Bleep leaks...

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BatmanMatt
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Bleep leaks...

Post by BatmanMatt » Mon May 23, 2022 6:17 am

Just in time for the new Bleep, I'm having constant leak issues with a my second unit of the Bleep. I didn't struggle with leaks until this past month.

What kind of leaks do these look like?

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Pugsy
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Re: Bleep leaks...

Post by Pugsy » Mon May 23, 2022 6:39 am

With any sort of nasal mask the mask movement leaks don't look any different from mouth opening/breathing leaks.
I wish we could tell with certainty which leak is what because it would making fixing a problem so much easier.

Some questions...

Did these leaks wake you up?

Was your mouth taped? If it was....was the tape solid and secure this morning?

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BatmanMatt
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Re: Bleep leaks...

Post by BatmanMatt » Mon May 23, 2022 7:09 am

No tape, woke up once I think. Separately, does tape spell any kind of suffocation risk?

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Pugsy
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Re: Bleep leaks...

Post by Pugsy » Mon May 23, 2022 7:19 am

My best guess is these leaks were minor mouth opening leaks.
In between the leaky episodes the leak graph goes back to the 0.0 line so we would think that there's nothing in the attachment process that if causing the leak. Attachment process leaks are usually going to be a more constant leak at some level but not at 0.0 so much.
In other words it wouldn't go back to 0.0 line each time.

I would assume you would notice if the adhesive on the nostril had come loose so I doubt it was that.

Here below is my last night's report. Couple breaks in therapy from awakenings (actually at least 3 but only had presence of mind to turn off the machine twice) so not a great night but it had nothing to do with OSA or the mask and everything to do with another experiment involving meds and pain control.

This is with me using the Eclipse last night. I have kept the Beta unit and I am re-using the metal rings on the adhesive (long story will explain later)..... I have seen this type of leaking often. Sometimes more, sometimes less and the adhesive stuck solid and no leaks that I could feel at beginning of the night. I did do a mouth taping test a while back just to confirm it was mouth opening...and the results confirmed it was mouth opening because the leak line never varied. I choose NOT to tape nightly because these leaks don't wake me up and even if they cross into large leak territory they don't stay there long. I also rarely wake up with a dry mouth and it certainly doesn't cause dry mouth in the middle of the night. On a rare occasion I might have a little dry mouth when I wake up but it's very rare and very little and easily dealt with.

Now if you did tape your mouth shut last night and the tape was solid and secure this morning....we get to have a bit of a different discussion.

Image

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Pugsy
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Re: Bleep leaks...

Post by Pugsy » Mon May 23, 2022 7:25 am

Why do you think you would suffocate with the tape?

1...did these leaks wake you up...important to know...was your mouth horribly dry this morning?
2...your leaks were very minor in the grand scheme of things. Well within machine's ability to compensate for sure.

Your leak graph is actually better than mine...and for mine I shrug my shoulders and move on. :lol:

I choose not to tape my mouth and accept the fact that I open my mouth and probably do a little mouth breathing because I figured out years ago that while I could tape my mouth shut it actually caused more sleep disruption than going without tape.
Everyone knows my sleep is already very fragile from the pain thing....I just am unwilling to add another potentially sleep disruptive thing to my routine just to get a pretty flat 0.0 leak line that looks good but means nothing in how I feel.

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BatmanMatt
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Re: Bleep leaks...

Post by BatmanMatt » Mon May 23, 2022 7:30 am

If my leaks are minimal I would rather not tape. Thank you!

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booksfan
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Re: Bleep leaks...

Post by booksfan » Mon May 23, 2022 8:09 am

I also have some leaks show up with the Bleep. I have determined they are mouth leaks. I occasionally do have dry mouth. Like Pugsy, I have chosen not to mouth tape. I also have some pain issues that disturb my sleep and because of eye issues I have to sleep with a silicone eye mask. The tape is one step too much for me. Most of the time I do not go into large leak territory so I don't worry about it.

On the very, very rare night, I DO actually develop a leak (think a "tunnel") out from the Bleep port or Halo (I was a beta tester). This happens many once every few months, so possibly 3 times year? I am very sensitive to such things, so the air blowing across my face wakes me. I get up and stick an extra piece of tape on and I'm good to go the remaining hour or so of the night.

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Pugsy
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Re: Bleep leaks...

Post by Pugsy » Mon May 23, 2022 8:20 am

Assuming minor leaks don't disturb sleep...they can be ignored. ResMed says that the machine can easily compensate for leaks up to 24 L/min excess leak and ResMed machines only report excess leak. They remove the vent rate intentional leak before reporting the leak rate.

The ResMed people have come up with a very conservative (IMHO) line in the sand for large leak territory to begin.
They use 24 L/min as the beginning of large leak territory. In real life the machine can do a very decent job up to 30 L/min excess leak and after that things start getting a bit iffy but it is a thing where the deeper you go into large leak territory the worse it gets. Things just don't go immediately deep into the toilet at 25 L/min nor even 31 L/min or even 35 L/min which is where the machine might start seeing events that it couldn't quite figure out what kind of event is happening. When that happens we start seeing a lot of UA flags which means unknown apneas or unclassified apneas on machines that can distinguish between central apneas and obstructive apneas. The thing about large leaks is that we can't be for sure that the nice low AHI during large leak is because nothing happened or the leak was so bad the machine missed it. That's why we monitor large leaking....just to make sure that a nice low AHI during large leak is an accurate measurement.

