The Daily Blowdown

4/3

AHI 4.6
Leak 10.1

Looks like the slightly higher pressure is working, I'm going to stay at this level for a week and observe the results.

What I learned: I definitely need the mask pad (it's on it's way) as the bridge of my nose is quite sore after 2 days on the full face mask.

4/4

AHI 2.2
Leak 20.1

Hmm, bit of a spike in leak rate, but still below the 23L/sec redline. I'm guessing I just slept oddly and pushed the mask around. Otherwise a good night's sleep.

What I learned: When I sleep really deeply, I drool. Yes, I checked, it's not rain-out. Oh well.

TalonNYC wrote:4/4

AHI 2.2
Leak 20.1

Hmm, bit of a spike in leak rate, but still below the 23L/sec redline. I'm guessing I just slept oddly and pushed the mask around. Otherwise a good night's sleep.

What I learned: When I sleep really deeply, I drool. Yes, I checked, it's not rain-out. Oh well.

That leak rate is still pretty high. It really would help if it were lower, but knowing that your padding is arriving soon, hopefully that will allow you to plug the leaks without aggravating pressure sores.

I've got the blister bandaid things now, so I can use those until the gel pad arrives and tighten down a little bit.

Update for 4/4

I had a look at my ResScan system this AM. Looks like a few big leaks during the night, but for the most part it was down below the redline. Also, the leaks did not correspond to AHI spike clusters. So, for this week I will keep things as-is (FFM, 13cm/H2O) and just tighten up the mask a little bit to help reduce the leak spikes.

Average for the week was a 3.7 AHI, not bad at all!

4/5

AHI 2.1
Leak 15.2

Higher leak rate today (going to re-loosen the straps and get it back to 10L/M tonight). Lower AHI, so the full-face mask is doing well.

Here's the question, should I be worried about 8-15L/M leak rates? Based on this info from another thread:

Ultra = 18.3 L/m @ 4 cm H2O to 53.1 L/m @ 20 cm H2O At 12 cm the rate is 38.4 L/m
MIR FULL = 22.1 @ 4, 40.5 @ 12 and 54.3 @ 20
ACTIVA = 19.2 @ 4, 34.4 @ 12 and 45.4 @ 20

The full face mask can get between 22 and 54 L/M without going outside the "standard deviation" and my 8-15L/M is actually low.

What does the "group conscience" think?

I would post data graphs, but the mac ate the data on the SD card, so I have to remember to only use ResScan when I have BootCamp running from now on LOL

Edit:
What I learned: I've started waking up with my mouth lax and opened slightly. This is how I used to wake up way back when (as in 15 years ago), which for me was a huge sign of some progress happening. Before the apnea came into my life, I always associated that jaw slack with deep sleep!

TalonNYC wrote:
Here's the question, should I be worried about 8-15L/M leak rates? Based on this info from another thread:

Ultra = 18.3 L/m @ 4 cm H2O to 53.1 L/m @ 20 cm H2O At 12 cm the rate is 38.4 L/m
MIR FULL = 22.1 @ 4, 40.5 @ 12 and 54.3 @ 20
ACTIVA = 19.2 @ 4, 34.4 @ 12 and 45.4 @ 20

The full face mask can get between 22 and 54 L/M without going outside the "standard deviation" and my 8-15L/M is actually low.

1. In the CPAP world different machines report different types of leak rates. Some machines report total leak which is the amount of venting through the exhaust ports plus any unintentional mask leak. Your machine subtracts the designed vent of your mask and only reports the unintentional leak. The leak rates you quoted for three masks are the designed vent rates and should not be compared to the unintentional rate your machine is reporting.

2. I don't like looking at summary data. If you have a leak rate of 20 for the night, it could be you had about 20 all night long. Or it could be that you had 40 for half the night and zero for the other half. You need to look at the details report to get a clear picture.

Indeed, I wanted to view the detail data, but my mac ate it when I inserted the SD card. I'll have that tomorrow.

Meanwhile, the last time I looked, the numbers were peak leak rate.

NightMonkey wrote:2. I don't like looking at summary data. If you have a leak rate of 20 for the night, it could be you had about 20 all night long. Or it could be that you had 40 for half the night and zero for the other half. You need to look at the details report to get a clear picture.

Ditto to what NightMonkey has said.

Since ResMed machines already subtract the vent rate before it reports a leak, what you see reported is excess leak.
Given you are new and still struggling with masks and leaks. I wouldn't be overly alarmed with leak of 8 to 15 unless it shows on the graph as a lot of time being up near or over that red line.

Since you can't see the details from last night I would just continue to do what you are doing. The 15 L/min isn't a true average anyway. 95% number meaning that for 95% of the time you were at or below that number of 15.
It's a lot better than 20 or 25....

AHI is great. I doubt the leak impacted the numbers to any great extent. The machine can compensate for some leak very effectively. I never put much interest in a leak "number" anyway. I just look at the graph to see if it might or might not explain some events and go from there.

Got the summary readings off the card, the 15 number is 95 percentile, with the peak being 22.8 and the median being zero. From the night before, it appears as though I have a series of leak spikes, but spend most of the night pretty well sealed up.

This is the graph from the night before:

As you have discovered masks and leaks are the hardest part of this therapy. Just watch that line and if it spends too much time at that red line or over then the machine may not be able to score events. We never are really told what actually happens to the data above that magic red line. One would think that if it can't be effective we would see a truck load of events then but we often don't see anything so we don't know for sure if the machine is not scoring events because it couldn't or there simply were none to score at that time. Just a limitation of the machine and software.

You are still new to all this and still experimenting with masks to determine which give best therapy with minimal leak and what accessories help or don't help. Just remember that whatever you see now (even if imperfect) is still better than no therapy and all we can do is learn from it and try to continually work on making things "better".

You have a good solid head on your shoulders and with time and experience you will figure out what works best for you. All in all you are really doing quite well for being new and struggling with masks and leaks.

Thanks Pusgsy! I'm a gearhead - I love gadgets and tech, so I'm approaching the entire CPAP experience as "look, new toys!" That let's me keep a positive outlook, as If all else fails I can just start over (reboot therapy, so to speak) and go back to the original settings and equipment (which I have documented).

You're right, so far the leak is the frustrating part, as the AHI keeps inching lower as I fine-tune, but leaks seem random an unaligned with other events. Ah well, eventually I'll get there.

4/5/2011
Now we're cookin' with gas!

AHI 3.8
Leak 18.1

Still not a morning person, but I am slowly seeing it become easier to get going in the AM. This process will happen over time, I know, and there will be setbacks, I know, but it's so cool to start seeing an impact.

What I learned: ALWAYS READ THE GRAPH! (Thanks Pugsy)


So it looks like there's just a few leak spikes, and they do NOT correspond to AHI spikes. Very reassuring to see this!
Aside from the beggining of the night (when I adjusted the mask twice) it seems to be below the redline for the most part. I'm nearly positive the two "camel humps" are when I shifted position to my left side, which seems to cause leaks a lot more than my right side does. Go figure.

Oops, I am running LATE today!
4/7/2011

AHI 3.8
Leak 10.1

Really deep sleep, mouth open, whole thing. My body now wants more sleep, I guess trying to catch up for several years of missed stuff.

What I learned: Pressure sores on the bridge of your nose can HURT. Yes, they are healing now that I've got the mask adjusted, but they still sting like hell right now =)

TalonNYC wrote:Thanks Pusgsy! I'm a gearhead - I love gadgets and tech, so I'm approaching the entire CPAP experience as "look, new toys!"

This is exactly how I am approaching the whole CPAP experience!!!