Can mask leaks effect your treatment?

[Petermk8]

I have been lurking on this great forum for a while but now I have one question.

I have been a CPAP user because of obstructive sleep apnea for 3 months now and my machine is a resmed autoset s9 and I use a Quattro mask.

I always use my CPAP without question every night. Sometimes however I get mask leaks but they do not wake me. Usually my AHI is about 2.5 with the smiley face logo (no leaks). But when my mask leaks and I am not aware I wake up in the morning and see the frown face my AHI is usually about 0.2? Why could I getting less apneas with mask leaks?

Also with mask leaks does that mean the apnea is not fully treated and the treatment may not be actually effective? Is this dangerous because aparently my heart is already affected from my sleep apnea.

[Julie]

Hi - I would say that theoretically yes, it matters, except that from your numbers, which are so low as to be harmless, you don't need to worry at all. You're right that the larger and longer the leak, the less effective would your therapy be, but there are high 'limits' for average leaks, and specific figures for different masks... do you not have the clinician's manual that explains about that? If not, you can go to Apneaboard.com and download one for free.

[Gerald?]

Hi.

Take a few seconds to fill in your equipment in your profile, it will allow people to help you more easily.

Yes mask leaks can affect treatment.

If the mask leak is particularly bad you are not getting effective therapy. A few leaks is not worth getting worried about, but sad face means you are having quite a few.

If the leaks are fairly bad (which might be the case with sad face) then your s9 (and any other machine) cannot accurately determine you AHI. So an AHI of 0.2 does not mean you have had a good night's therapy. I suspect you would get quite a good AHI if it was not connected to your face at all!

I don't have a Quattro mask but there will be plenty of people around who do that can give you tips on how you can control leaks.

[Pugsy]

Mr Green Frowny face doesn't show up unless 30 % of the night the leaks are in large leak territory and (with ResMed machines that is 24 L/min and above.

[chunkyfrog]

My hubby woke up last night to a breeze coming out from the lower right corner of my zzz mask.
He held it down until he was too tired, then woke me up to fix it. Such a sweetie!

[DreamStalker]

The key to successful CPAP treatment is in eliminating all mask and mouth leaks.

If you can control and eliminate any and all mask/mouth leaks you are 80 to 90 percent there and the remaining effort is in tweaking your machine, data analysis, settings/feature options and sleep hygiene.

Until you have all leaks under control, the type of machine, its features, its data, and its settings are all pretty much meaningless.

Unfortunately, this is and has always been the hardest part of this therapy ... so many different face morphologies and so many mask designs and sizes and each of us has to figure out how to get matched to a mask. Then the mouth leaks add another layer of complexity for nasal/pillow mask users.

Best of luck in quickly finding your match.

[robysue]

I always use my CPAP without question every night. Sometimes however I get mask leaks but they do not wake me. Usually my AHI is about 2.5 with the smiley face logo (no leaks). But when my mask leaks and I am not aware I wake up in the morning and see the frown face my AHI is usually about 0.2? Why could I getting less apneas with mask leaks?

According to Resmed literature, Mr. Red Frowny Face shows up when your leaks have been both large enough and long enough to affect both the accuracy of the AHI data and the efficacy of your therapy.

Resmed defines a large leak as an unintentional leak of 24 L/min or greater. Short lived leaks at this rate are not usually a problem.

But if you spend significant amounts of time with unintentional leaks AT or ABOVE 24 L/min, the machine may not be able to provide effective therapy AND the machine may not accurately detect the events that you have.

The Resmed engineers decided on a line of 30% of the night being in Large Leak as being bad enough to adversely affect the efficacy of the therapy and the accuracy of the data. And so when your leak rate is AT or ABOVE 24 L/min for at least 30% of the night, Mr. Red Frowny Face shows up to tell you that your leaks are not acceptable.

My guess is that when Mr. Red Frown Face shows up with that extra low AHI = 0.2, the problem is that the machine could not accurately measure the airflow into/out of your lungs during the extended periods of high leaks. And so the machine failed to record all the events that occurred during the night.

Also with mask leaks does that mean the apnea is not fully treated and the treatment may not be actually effective? Is this dangerous because aparently my heart is already affected from my sleep apnea.

Yes, when Mr. Red Frowny Face pays you a visit, you cannot trust the data and you may not have been fully treated during the night. And yes, that means it could be dangerous for your heart since it is already adversely affected by your apnea.

If you are seeing Mr. Red Frowny Face on even a semi-regular basis, you need to contact the DME and the sleep doc. You will need to work on getting the leaks under control. That may mean switching masks. It may mean using a chinstrap. It may mean trying mask liners. It may mean trying out an anti-leak strap. It may mean more careful fitting of the mask at the beginning of the night.