Finally I have a reader and a report

[Snoredog]

you ARE mouth breathing.

[lilsheba]

ApNoob; AHI stats could be wrong due to large leaks. During large leaks the machine may not record events.If all the leaks are stopped a lower pressure may be possible. Leaks can also disturb sleep, and we like to avoid that!
kennethryan; with a resmed machine, you set the machine to the mask. The leak the machine shows should not be more than say .04 . If my mask shows an acceptable leak rate of 25, I do everything possible to show a leak of 25.
lilsheba; Each mask comes with a little booklet that has a leak chart. You can also contact the manufacturer for the info.

Brenda

Leak chart? Sigh I guess I should go look for that huh....I'll try their webpage too

I found it and I also found an error in what I typed before:
av max leak 120.0
av 90 percent leak 46.0
av leak 41.0
av large leak 9 mins This should be zero minutes. But at a pressure of 16 the expected leak rate was between 30 and 35 on their chart...so in my numbers which should I go by? The average leak of 41? 90 percent leak of 46? Which number should I really pay attention to?

Thanks guys
_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): resmed, AHI

[lilsheba]

you ARE mouth breathing.

Who me? I tape it shut I don't see how I can.

[sharon1965]

so in my numbers which should I go by? The average leak of 41? 90 percent leak of 46? Which number should I really pay attention to?

i feel so dense in this regard! i just can't seem to get my head around the leak information.

i second the question...my epa shows max leak, 90% leak, average leak and large leak, so for one night in particular i had these numbers:

pressure: 8.5 cm,
(intentional leak rate: 22)
total events 6
total oa's 5
total h's 1
ahi 0.8
oai 0.7
hi 0.1

max leak: 102 LPM
90% leak: 23.0 LPM
avg. leak: 23.0 LPM
large leak: 0 secs.

so what does the max leak represent? and this value changes all the time: i 've had nightly max leaks of 104 LPM, 105 LPM, 54 LPM, 102 LPM, 105 LPM, 108 LPM, 44 LPM , etc...

this max leak only shows up on epa, not on the leak chart on encore pro

since my pressure has been at 8.5 my ahi has been really good, between 0.8 and 2.6, so i assumed it was better than at my prescribed pressue of 6...,

but i'd feel a lot more confident if i could just get this leak stuff to make sense to me...incidentally, i'm not normally this dumb, but i've never beenaccused of having a logical mind!

thanks
sharon

[Snoredog]

so what does the max leak represent? and this value changes all the time: i 've had nightly max leaks of 104 LPM, 105 LPM, 54 LPM, 102 LPM, 105 LPM, 108 LPM, 44 LPM , etc...

this max leak only shows up on epa, not on the leak chart on encore pro

what does it mean? It means that was the highest leak seen and usually says for how long.

Thing to understand is when leak exceeds 75L/m the machine stops responding to events irrespective of what may be happening at the time w/SDB. It will go along for about 45 seconds sounding an alarm flashing the LED's etc. then it begins lowering pressure by 2 cm and continues to lower pressure until the leak is stopped (if auto:off is disabled and mask alert enabled).

Leaks above 75L/m also cause the machine to miscount the events seen so it can throw off the data you are looking at. AHI "may" be low because the machine cannot see them to score them.

If you have your mouth taped and are sure it is not leaking there then it is leaking elsewhere.

If you are running in CPAP mode it doesn't matter so much the machine just revs up to compensate, if leak surpasses the machines ability to respond it just keeps blowing. Autopap is different, it has to monitor that air pressure (which is now lost) so it means it stops listening, even leaks not exceeding 75L/m can cause problems for it, such as snoring it looks for those vibrations from it and that is only transmitted back to the machine if a pressure seal is maintained.

The machine works sorta like hydraulics or if that air moving back and forth was a liquid solid. If you put a piston on each end of a cpap hose and moved one end the air pressure would move the piston on the other end as long as the seal is maintained. Since you use a mask with an intentional leak the machine's motor compensates for that leak by revving up in RPM to keep that static pressure needed maintained.

