Leak Rate question

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
User avatar
Perrybucsdad
Posts: 834
Joined: Mon Sep 12, 2011 7:09 am
Location: Northeast Ohio

Leak Rate question

Post by Perrybucsdad » Fri Aug 05, 2022 10:01 am

I know there is another question out there recently about this, but with a different OP and different unit. Not wanting to Hijack their thread, I started a new one.

I have been trying to find ways to increase my quality sleep. I was getting up quite a bit, and I am working on that. One of the other things that My Air has been reporting to me is that my leak rate has been a bit high. I know, the general consensus has been if your leak is high, but your AHI is low, that is good. Well, my 95% leak rate is 46.13 L/min over the past 30 days (43.29 past 90 days and 46.13 past year). My AHI has been 1.30 events an hour over the past 30 days (1.42 events an hour over the past 90 and .97 over the past year). I'm thinking AHI > 1 is cause for concern, so I wanted to ask what others think.

I use a ResMed AirSense 10 Respond, and the Resmed AirFit 10 nasal pillows. I hate that new strap they have, but I have gotten it. I replace the pillows about every 2 - 3 months (I know, it should be more frequently).

Anyhow, let me know your thoughts or if you need to see some charts from something.

Blessings!

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: ResScan v5.9; Sleepyhead v1.0.0-beta

User avatar
palerider
Posts: 30940
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: Leak Rate question

Post by palerider » Fri Aug 05, 2022 10:13 am

Perrybucsdad wrote:
Fri Aug 05, 2022 10:01 am
Well, my 95% leak rate is 46.13 L/min
That's too hig
I'm thinking AHI > 1 is cause for concern,
I'd say anything below 1.5, maybe 2 is fine.
ResMed AirSense 10 Respond,
Never heard of that one. which one does it correspond to?
I replace the pillows about every 2 - 3 months (I know, it should be more frequently).
No, they should be replaced when necessary, not on any artificial schedule. I've gotten more than a year on them before.
Anyhow, let me know your thoughts or if you need to see some charts from something.
Without Oscar charts, all we can do is guess.

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
Get OSCAR and come chat on IRC: #cpaptalk on irc.libera.chat

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

User avatar
Pugsy
Posts: 61623
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Leak Rate question

Post by Pugsy » Fri Aug 05, 2022 10:17 am

The 95% leak number just means you were AT OR BELOW that number for 95% of the night.
It is NOT the overall average or where you spend 95% of the night at that leak number. The "or below" part of the definition is critical.

Do the leaks wake you up?

To really evaluate leaks and potential impact on therapy you have to look at the leak graphs themselves.
You want to see how deep into large leak territory you go and how long you stayed there (or above 30 L/min which is where the machine can start experiencing problems with sensing, responding and recording of any apnea events that might happen).

You have to use OSCAR.
Mask: Bleep no headgear mask.. https://bleepsleep.com/
Machine: AirCurve 10 VAuto

I may have to RISE but I refuse to SHINE.

User avatar
Perrybucsdad
Posts: 834
Joined: Mon Sep 12, 2011 7:09 am
Location: Northeast Ohio

Re: Leak Rate question

Post by Perrybucsdad » Fri Aug 05, 2022 11:42 am

I don't believe that the leaks are waking me up at this time. I do know there was a phase when I was waking up with my mouth open for some reason, but that was quite some time ago.

Here are the AHI, LL, and leak rate charts for the past 92 days.
Greenshot 2022-08-05 13.40.15.png
Greenshot 2022-08-05 13.40.15.png (225.66 KiB) Viewed 161 times

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: ResScan v5.9; Sleepyhead v1.0.0-beta

User avatar
Perrybucsdad
Posts: 834
Joined: Mon Sep 12, 2011 7:09 am
Location: Northeast Ohio

Re: Leak Rate question

Post by Perrybucsdad » Fri Aug 05, 2022 11:50 am

Here is just last night and more detail.
Greenshot 2022-08-05 13.49.34.png
Greenshot 2022-08-05 13.49.34.png (163.18 KiB) Viewed 157 times

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: ResScan v5.9; Sleepyhead v1.0.0-beta

User avatar
Pugsy
Posts: 61623
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Leak Rate question

Post by Pugsy » Fri Aug 05, 2022 12:50 pm

Have you checked the hose(s) for a hole?
Your baseline leak is pretty high. You should hit 0.0 at least at some point but you never really do.

See my baseline here? Come to find out I had a teeny tiny hole in my heated hose. I never could feel it though. I had to do the water in those test to find it.

Image

And here it is after I got a new hose.

Image
Mask: Bleep no headgear mask.. https://bleepsleep.com/
Machine: AirCurve 10 VAuto

I may have to RISE but I refuse to SHINE.

