Large leak debacle

Hello all,

For the past few weeks I've been getting unusually high numbers on my "Large leak" data readings (on a Phillips Resp system One machine). I check it each morning and it tends to range from the teens into the high twenties. That's a really bug leak right? I have no idea what is causing this; the data has no relationship to the way I perceive my sleep. In other words, I can wake up and feel like I had a great nights sleep and then see I had huge numbers in "large leak". I have tired changing to a smaller size mask and changing hoses in case there's a leak; no luck. Liners help a bit but not much. I'll try a post a graph of the past two weeks below)



Adding this snapshot of a single day with 24 large leaks:

What have your AHIs been like? You only had big leaks at certain times, not all the time, and you haven't shown other data like pressures, etc.

Thanks Julie; I'm not sure which data is most helpful. Here's a bunch more:

Everything looks fine, though you might want to raise your lower pressure by 1-2 cms.

Most of the time you barely went into large leak territory. It's hard to judge just where your large leak territory because it appears the pressure is also fluctuating and as pressure goes up so does the expected vent rate so not all the higher leak spikes are in large leak territory but you are probably really close when you are up in the 80 to 85 L/min area.

The machine can still do a decent job of sensing and flagging events until you get up around 100 L/min area so I suspect that your AHI is fairly accurate. So I don't think that the therapy itself is in the toilet all that much.
Looks like the worse night was Nov 29 in terms of how far it went into large leak territory. Unfortunately from the overview graphs we can't tell just how long you might have spent in large leak territory.

I suspect your mask is moving some and it may be related to the pressures but the detailed pressure graphs are absent and again we can't tell much from the overview graphs.

When you have time you might update your profile to show the new equipment. Right now it just shows the old M series humidifier.
Also might help if you would add your pressure settings in the comments section.

If you are using APAP auto adjusting pressure mode are you fitting the mask to the lower starting pressure or the pressure you are hitting during the night. If there is a big difference you may want to try fitting it to a higher pressure.

I was going to suggest changing the cushion but you say you tried a new mask and that didn't help much. It doesn't look like a hole in the circuit though (like a hole in the hose)...it looks more like the mask is simply moving around a lot and isn't fitted well.
If it was a hole in the circuit the leak would be more consistently large and not sporadic.

And yes..we can sleep through some pretty big leaks. I do it myself.

I would suggest just keep working on getting the fit and seal better. If you stay below 100 L/min then the machine's data is going to be accurate. You are reaching large leak territory at time but just barely and while the leak graph looks ugly...I have seen a lot worse.

If you often see clusters of snores like the one report shows then maybe a little more minimum pressure (probably 1 cm would do the trick) might be something to try but if that snore cluster is a rare occurrence it may not matter.

When I started having lots more large leaks I had been using the same cushion for 4 months. I decided it was past time for a new cushion, and once I started using the new one my leak rate was back within normal limits most of the time... so maybe your cushion is worn out. All things wear out eventually, including cpap machines and supplies.

Wow; I'm overwhelmed that you all took the time to help me. Thank you! I'll get a new cusion and then really focus on fit. I roll over a ton and think I'm dislodging the mask. I also just ordered a new pillow that was mentioned in the forums and supposedly works well for Pap users. Thank you all so much.