[sharon1965]

what does it mean? It means that was the highest leak seen and usually says for how long.

thanks, snoredog, i was hoping you'd weigh in

from what i can tell on the charts, these max leaks cause a noticeable spike on the graphs and seem to correspond to interruptions (ie. bathroom trips) where it takes me a few seconds to get around to removing the mask and turning off the machine...it does have the patient disconnect alert/auto off, but for some reason doesn't seem to work with the aura...

so if my data shows zero large leaks, can i assume that the numbers are correct? i've been paying more attention to large leaks on epa than the max leak data

also, as i mentioned, the max leak doesn't show up in the encore pro raw data...even though the spike may show on the line graph...is it because it's so short as to be irrelevant? (if i only had encore pro and not the analyzer program i wouldn't even be aware of max leaks, only large leaks and time spent in large leak, so i think this is what has me so confused )

thanks again
sharon

[lilsheba]

Well I'm still confused as to which number I should pay attention to and what's the threshold, what should it be under?

av max leak 120.0
av 90 percent leak 46.0
av leak 41.0

[rested gal]

Well I'm still confused as to which number I should pay attention to and what's the threshold, what should it be under?

av max leak 120.0
av 90 percent leak 46.0
av leak 41.0

I'm not mathy enough to know for sure, but I always go by the 90% number. I want to see the 90% leak be below 40 (using a Respironics machine...resmed machines calculate leak rate differently.)

For most people using pressures below, say 18 - 20, and using just about any mask except maybe the original Hybrid which had an ungodly high "normal" vent flow, I think the 90% leak rate should be no more than 40 l/m. I never bother to look at vent rate charts for masks. As long I've registered no LL's (Large Leaks) and the 90% leak rate on my data is below 40, I figure there haven't been enough leaks to compromise getting good therapy.

Higher than 40 with most masks at most pressures...you can figure there's too much leak somewhere. You have to be a detective to figure out where the leak's coming from. Could be mask, mouth (if not using a FF mask) or a leaky hose or leaky hose or humidifier connection. Usually it's mask or mouth... or both.

Although you corrected your typo, lilsheba, and didn't register a Large Leak after all, it's worth noting this in case it ever happens:

As Brenda said, during a Large Leak situation an autopap will drop down to using only the lowest pressure you have set in the range. The machine will not notice or record apneas and hypopneas that happen during that time. The AHI reported from a night that had a Large Leak will not be useful.

BTW I do mouth taping but I still feel little leaks all over that I have to compensate for.

If you mean you feel little leaks coming from your mouth...from around an edge or corner of the tape, you're perhaps not using a "sticky" enough tape or you're not making a large enough patch to cover beyond the lips themselves. When I taped, I had to apply the tape at least a half inch beyond both corners of my mouth AND well above and below the lips. For me that meant using two horizontally applied overlapping strips of 1 inch wide tape. BIG patch over the mouth.

The stickiest tape I ever used was Tegaderm. Never had any leaks with it. It was the handiest also because it came in various sizes of large patches. But I couldn't use Tegaderm more than two nights in a row. I'd get a little rash around my mouth if I used it a third consecutive night. You might not have that reaction to Tegaderm. Would be worth a try. Another one that was good for "sticking" (but also gave me a rash) was a paper tape made by 3M. "Micropore", I think it was called.

[StillAnotherGuest]

I never bother to look at vent rate charts for masks.

What? No graphs?! That's BLASPHEME!!

Life without graphs is like a giraffe out of water! No wait, a fish with a sore throat! No, that ain't it either. An elephant in the refrigerator...

...OK, I'll have to get back to you on that.

Anyway, while 40 LPM might be a good across-the-board number to use, at least consider that a lot masks, at low therapeutic pressures, are looking at ILRs a bit lower than that.



SAG

[lilsheba]

thanks for the info rested gal.....it's looking somewhat better today.

av max leak 92.3
av 90 percent leak 42.6
av leak 40.0
av large leak 0 mins

av ahi 2.0

I've checked the hose and the humidifier and they seem fine. It must be the mask leaking beyond whatever is blowing out for exhaust. It's the respironics comfort select I'm using right now. I may switch back to the Swift II and compare data now that I can and see if there is any difference. Then we will know it's the mask for sure.