User avatar
Dog Slobber
Posts: 3338
Joined: Thu Feb 15, 2018 2:05 pm
Location: Ontario, Canada

Re: Leak Rate question

Post by Dog Slobber » Fri Aug 05, 2022 3:21 pm

Check for a hole. Check humidifier, and all hoses are properly seated and tight.

I've had some masks that never hit zero, but when your leak rate is 20 lpm, when you first put your mask on, and you don't feel anything, that leak is coming from somewhere.

Also make sure your mask settings actually matches your mask type. Your profile says pillows.

User avatar
Perrybucsdad
Posts: 834
Joined: Mon Sep 12, 2011 7:09 am
Location: Northeast Ohio

Re: Leak Rate question

Post by Perrybucsdad » Sat Aug 06, 2022 5:36 am

Dog Slobber wrote:
Fri Aug 05, 2022 3:21 pm
but when your leak rate is 20 lpm, when you first put your mask on, and you don't feel anything, that leak is coming from somewhere.
I'm wondering if that 20lpm is the expected leak rate from the pillow. On the AirFit, there is supposed to be some leak (I've been trying to find on the ResMed site what the expected leak rate is supposed to be but I can't find it.

I did check for leaks in the hose... none I could detect. The lightweight hose though that is part of the head gear assembly on the AirFit P10 is really sloppy where it connects to the hard plastic that slides into the heated hoseline for the machine. I didn't detect any air, but then again, I didn't hold it under water either to see if I could see air bubbles.

Last night's leak rate was worse. Woke up with the red face on the unit. Strange as I felt like last night I had a good night sleep. When I look at the data though, I had Large leaks a good part of the night. % in LL was almost 32%. I really think the new strap design on the AirFit P10 might be the issue... but who knows. I do have a bunch of replacement straps for the headgear, so maybe I should swap one out. I guess I could also just tighten it too, but then my nose hurts in the morning. Maybe I just need to find or try a different type if nasal pillow with different headgear. I saw the ones that you have Pugsy, but I don't think I could deal with it being stuck with adhesive to my nose, especially if I am getting up a few times a night.

Edit:
I wonder if I should try the AirFit P30i? I do roll over and flip around a lot, and I wonder if my turning and all that may be some of the issue. I have a bunch of spare pillows for the P10 though and I don't think they are interchangeable with the P30i. I guess I could always sell them too.

Are the pillows best for people who go from their stomach to side and all over during the night? I know the full face never worked for me as I have facial hair and the leak rate was really bad when I had that many years ago. Just wondering what has less issues with people who toss and turn, nasal pillows, or a nasal cradle. I don't think the cradle is as forgiving, but I may be wrong.

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: ResScan v5.9; Sleepyhead v1.0.0-beta

User avatar
Pugsy
Posts: 61623
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Leak Rate question

Post by Pugsy » Sat Aug 06, 2022 6:08 am

Watch for the release of the Eclipse...hopefully in a couple of months. It's the new and improved Bleep model.
But for now....if getting up during the night is an issue.....You unhook the Bleep mask at the short hose to long hose connection and go do what you need to do with the elephant trunk hanging from your nose.
With the Eclipse there are little magnets holding the mask frame to the ports and you can just slide the magnets to break the connection and go do your whatever that you want to do in the middle of the night without the elephant trunk and then reattach with the magnets when you go to bed.

Now for the mask's expected vent rate that you are talking about. Yes, all masks have those vent rates or intentional leaks as they can be called. You can usually find the numbers for that vent rate at whatever pressure in the mask paperwork that should have come with your mask.
Page 7 of this online guide paperwork
https://document.resmed.com/documents/p ... er_eng.pdf

BUT....your machine should automatically deduct this vent rate from the leak numbers because your machine ONLY reports the excess leak.
Now if you were using a Respironics machine it does report the total leak which is the mask's expected vent rate PLUS any excess leaks.
ResMed machines deduct any expected vent rate before reporting leak numbers and only report excess leaks so what you are seeing is excess leak ABOVE the vent rate and it should at or near 0.0 for a baseline leak. When we first start the machine and are awake and we KNOW that there is no leak that we can feel or hear then that baseline leak should be at or near 0.0.
Yours isn't which makes us wonder where that excess leak is coming from.

Everyone should be able to start the night at or very close to 0.0 leak. That's part of why we have a mask type selection on the machine because it affects the calculations that the machine does for removing the vent rate prior to reporting leak numbers. Not the entire thing but part of it.

When you start the night with an already high baseline leak number then that just increases the chances of the machine report lots of leaks above 24 L/min when in reality those leaks aren't that high.
When your starting point is 20 L/min base line it doesn't take long to hit 24 L/min and get a large leak flag and an Mr Frowny for leak management.

