just have nothing technically helpful to add (just support, I guess!).

I'm always interested in leak rate discussions - mine are always all over the place like a mad woman's breakfast aesthetically-speaking , but still average out to an acceptably decent number. I'd love to have a really flat line one day, but perhaps I'm a restless sleeper or whatever!

[ozij]

Your not talking to yourself at all.

The story started with suddenly having more rainout.
viewtopic.php?f=1&t=42564&p=375606#p375105
The only thing that's changed is the brand of window unit a/c I'm using.

That is either a change in your environment:

• -- more humidity in the air from the cpap
  -- lower temprature in you room

Now, if your A/C is too big for the room, and not clearing humidity properly the air coming into the machine may be more humid and condenses in the hoses.
I don't think you should adjust to the reainout, because the condensation messes up the machine's ability to understand what's going on and to respond properly.

Changed machine, and still have rainout - no matter which the mask.
I would suggest hose covers - both for the main hose and the mask hose.

I would also set up a medical checkup. I do think its the new A/C --> more general humidity --> condensation --> machine's bad response -->awakening --> not feeling well.


But if it were me, I would want to make sure its not a change in my body.

Can you sleep somewhere where the A/C is functioning well - to compare?
O.

[CollegeGirl]

Thanks, grandmma, for the support! I really appreciate it.

O -

No, unfortunately, I don't have somewhere else I can sleep. Only two rooms in my home have a/c, and they're both big window units. What I *could* do is sleep with my door open so the a/c has a much bigger area to cool (i.e., the rest of the house). I'll try that tonight. But I have ordered some hose covers from Karen-Pada , so hopefully that will help. I don't *think* the condensation is making it back into the machine, because my hose management system would prevent that from happening (the hose is hung up at a relatively high angle). The condensation appears to be only happening in the mask itself, in the immediate area where my warm, exhaled air hits.

I actually, surprisingly, feel like I slept much better last night. I went back to the new mask, and I got out my old friend the pantyhose strap to see if that would help (though it doesn't seem to have made a difference in leak). I also lowered my CFLEX to 1, and upped my min pressure to 11.5, since my 90% number seems to stay at 12, and since I was somehow feeling like I'd not been getting enough air lately. I was definitely cognizant of waking up once last night gasping for air, still. Not sure what that's about. However, I only woke up once to use the bathroom, and that was after about 8 hours, so that was definitely a reasonable time to do that, and that's pretty common for me. I also am not dragging as much today.

Here's last night data:

[silver123]

I've only used that same machine that you are using with the Swift LT and yeah, rainout is a problem to the point that I just use it in passover mode. I recently got a new mask, same Swift LT and noticed the leak rate changed. No AC to mess with. AFLEX is on 1.

And I get that same wierd spikeness that you can see on your graph. I've tried triple checking all connections, etc. I think I am going to try the unit without the humidifier and see what happens.

Keep letting us know how it goes.

silver