Leakage at 111.6L/min, is this bad. Help please.

[insomniacInToronto]

Leakage averaged 85.2L/min over 102 days. Average increased to 111.6L/min in last 30 days. Got replacement machine 102 days ago, humidifier broke, don't have full year results. I know I have 101 sleep apneas per hour including about 9 central sleep apneas per hour (doctor won't give me my reports). Machine says my AHI is O.8 over 102 days on average, this is good right (0.7 in last month average). Central AI 0.0, and total AI 0.4, not sure what these letters numbers are exactly, I guess I've had no CSA. I am extremely tired to the point where I ended up in the metal health ward for 72 hours, because I was suicidal, had apparatus ready, police broke down door. My brother committed suicide 9 months ago, he did not have sleep apnea (used same apparatus, I will not provide details on apparatus). I have high anxiety, depression and insomnia. My pressure is set at 14cm, (I think the scale is called cm, the max pressure on machine is 20). I hacked my machine last night to get this info. My weight has increased by 35 pounds since study, and medication has changed. Live in Canada, socialized medicine, only allowed sleep study every 2 years. Illegal to pay for sleep study or MD's n Canada. Can only pay for psychologist, getting one. I can goto Buffalo, I assume and pay for new study and psychiatrist. Thinking I should call my CPAP supplier and tell them. Do I need new mask, don't notice/feel leaks at night. My mask is a large size. I'm 5'9 235 pounds, I do not have a big nose! Thinking mask is not good fit possibly (to big), and moving around at night. Don't see any leaks in hose. Water tested it as well. Thinking of getting custom mask, is it worth it. Was thinking of changing pressure myself from 14 to 15, but I guess no need since AHI very low. Thank you in advance for any help you can offer. Formerly guest "justwondering". If need more details please let me know. My equipment should show up, I just joined an hour ago.

[Pugsy]

Yes...that amount of leak is very, very bad. So bad that it likely is affecting the machines ability to sense the events an properly score them..meaning that low AHI could just be the machine not being able to effectively sense and record the events.

For your brand of machine...ResMed...you don't want to have more than 24 L/min leak for very long...that is where ResMed says that they lose ability to compensate for leaks.

The onscreen leak data you are seeing...means 95% of the time you were at or below that number...Pretty massive leak.
Need to see your reports to be sure but I imagine that most of the time the leak was excessive.

The leaks are so bad that it is likely you are continuing to have apnea events and the machine simply cannot sense them.
I would need to see a graph of the leak line to confirm that most of the night is spent in large leak..but I am pretty sure of what I would see in this case.

You can use SleepyHead with your machine..Great software...I have all the links you need to get started in my signature line at the bottom of this post...lower left.

[insomniacInToronto]

Thank you. Calling CPAP supplier right now. Thanks for getting back so fast.

[insomniacInToronto]

Sleepyhead not downloading. Really tired. Sleepyhead was binary file. I'm I doing something wrong. The program I downloaded is for doctors. It says Leak L/min Median 20.4. 95th Percentile 68.4. and maximum 113.4

[Tino2You]

Insomniac,

You have to get your leak rate down before you can seriously look at your other data.

Try using the mask fit setting in your setup and make sure the 'smiley" face is showing when you exhale. Try doing it lying down too.

Often times when you turn your head or re-position your body, the shape of your face changes and that causes leaks. I had a full face mask that would burp and fart on my face...was very annoying and leaked! I switched to a nasal pillow mask.

I still get leaks. Last night, was one. At 3pm felt like I was a dog hanging out a car window, there was so much air on my face. I took my mask off, went to the bathroom and restarted my nightly procedure once I got back into bed.

