Confusion about large leaks and flow limits

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
User avatar
Deborah K.
Posts: 432
Joined: Mon Feb 24, 2020 11:15 pm
Location: Colorado

Confusion about large leaks and flow limits

Post by Deborah K. » Mon Dec 06, 2021 5:10 pm

I am confused. Since I have been using my new Resmed AirSense 10 Autoset For Her I am reported as having massive leaks. While using the Dreamstation, the leak rate looked bad too but was reported as 0 large leaks so I figured it was fine. How could this be? I was worried that maybe something was wrong with my new machine until I saw that the chart on the Dreamstation showed the same thing. I don't FEEL like I have a lot of leaks. There is no air hissing onto my face or anywhere else. I can only feel any air coming out of the vent. I thought maybe I was having more mouth leaks than I thought, so I bought and used mouth tape for a while, but the leak rate did not drop. I cannot feel any leaking where my hose attaches to the machine or where it attaches to my mask, so I just don't get it. My hose is brand new and fine. Any idea what is going on and what, if anything, I should do?

On a second note, I see that my flow limit chart looks pretty bad. I am sleeping well, and don't feel at all uncomfortable; actually much more comfortable since switching to the Resmed. Should I do anything about the flow limit?
Machine: Resmed AirSense 10 Autoset For Her
Mask: Bleep Dreamport mask system

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Confusion about large leaks and flow limits

Post by Pugsy » Mon Dec 06, 2021 5:43 pm

Bleep????

If so...we got a problem somewhere for sure.

How old is the Bleep system itself? When was the last time you took it apart and put it all together again?
Something didn't get put together quite right...somewhere. Or else something came loose and you didn't know it.
Places to look extra closely at...where the silicone cushion thing attaches to the frame/hose part.
And the tiny taco things that Jason talks about in his video. Have you seen that video.

Have you done an awake test for about 30 minutes and checked to see what the leak graphs show when you know for sure the only air you feel moving is from the vent holes?

I will let a lot of large leak slide sometimes but you shouldn't be having that much large leak with the Bleep and it's more than I would want to let slide. If the mouth is taped and the tape doesn't come loose...or you are awake and know for 100% that the mouth was shut....something is wrong with part of the mask's connections somewhere.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Confusion about large leaks and flow limits

Post by Pugsy » Mon Dec 06, 2021 5:46 pm

As for the FL graph....looks like you are maybe using the for Her auto mode???? If so don't worry about the FL graph activity too much right now. The for Her mode always makes mountains out of mole hills when it comes to the FL graph.

Have you ever tried the regular auto mode? If not...I would try it.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
Deborah K.
Posts: 432
Joined: Mon Feb 24, 2020 11:15 pm
Location: Colorado

Re: Confusion about large leaks and flow limits

Post by Deborah K. » Mon Dec 06, 2021 6:17 pm

Pugsy, thanks for your replies. My Bleep system is all pretty new, and I can't feel any leaks at all. Maybe I will hook it all up early tonight and see if I can find anything, or maybe keep it on when I wake up tomorrow and watch things then. That way I would not have to waste any Dreamports (what a cheapskate I am. :roll:) The leaks look pretty much like when I was using the Dreamstation. Would I still get good AHIs if I was really leaking so much? With the Resmed I have even had a couple of 0.0s in the short time I have been using it. I sure like those!

As to the flow limits, I am using the For Her algorithm, but it feels so good I think I will continue to use it. Breathing with this machine is so much more natural and comfortable than with the Dreamstation. I can't believe the difference! I'm not glad that Philips created the mess they did :? , but I AM glad that I got a Resmed. To me the difference in comfort is astonishing! It's way better than I expected. :D
Machine: Resmed AirSense 10 Autoset For Her
Mask: Bleep Dreamport mask system

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Confusion about large leaks and flow limits

Post by Pugsy » Mon Dec 06, 2021 6:31 pm

From my own personal experience with large leaks and reliability of the numbers....30 to 35 L/min excess leak is where I started to see evidence of the machine struggling to respond or record events. I would see UAs first though...and then if I got over 40 L/min the UAs would go away so I had to assume the worst which was over 40 L/min I couldn't rely on nothing being reported as nothing actually happening.

Your time spent over 35 L/min is actually not all that much and I see one UA.
While I suspect a handful of potential events may have been missed...probably not a huge number.

The for Her mode isn't really known to be all that great when people need over 12 cm. You do need upwards of 12 part of the time. Something to think about....not urgent though.
I don't think it is related to the leaks at all. Just a side note about the FL graph and how the for Her mode makes mountains out of mole hills.

