Leak Rate comparison between Dreamwear and P10

New user here, so forgive me if this is a basic question. To begin with, I recognize that my leak rates are very good and many will love to have these numbers.

I just started my therapy last week with a Dreamwear mask and tried out the P10 for the first time last night and my leak rate has gone up. I am using an Airsense 10 Autoset and for both masks, I had the unit set to pillows. All other settings are identical. The other difference I noted is that the Dreamwear mask has the hose attachment at the top of the head and the P10 has it at the nose. When I used the P10, I rigged a hanger to have the hose descend from above, but I did notice slight tugging as I moved around in my sleep. Because the Dreamwear hose attachment is at the top, it isn't as much a factor as I move from back to side sleeping.

Here are my SleepyHead graphs taken a day apart. The AHI's are almost identical:
- Dreamwear
- Airfit P10

You will notice that for the Dreamwear, the medium leak rate is 0.0, where as the P10 is 1.2. My MyAir numbers correspond with zero leaks for each time I used the Dreamwear and 2L/min when I used the P10.

My understanding from reading the forums is that the Resmed units register the leak rate as the total leak rate minus the intentional leak rate of the mask. Below are links to the documentation on the 2 masks:
- Intentional leak rates for Philips Respironics Masks
- Airfit P10 users guide - See page 7

Dreamwear intentional leakage at 5cm H2O = 17.7; at 10 cm H2O = 26.6
Airfit P10 intential leakage at 5cm H2O ~ 22; at 10 cm H2O ~ 33

So the P10 design inherently has a higher leak rate. Because the Airsense 10 treats both the same, is the difference between my 2 night showing this intentional difference or is there something I can do to get the leak rate for the P10 down to 0?

I am also wondering if others are able to get lower leak rates with the P10 close to zero? Please post your medium leak rates for P10 is possible. I guess I'm wondering if there is any point in chasing a 0.0 leak rate with a P10.

Thanks for reading.

Leaks are fine and as long as your AHI is low and you are sleeping well, don't worry about getting leaks to zero....it isn't going to happen on a regular basis. You could reduce your AHI by increasing your minimum pressure to about 8 and max to 12.

kasmca wrote:So the P10 design inherently has a higher leak rate. Because the Airsense 10 treats both the same, is the difference between my 2 night showing this intentional difference or is there something I can do to get the leak rate for the P10 down to 0?

You know it might be that what you are seeing is the intentional/vent rate difference and you won't ever be able to get 0.0.
I use the P10 and I just looked back through probably a month's worth of leak graphs and I had median leak 0.0 one night. Most of the time it was showing 1.2 or something in that range.

So you might get it..I got it once but you will need to use the P10 for a bunch of nights to see if you can do it. It's funny that the one night with median 0.0 wasn't entirely leak free either.
What I did notice is that with the P10 the leak line is never at the 0.0 mark. It's always just a little above 0.0 even at the very beginning of the night while awake and I know for darn sure there is zero leak. So that points to the intentional venting thing.
You might be on to something here.
ResMed subtracts a generic vent rate number and maybe that number still leaves us with a bit of a "leak" that really isn't a real leak.
I have used the DreamWear but I only used it for about a month and didn't really pay that much attention to the leak graph at this level. It's not something that I pay that much attention to because for me needs it doesn't really matter. It's been well over a year I guess now and I don't remember exactly when I used the DreamWear to go back and review those leak graphs but I do seem to remember seeing a few nights with the leak line flat on 0.0. Maybe it is just the inherent vent rate difference between the 2 masks you are seeing.

It's hard for me to go just by numbers because I always seem to have a least one small section of the night where the leak jumps up noticeably...sometimes into large leak territory and sometimes just comes close. So those small time segments with that leak kinda messes with the overall leak numbers a bit.

Real or not I don't think this minor difference is going to impact therapy at least in terms of holding the airway open and preventing the airway from collapsing.

About the only thing I can suggest that you do to test things out is use the P10 for about an hour while awake and you know for darn sure if the mask is leaking or not and then go review the leak line graph itself and see what it looks like.
Do the same thing with the DreamWear.
Then compare the baseline leak line and don't worry about the median number in this experiment. Doing the test while awake eliminates any potential mask movement and seal breaking or mouth opening leaks from the equation.

I think that one hour would give you a long enough duration to see where the ResMed at least starts the leak calculation and you might have your answer to the question about that difference in vent rate with the 2 masks.

When it comes down to which mask is "better"...I would use the one that I felt that I slept better with for whatever reason or was simply more comfortable to me.

kasmca wrote: I guess I'm wondering if there is any point in chasing a 0.0 leak rate with a P10.

Hello and welcome,

First, let me say as others have, that your leaks appear to be insignificant.

As an aside, in my opinion, average is a better metric than median when comparing variables of this type. Average can be chosen under preferences in SleepyHead.

Next, has it occurred to you that your P10 numbers might be correct and the Dreamwear wrong? The P10 is a ResMed pillow mask being used with a ResMed machine with the appropriate mask setting. The Dreamwear is not a ResMed mask and one could argue that it is more like a nasal mask than a pillow mask. ResMed mask settings are for ResMed masks only. ResMed does not publish settings to be used with other brand masks. It is interesting the two masks have different static leak rates, but not significant, in my opinion.

The P10 mask graphic does indicate a low level of leakage that looks a little like it could be from mouth leaks. The Dreamwear doesn't show that, but it could be, as Pugsy said, due to different circumstances, different nights. Or, it could simply be hidden by the lower static vent rate of the Dreamwear, which I think likely.

If I had to pick a graphic that was correct, I would choose that of the P10 (ResMed mask, ResMed machine, appropriate setting).

Leaks matter if they are disturbing or interfere with the therapy, regardless of value, but 0.0 isn't necessarily something to strive for. Unless your leaks become significantly greater or become bothersome, I see no point in chasing it.

Here is a sample P10 leak graphic (P10, S9, Pillow Setting): The average leak rate (dotted line) for the night is 4.85. The leaks are comprised mostly of mouth leaks (plateau shaped). Notice there is some time of 0.0 leak rate after 03:00. Since these leaks were not disturbing and were well below the cautionary 24L/m, I consider them satisfactory.

Thanks everyone for the great replies. Based on your feedback, I won't worry much about leak rate as long as the avg is relatively low and there are no large spikes for extended periods, especially if they are not affecting my sleep. I have also changed sleepyhead preferences to show avg vs median.