The other factor we look at besides how deep into large leak territory we go is duration of the large leak....was it 5 minutes or 50 minutes??? So lets say someone hit 38 to 40 L/min for 5 minutes...it's not the end of the world. 5 minutes out of a 7 hour night is not a big deal. Now if that someone stayed at 40 L/min for 50 minutes the potential for missing events is there and while still not the end of the world if it happened once during a 7 hour night....we would stop and take notice and if it happened a lot then work would need to be done.
On a 7 hour night (420 minutes) that 50 minute prolonged large leak at 40 L/min would amount to only about 12 % of the night. Not a horrible number and Mr Frowny doesn't eve show up until time in large leak (0ver 24 L/min) is over 30%.

I don't even blink an eyelash until my leaks get over 30 L/min and make up a double digit percentage of the night.
I have had some really horrible leaky nights and still not get enough leak to see Mr Frowny the next morning....but I have seen him on a rare occasion but then I remember that he uses 24 L/min and I prefer the 30 L/min line.
At that point I will go look and see just how much time I was deep into large leak territory and not just barely over the line in the sand.

Your leaks last night were VERY minor and only once did you barely kiss 24 L/min or get close and even then it was VERY brief. Your machine very easily compensated for your minor leaks and they didn't impact your therapy and there was no chance of it missing flagging of events during the leaks.

Time to shrug your shoulders and move on and not bat an eyelash of worry over the leaks.

Now if tiny leaks disrupted sleep a lot...then we have a different discussion but one wake up even if from a leak is not enough to worry about.

You don't want to tape...that's fine and dandy because you don't need to tape anyway.

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Pugsy
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Re: Bleep leaks...

Post by Pugsy » Mon May 23, 2022 8:25 am

One thing to remember...the Eclipse version of the Bleep isn't going to stop the mouth opening leaks. It will stop the problem a lot of people have attaching the ports (which has caused a lot of people to give up on the Bleep) and the leaks that come from improper port attaching.

Mouth opening leaks...can be a bad thing depending on how deep they put you into large leak territory AND how long you are deep into large leak territory.
Just remember that "can be a bad thing" doesn't always equal a "for sure bad thing".
We don't have to have a 0.0 flat leak line all night to have effective therapy.

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khauser
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Re: Bleep leaks...

Post by khauser » Mon May 23, 2022 4:06 pm

Pugsy wrote:
Mon May 23, 2022 7:19 am
This is with me using the Eclipse last night. I have kept the Beta unit and I am re-using the metal rings on the adhesive (long story will explain later)....
Is it later yet?

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Pugsy
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Re: Bleep leaks...

Post by Pugsy » Mon May 23, 2022 4:43 pm

khauser wrote:
Mon May 23, 2022 4:06 pm
Pugsy wrote:
Mon May 23, 2022 7:19 am
This is with me using the Eclipse last night. I have kept the Beta unit and I am re-using the metal rings on the adhesive (long story will explain later)....
Is it later yet?
I guess.... :lol:
I don't remember exactly when I first did the Beta test with the Eclipse and I am not exactly sure I have the final version of it or not as there were 2 versions with magnets that I tried. I am thinking the second version of the magnets is what is in the final product but I won't know for sure until I actually go buy the publicly available model.
Anyhow it was a short beta trial with maybe a week's worth of halos but I kept the main frame/hose part.
By early last summer my right wrist/hand was giving me fits and I couldn't do a thing with my thumb and index finger so I called up Stuart and asked when the Eclipse was going public because I was going to be having surgery on my hand and I knew it would be out of commission for quite a while. I needed to be using the Eclipse all the time.
He didn't have enough Halos with the metal ring to give me very many but he sent me maybe a weeks worth of halos with the metal rings on them and I had to remove them, wash, clean with alcohol and reuse them along with a sizable supply of the adhesive parts but without metal rings. So that's what I have been using once I was able to use my thumb and index finger (used the P10 otherwise).

So that's how come I have been re-using the metal rings on the Halo part. Sometimes I forget until it's too late to wash them so I intermingle using the P10. Re-using the metal rings is a lot of work. Tried buying some rings at the hardware store but the closest I found was a bit too thick and didn't hold the magnet quite as well.

I can use the P10 but I got spoiled with the Bleep and still prefer the Bleep/Eclipse over the P10.

I could probably master the plastic Bleep ports now but my dexterity still isn't 100% yet. Attaching is hit or miss for me now. The magnets are SOOOOOOO much easier.

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khauser
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Re: Bleep leaks...

Post by khauser » Mon May 23, 2022 5:24 pm

I know what you mean, as I prepared for surgery I packed my tap pap, which I haven't used in a long time, and a few bleep adhesives. I dreaded going back to the tap pap that we once my preferred interface, and luckily I was able to apply my bleep adhesive so i didn't have to resort to the tap pap.

Currently not having trouble with the bleep connectors but I'm looking forward to the eclipse.

Thanks for story time!

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Re: Bleep leaks...

Post by chunkyfrog » Tue May 24, 2022 10:24 am

Concern about danger from taping is usually greater than the actual danger.
Try chin up strips, which do not completely block the lips, but the lower lip
overlaps the upper lip, allowing a small opening through which it is possible
to speak--or spew--as needed.

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