Respironics BiPap Auto SV Advanced- Any Experts Here?

Ten days ago I got a new Respironics BiPap AutoSV Advanced machine and a Swift LT mask. Everything was working great. I checked my leak rate every night both in a sitting up position and if I happened to wake up during the night. Numbers were usually somewhere between 6 and 12. Yesterday I went to my DME to have her download my data to ensure my new machine was in fact treating the apneas and the results were very good. AHI averaged about 9 and my average leak rate was 7.1. My pressure is set at 7.0

I went to use my machine last night and suddenly my leaks are ranging from 22 to 30 !! I have checked everything I can. I sense no leaks from the mask. I tried new tubing just to make sure a little hole hadn't developed. I've tripled checked that the pillows are properly inserted. I can't determine what has happened here and can't reach the DME until Monday.

In doing a search here, I see where there are some comments that a leak rate as low as 7 is unusually low. Other posters refer to a chart in the Swift LT Users Manual but I don't understand how the Flow rate is related to an acceptable leak rate. Am I to understand that at a pressure of 7.0, a leak rate of around 26 is normal ??? And if so, does it mean that something was probably wrong when I had leak rates of around 7.1 ??

I just can't understand how this leak rate could more than triple in one day with no obvious leak. Help !!!!!

different manufacturers report leaks differently

resmed reports excess over what is expected based on the mask in the menu

respironics reports actual flow rate so it doesn't consider any menu

is this the problem?

I'm sorry but I don't really understand your response and I a novice at understanding all the workings of CPAP machines.

I have a Respironics machine and a Resmed mask. Using a pressure setting of 7.0 on my Respironics machine, is a leak rate (that's what's shown on the machine) of around 25 way too high? And is one of around 7 abnormally low? I just can't understand how I can go from a leak rate of 7 to 26 in one day using the same machine and mask and with no apparent leaks.

Where are you getting your leak rate information?
Respironics SOFTWARE (Encore Viewer or Encore Pro) shows the true outflow expressed as liters per minute.
The screen on the machine shows only average "large leaks" and if ANYTHING is showing up there means you have a leak problem.

You say your "average leak rate is 7.1" If you are stating an average, I'm wondering if you are referring to "Large Leak" on your machine's screen, since you don't seem to have the software yourself, which means that you have a problem. 26 is even worse! 26 on the software is fine, that's liters per minute and well within the acceptable leak rate for that mask. But 26 on the machine screen (average % large leak) is bad, bad news.

The most common cause of a large leak with a Swift LT mask is putting the pillow in BACKWARDS. Make sure that the raised ResMed logo on the pillow is facing forward, away from you, when you are wearing the mask. Other than that, perhaps you are using the wrong size of pillow, and because you are new to this it may be hard to distinguish between the vented outflow and leaking around your nose???

Your AHI is too high too. Something is not right.

Janknitz wrote:
Your AHI is too high too. Something is not right.

Jimchi probably has some kind of mixed / central sleep apnea problem based on his machine. This might be a good as possible.

The screen on my machine says it is showing leaks in liters per minute and is constantly updated with every breath. The software which the DME used (Encore) also shows the leaks in liters per minute as well as "Average % Night in Large Leak" and it showed zero. So, I shouldn't worry much if the leak rate went from 7 to around 25 ?? Do most all patients have an average leak rate much higher than 7, so that the 7 for me was an aberration and probably wasn't true?

Thanks for the responses.

is this a tank? is there data on the screen or is that the pressure?

this is the picture I find at respironics site - that is the tank - only data is from reading the card I assume

Yes that looks like my machine, except I also have a Respironics Remstar Humidifier with it also. And 4 parameters of data can be read on the little screen on the machine without having any software. The parameters are "Leak" (shown as LPM), "respiratory rate" (in BPM), "minute ventilation" (in LPM), and "exhaled tidal volume" (in ml). I can scroll through these by pushing the "scroll" button on the machine. This is per the Users Manual. I got the leak rate by looking at the screen on the machine (was around 7.0 - now around 26) and the DME got it off the SmartCard which (yesterday) confirmed a leak rate of 7.

I think we need someone familiar with your exact machine to chime in here.

I wasn't aware that any Respironics machines showed the actual liters per minute of leaks on the screen itself. If that's the case, then your leaks are still well within the mask tolerance. Sometimes people report really low LPM and I'm not sure why it can be so low.

Janknitz wrote:I think we need someone familiar with your exact machine to chime in here.

I agree as I am not familiar with it and tried to read the manual briefly and there is a leak reported.

Perhaps if the thread title was edited to add "with BiPap Auto SV" that would get someone who knows the machine to read the thread.

OK- I changed the subject. Hopefully it will catch the eye of someone familiar with the machine and the mask. Thanks !

I am still very concerned about this issue. I tried calling Respironics and they told me they can only talk with my DME. Called her and she contacted their Respironics sales rep. His response was that at first my machine was reporting only the excess leak, after subtracting the expected leak. This then changed after the DME downloaded the data from the machine and it is now showing the total leak. This explanation makes no sense. The machine never knew what mask I was using or what the expected leak rate is. In addition, when I visited the DME she increased my pressure by 1 point and did this using the SmartCard rather than through the machine itself. When I got it home and used it, the pressure reverted to the original number, in addition to the leak rate showing a more realistic number. She insists she confirmed that the increase in pressure was accepted by the machine.

So two strange things have happened with this machine in the first 10 days that I had it. I am concerned that the machine is defective and may not be reporting the correct numbers. If so, I think I should get a replacement unit. But the Respironics sales rep may just be brushing the DME off. I find his explanation hard to believe.

Has anyone had any luck e-mailing Respironics tech support or contacting them with a direct phone number? Does the sales rep explanation sound plausible? I'd appreciate any advice from anyone who might be an expert with this machine.