You could also do the awake test at the beginning of the night if you wish...just make sure you are doing something that keeps you awake for at least 15 minutes so you have a for sure known time where you aren't feeling any extra air moving anyway.
My suspicions...ports not attached quite completely....tiny taco has the silicone turned a bit...or the silcone barrel isn't quite in the little groove on the frame/hose part.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Confusion about large leaks and flow limits

Post by Pugsy » Mon Dec 06, 2021 6:44 pm

FWIW....I have on occasion seen big leaks like that with the Bleep but 90% of the time I have woke up and felt it leaking at the ports attaching area. Usually fixed by just a little movement or using my hand to apply a little upward pressure to stop the leak. From the looks of the leak graph I can see where the pressure of my hand stops the big leaks...so that tells me something isn't attached completely securely. The other 10% it was from a wrinkle in the adhesive causing a tunnel for the air to sneak out.
But I have seen other peoples reports where the cushion wasn't complete resting in the groove and I saw one report where the leak was because of the tiny taco area not being perfectly fitted.

When everything is fitted like it should be...the leak graph line should be at 0.0 or very close to 0.0.
If it's not...it's leaking somewhere.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Confusion about large leaks and flow limits

Post by Pugsy » Mon Dec 06, 2021 6:46 pm

The DreamStation not showing as much large leak...that's because the DreamStation had a more forgiving line in the sand where large leak territory begins.
ResMed has always had an ultra conservative line in the sand...and why I don't even blink an eye until I get around 35 L/min leak or more and it's more than a couple of minutes. Doesn't matter what mask.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
Deborah K.
Posts: 432
Joined: Mon Feb 24, 2020 11:15 pm
Location: Colorado

Re: Confusion about large leaks and flow limits

Post by Deborah K. » Wed Dec 08, 2021 11:29 am

Well, here are two more screenshots. The first is the 6th, and the second is the 7th. The 6th shows a lower ahi, and a better leak rate. I even had the smiley face on the front of my machine. The truth though is that I woke to a great deal of leakage from my mask because of a stupid cut I made to the tape to avoid a spot on my face I wanted to not cover with the tape. The air was simply flying out, the worst Bleep leak I have ever had. You can see at the end of the night I turned the machine off for a few minutes to cause a break between awake and asleep. The awake part shows really low leakage, but the mask still had its massive leaks going on.

Then last night I had absolutely no leaks anywhere. I checked the mask and hose at every attachment, but I showed a higher leak rate. I cannot make any sense of it. I think maybe I will simply ignore the leak report and the annoying red frowny face on the front of my machine, at least for now.

screenshot-20211208-100138.png
screenshot-20211208-093903.png
Machine: Resmed AirSense 10 Autoset For Her
Mask: Bleep Dreamport mask system

User avatar
Miss Emerita
Posts: 3416
Joined: Sun Nov 04, 2018 8:07 pm

Re: Confusion about large leaks and flow limits

Post by Miss Emerita » Wed Dec 08, 2021 1:19 pm

Deborah, do you test the Bleep after you attach the ports to the rest of the system? The way to do it is to put your hand over the end of the tube and try blowing out. You should not feel or hear any air coming out from anywhere.

That said, it is possible to have the attachment pass the test and still have something come loose during the night. That happened to me last night -- very annoying. I would press here and there and get everything quieted down, only to have the same thing happen the next time I turned over.

My guess is that I was missing one of those tiny clicks I can hear when I attach the ports to the rest of the Bleep. I was compensating with friction and brute force, but without the missing click, that wasn't enough. That's my theory, anyhow.
Oscar software is available at https://www.sleepfiles.com/OSCAR/

User avatar
Deborah K.
Posts: 432
Joined: Mon Feb 24, 2020 11:15 pm
Location: Colorado

Re: Confusion about large leaks and flow limits

Post by Deborah K. » Wed Dec 08, 2021 5:48 pm

No, I check the Bleep like that every night. I can tell in the morning if any leak has managed to occur by keeping the machine running and checking whether any air is coming out of any spot except the vent of course. It is tight as a drum.

