Leak rate OK?

[OzMatt]

Hi, this is my first post here so go easy on me OK?
I have just installed Sleepyhead to try and get some idea how my new machine is performing but I'm not real sure about how some of the info should be interpreted.
I was diagnosed earlier this month with severe OSA ( AHI of 101/hr and 117/hr in REM sleep ). I was then given a F&P ICON machine with the SIMPLUS FFM mask to trial for a week which was a disaster due to not being able to get used to the mask in that time. My AHI during that only week dropped to around 45, so they took that machine back and gave me a Respironics REMstar Auto with the ESON Nasal mask to trial which has been FANTASTIC. I feel like a new person and my AHI is now averaging 1.4.
My only concern is, am I leaking too much through the mouth? This was the concern that my specialist had initially which is why I was given the FFM in the beginning. She never mentioned it as being a problem when I went back this week but looking at the Sleepyhead graph, is this too high or not?

Thanks for your help!
Matt

[Julie]

It seems to be on the high side, and if only for e.g. times you have a cold, you could look at other FFMs that work better than the Simplus did.

[VictorC]

I don't know that it is too high. From the graph you posted it looks like leaks are well controlled for most of the night. Usually (but not always) air leaking out of your mouth will wake you. Large leaks that way are usually loud and somewhat uncomfortable.

[Julie]

Victor, the odd large leak may or may not waken people, depending on other factors, and you can't assume that's the case here. I think the rate's on high side and seeing as he asked about it, it might be worth looking at further.

[novatom]

Congrats on the reduced AHI! I've been on CPAP for a month now and am struggling to get below 5.0 per night.

[Pugsy]

The leak is only pushing towards the high side when it is upwards nearing the 70 L/min mark. The rest of the time it is well within acceptable limits and technically at even 70 L/min it's within acceptable limits.
This particular machine at these pressures with this mask probably has a large leak territory beginning around 90 L/min.
Remember when you see the pressure auto adjust upwards to where it pretty much levels out we would expect to also see that top leak line increase because that leak line is total leak which includes vent rate and vent rate increases as pressure increases.
On this report when you see that top leak line reduce after the first initial increase....pretty much that means 0 excess leak or very minimal excess leak is happening. From about 1 AM onwards...minimal leaks.

According to the statistics...less than 2 % of the time spent in large leak territory (remember Respironics red line should be different than ResMed redline even though SleepyHead defaults to ResMed redline).

So the first part of the night from 11:30 to around 1 AM....pushing things sort of but not horrible...after that there is no excess leak to speak of.

All in all I think a very acceptable report and wouldn't worry about leaks unless you start seeing SleepyHead report double digit time in large leak territory. Less than 2 % I wouldn't give a second glance.
The only thing I would tweak would be the minimum pressure a little if it were me just because I like to tweak stuff.

But....if the leaks are waking someone up...they need to be fixed even if not technically in large leak territory. Anything that wakes us up is unwanted. The name of this game...Good Sleep.

[Nick Danger]

Ozmat, it looks like you are doing a good job! Keep it up. The numbers are good. How are you feeling?

[OzMatt]

Thanks for the replies everyone!
I have decided that for the last 2 weeks of my trialling period I am going to ask for a Nasal Pillow mask just for a comparison. If that doesn't improve things, I am more than happy with the ESON mask as I have no trouble with it and as far as I am aware, I am waking up very little.
CPAP therapy has definately been a revelation to me already, I have only been using it for almost 4 weeks and the changes for the better in my life have been HUGE. While I still get tired during the day physically, mentally I feel so much more alert that other people at work have commented on it!
Matt.