Your mask is leaking somewhere somehow...or the hose is leaking somehow somewhere. Your baseline leak numbers should be at or close to 0.0 at least at the beginning of the night.
Mask: Bleep no headgear mask.. https://bleepsleep.com/
Machine: AirCurve 10 VAuto

I may have to RISE but I refuse to SHINE.

User avatar
Perrybucsdad
Posts: 834
Joined: Mon Sep 12, 2011 7:09 am
Location: Northeast Ohio

Re: Leak Rate question

Post by Perrybucsdad » Sat Aug 06, 2022 6:35 am

Okay, so I have some homework to do then. Only other place I can think of is the water tank (the seal in the tank itself and then the seal when you push the tank into the machine).

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: ResScan v5.9; Sleepyhead v1.0.0-beta

User avatar
Pugsy
Posts: 61623
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Leak Rate question

Post by Pugsy » Sat Aug 06, 2022 6:47 am

Usually if the water chamber isn't inserted completely the leak is loud and annoying and the cpap machine will complain immediately about it....but worth checking out for sure.

You might take the time to do some awake tests to see if you can figure out where the leak is at.
Like maybe 15 minutes or so using the mask and machine and evaluate things.
Mask: Bleep no headgear mask.. https://bleepsleep.com/
Machine: AirCurve 10 VAuto

I may have to RISE but I refuse to SHINE.

User avatar
Pugsy
Posts: 61623
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Leak Rate question

Post by Pugsy » Sat Aug 06, 2022 6:50 am

Systematic awake experiments...first start with a brand new long hose...then look at mask hose...make sure water chamber is inserted completely....look inside where the chamber goes to see if anything is loose, etc.

OSCAR has a minimum session duration criteria before it will import a short session. I don't know what that criteria is but someone tried a 3 minute experiment and it didn't show up in OSCAR.
Mask: Bleep no headgear mask.. https://bleepsleep.com/
Machine: AirCurve 10 VAuto

I may have to RISE but I refuse to SHINE.

lynninnj
Posts: 128
Joined: Mon Jul 25, 2022 8:56 am

Re: Leak Rate question

Post by lynninnj » Sat Aug 06, 2022 1:06 pm

Dog Slobber wrote:
Fri Aug 05, 2022 3:21 pm
Check for a hole. Check humidifier, and all hoses are properly seated and tight.

I've had some masks that never hit zero, but when your leak rate is 20 lpm, when you first put your mask on, and you don't feel anything, that leak is coming from somewhere.

Also make sure your mask settings actually matches your mask type. Your profile says pillows.
Curious- I don’t want to hijack but quick on topic question…. I have an N30 cushion. Is that considered a “pillow” in the settings or do I need to change it?

_________________
Machine: AirSense 11 Autoset
Mask: ResMed AirFit N30 Nasal CPAP Mask with Headgear
Additional Comments: Newbie who loves her machine!

lynninnj
Posts: 128
Joined: Mon Jul 25, 2022 8:56 am

Re: Leak Rate question

Post by lynninnj » Sat Aug 06, 2022 1:14 pm

Pugsy wrote:
Sat Aug 06, 2022 6:47 am
Usually if the water chamber isn't inserted completely the leak is loud and annoying and the cpap machine will complain immediately about it....but worth checking out for sure.

You might take the time to do some awake tests to see if you can figure out where the leak is at.
Like maybe 15 minutes or so using the mask and machine and evaluate things.
When pugsy gave me the video to explain how to put the Bleep on, The dude did something very interesting. He covered up the bottom of the hose and tried to breathe out. His nostrils got all puffed out.

I have a similar mask to what the original poster has with the N 30 and when I put it on I do the same thing. I cover the bottom of the hose and see if my nose puffs out to know if I have a leak.

I would imagine you can do use the same techniques attached to the longer hose or even the shorter hose with the pillows?

Hope that helps.

_________________
Machine: AirSense 11 Autoset
Mask: ResMed AirFit N30 Nasal CPAP Mask with Headgear
Additional Comments: Newbie who loves her machine!

lynninnj
Posts: 128
Joined: Mon Jul 25, 2022 8:56 am

Re: Leak Rate question

Post by lynninnj » Sat Aug 06, 2022 1:17 pm

Perrybucsdad wrote:
Sat Aug 06, 2022 6:35 am
Okay, so I have some homework to do then. Only other place I can think of is the water tank (the seal in the tank itself and then the seal when you push the tank into the machine).
With my p10s I felt like the air was leaking where are the silicone pillows attached to the frame up above the hose.

I am not sure if I quoted you in one of my other posts but please look for it it might help you to try blowing out your nose while covering up the bottom of your hose just to see if you can find the holes that way.

Hope that helps

_________________
Machine: AirSense 11 Autoset
Mask: ResMed AirFit N30 Nasal CPAP Mask with Headgear
Additional Comments: Newbie who loves her machine!