I think I only want the leak rate to drop so I don't have to see that stupid red frowny face most mornings. :roll:
Last edited by Deborah K. on Wed Dec 08, 2021 5:53 pm, edited 1 time in total.
Machine: Resmed AirSense 10 Autoset For Her
Mask: Bleep Dreamport mask system

User avatar
Deborah K.
Posts: 432
Joined: Mon Feb 24, 2020 11:15 pm
Location: Colorado

Re: Confusion about large leaks and flow limits

Post by Deborah K. » Wed Dec 08, 2021 5:52 pm

As to the high flow limits, should I use EPR to make that drop? Or is that necessary only if I am uncomfortable or have high AHIs? My AHIs are now regularly in the 0.something range and I am sleeping very comfortably and well.
Machine: Resmed AirSense 10 Autoset For Her
Mask: Bleep Dreamport mask system

User avatar
Miss Emerita
Posts: 3416
Joined: Sun Nov 04, 2018 8:07 pm

Re: Confusion about large leaks and flow limits

Post by Miss Emerita » Thu Dec 09, 2021 12:41 pm

It occurs to me that there's one other thing you could check: your humidifier. Is the chamber seated properly? And is the seal inside the chamber seated properly?
Oscar software is available at https://www.sleepfiles.com/OSCAR/

User avatar
Deborah K.
Posts: 432
Joined: Mon Feb 24, 2020 11:15 pm
Location: Colorado

Re: Confusion about large leaks and flow limits

Post by Deborah K. » Thu Dec 09, 2021 12:48 pm

PUGSY, This morning I turned off my machine for a while, then started it again while awake. I could not feel any leaks. As you see on the Oscar chart, I showed no leaks at all. I guess this means I must be mouth breathing? I use a neck brace already, but maybe I should get a taller one. I'll try the mouth tape again. Maybe I need the wider version. This is discouraging. :(
screenshot-20211209-112750.png
Machine: Resmed AirSense 10 Autoset For Her
Mask: Bleep Dreamport mask system

User avatar
palerider
Posts: 32300
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: Confusion about large leaks and flow limits

Post by palerider » Thu Dec 09, 2021 12:55 pm

Deborah K. wrote:
Thu Dec 09, 2021 12:48 pm
I use a neck brace already, but maybe I should get a taller one. I'll try the mouth tape again. Maybe I need the wider version. This is discouraging. :(
Neck braces won't stop mouth breathing, and in my instance would make it worse. I find that if I tuck my chin, it keeps air from leaking into my mouth.

A chin strap, or neck brace won't do anything beyond keeping your jaw closed, but that won't prevent air leaks, since teeth aren't air tight. It's been suggested that one of those boil and bite mouth guards (without the breathing hole in the middle) will cut down on mouth leaks, as will taping.

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
Get OSCAR

Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Confusion about large leaks and flow limits

Post by Pugsy » Thu Dec 09, 2021 1:13 pm

Well....the mouth breathing may or may not be THAT big of a problem.
I know I mouth breath some....not nearly as much as you might be doing if those are mouth opening leaks we see...but it rarely goes above 35 L/min which is my line in the sand where I know it might cause the machine to miss recording and responding to events.
But like you it doesn't wake me up so I tend to just shrug my shoulders and move on.

You could do an experiment with taping the mouth shut just for one night and make sure the tape never comes loose...and see what the leak line looks like...and that should help you make a decision on how to proceed one way or the other.

Your leak line is ugly but if leaks aren't disturbing your sleep and you are sleeping well and feeling good...and you don't spend a huge amount of time deep into large leak territory...maybe you just shrug your shoulders and move on as well.

My mouth opening is usually when I am on my back which I try to avoid as much as possible because it makes my back pain worse and the back pain will for sure wake me up.
I have some nights with minimal to none leaks and some nights it is a bit ugly in terms of that leak line.
Since I really don't want to go to extraordinary measures to eliminate the sometimes mouth opening because I have found those other measures usually disturb my sleep more than the mouth opening is creating a problem....that's why I compromise and shrug my shoulders.

If you are feeling good and sleeping good....I don't know that I would spend a lot of time worrying about a not so pretty leak line. :lol: Would getting a nice pretty leak line end up causing more problems than the leaks might be causing????

If it was me I would do the taping of the mouth for one night...evaluate the leak line if that does confirm mouth opening then decide how to address it IF I wanted to address it.
You want to know for sure that it is mouth opening though...then decide how much you want to deal with it, if you even want to deal with it.

Me.....while I am okay with the taping...it's not something that I really want to do and unless there is a huge pressing need I know me...I won't bother because I am lazy. :lol: I sure don't want to wear any sort of chin strap or even a soft cervical collar. I want less on my face and head...not more. So I compromise. For me my sleep is already extremely fragile and to go doing extraordinary stuff is going to mess with my sleep even more. I have been there and done that years ago.
Getting to sleep and staying asleep is my number one priority. When I don't sleep well I feel like death warmed over no matter how pretty that leak line is or how low my AHI is.
Those nice pretty numbers and graphs don't mean squat when I feel like crap.

If your machine is missing a few events when you go up over 40 L/min leak....I bet it isn't very many anyway.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.