As for the mouth taping I don't really feel leaks from that so much it's from the comfort mask, I feel air going in my eyes and stuff and have to keep adjusting it.

Jeanine

[lilsheba]

Ok last night's numbers, different mask, I used the Swift II for a change.

Av max leak 91.9
av 90 percent leak 53.0
av leak 46.6
av large leak 0 mins.

Even worse. The nasal pillows are medium, and not old or anything, they are fairly new and haven't been used that much. I used saline gel to help create a seal but I could just tell it wasn't sealing very good.

*sigh*

I'm going to try the Comfort Full FF mask tonight and see what THAT does.

Thanks for my ongoing education with the data download! I've become an expert at d/l the stuff...and I've got it set to save as pdf files so I can store them all on cd eventually. If I want to

You guys are the best!

[rested gal]

The nasal pillows are medium, and not old or anything, they are fairly new and haven't been used that much. I used saline gel to help create a seal but I could just tell it wasn't sealing very good.

That's when you're supposed to grab a leg or two off a pair of pantyhose tights and place it across a strategic spot on the mask:


Tie it behind your head with a doublestart knot:
http://www.fieggen.com/shoelace/doublestartknot.htm

How do you locate that strategic spot?

Put your fingers at different places on the front of the mask. Press ever so lightly against those different places. If the leak stops, BINGO! THAT's the spot that needs a leeetle bit of stabilizing. Needs that homemade leg strap around it. The spot might be about halfway up the nose (not inside it, of course! ) Or might be to cradle the mask up a little closer under the nostrils. Or might even be at the forehead.

One you find the spot that needs that tiny bit of extra push, figure out whether the pantyhose strap will do the light pressing there better if you route the leg strap straight back, or somewhat upward toward top of head, or a lot upward.

Doesn't have to be tight at all. Just has to be "on there."

Try it. You'll like it.

My three favorite masks -- Headrest, ComfortLite2, Breeze -- would be absolutely, completely unusable for me without that extra strap across the front. Without the homemade strap, they'd shift and leak (careful how you read that phrase...LOL! ) constantly.

WITH the strap, they behave perfectly no matter how much tossin' and turnin'.

Gotta have the hose hung up out of the way, too, so it doesn't tug at a mask.

[ozij]

Maybe this is unnecessary, but I'll still say it:

With the Swift's vent holes where they are, a panty hose tights leg on the mask itself is close to impossible. But you might find a great strategic spot elsewhere.

O.

[linuxgrl]

Hi, was wondering if you all could take a peek at my numbers and tell me what you think? I'm trying to figure out the ideal straight CPAP setting or AutoCPAP range.

Over 1st 27 days:
Avg 90% pressure 9.0
Avg Pressure 7.0
Average non-responsive AHI 0.1
Average Obstructive Apnea Index 1.3
Average Hypopnea Index 2.1
Average AHI 3.4
Average Flow Limitation Index 1.1
Average vibratory snore index 0.3
Average Max leak 81.4
Average 90% leak 42.5
Average Leak 36.9
Average Large Leak 0 minutes

Over the 27 days I tried a few settings, 4-20, 8-20, 5-20 and 7-20.
I tried forcing myself to side-sleep with a backpack but I had to stop because I kept knocking into my husband and waking him up. Those numbers were a lot better - I needed a much lower pressure and had a better AHI.

Despite the low AHI, I still feel kind of sleepy throughout the day but not nearly as bad as I was pre-CPAP. Now I'd just like to tweak things to hopefully get a better result.

Thanks!

[ozij]

I'ld take the machine average 90% pressure recommendation and start for a week or two with that.

Your sleepiness may either be a result of the breathing obstructions occurring at the lower pressures, or they may have nothing to do with obstructions, and everything to do with arousals caused by the changes in pressure.

O.