Hang in there, take your time, things will get better

-tino

[insomniacInToronto]

SleepyHead v0.9.1

This is a beta software and some functionality may not work as intended yet.
Please report any bugs you find to SleepyHead's SourceForge page.
CPAP Statistics as of June 22, 2012
101 days of CPAP Data, between 13/03/2012 and 22/06/2012
Details Most Recent Last 7 Days Last 30 Days Last 6 months Last Year
AHI 0.00 0.80 0.69 0.59 0.59
Hours per Night 01:20 07:16 09:20 09:30 09:30
Pressure 14.00 14.00 14.00 14.00 14.00
Average Leaks 0.93 73.64 60.97 17.80 17.80
95% Leaks 6.00 145.20 136.80 136.80 136.80

Changes to Prescription Settings
First Last Days AHI Machine Mode Pr. Rel. Pressure
13/03/2012 22/06/2012 101 0.59 ResMed CPAP EPR x2 14.00
The above has a threshold which excludes day counts less than 5 from the best/worst highlighting

Machine Information
Brand Model Serial First Use Last Use
ResMed S9 Elite 23111301890 13/03/2012 22/06/2012

[Pugsy]

It says Leak L/min Median 20.4. 95th Percentile 68.4. and maximum 113.4

Overall median average..20.4 L.min
95% ...95 & of the time the leak was at or below that amount...68.4 L/min. When it is this high..usually means a lot of time over 24 L/min
Maximum 113..the worst it got and not all that big of a deal if it is just a big brief spike.

The 95% number concerns me though.

Look at the detailed report...example of mine is below...look for the red line...the times that you go above the red line the machine loses ability to compensate for leak. 26 to 30 L/min might not be a huge deal but go above that and pretty much things all go to heck.
ResMed machines already deduct the mask vent rate prior to reporting so all that is seen is excess leak.

I picked a large leak report that I had.. I was mask experimenting.

[Mary Z]

I would suggest talking to your equipment provider or doctor about a new mask or different size. A old time remedy for leaks is Macks silicone ear plugs. You take some of the earplugs and roll in your palms until soft then fashion into a rope the size of a pencil. Place this around the mask where it meets your face. It has to be redone every night. I removed the silicone, rolled into a ball and placed in an airtight container. Mask liners may also be of help. Good luck.

[insomniacInToronto]

Thank you all. I manage to get appointments with sleep doctor and CPAP supplier for this weak. Saw sleep doctor today, was told to go to CPAP supplier and get auto titration machine and use for two weeks. There setting it at between 5-19cm. Also borrowed 2 new masks, and going back this Friday to try new masks and see if one of the previous two masks work. The gave me a medium of my previous mask (large before). Will check Sleepy Head daily to see results for myself. Have updated Sleepyhead program. Waiting for Respiratory Therapist to interpret my results, and call me. Also have 90% deviated septum and narrow throat. Going to try to have surgery to fix. Also trying to get adenoids and tonsils removed. Have had ear and sinus problems since child, as well as swollen glands/throat. Tubes twice in each ear. As a child they always "threatened" to remove them if I had more problems but never did. I know they try not to remove them nowadays, as they trap bacteria/bad stuff. I'm told and realize this will not cure me as I have CSA as well as to many apneas (101 total per hour). But hopefully it will relieve pressure in head/ears, and maybe lead to decrease pressure setting. Also I'm thinking there will be less "resistance" to the air flow/pressure, making it easier for the air flow to get to my lungs. Any thoughts appreciated. How have these surgeries gone for others. Will check topics, I think I've seen topics on these issues/surgeries here. Thanks. Sleep Well my friends.

[insomniacInToronto]

Yeah, I finally had a good night sleep, not exhausted as I wake up. Leakage at 26.4L/min for last night. 10.5 hours total sleep, sleep bank starting to fill up finally!!!! Leakage still a tad high.

[insomniacInToronto]

Forgot to add, used new mask, same as old one (listed below), but in medium.

[Pugsy]

When evaluating leak numbers make sure you understand which number you are evaluating.
Median average number...95% number or the maximum number.
Obviously when maximum is less than 24 L/min...you are doing okay but if the maximum was brief and the other numbers acceptable..not a huge deal.