Someone 'splain this........Lars4life - ok to read!

So here is leak data from the software - it's all Greek to me, not sure if the graphs are supposed to be flatter or if the spikeyness is the norm.



Note: maybe some of the spikes are from dreaming about flying monkeys? (sorry Lars)

When it comes to leak graphs: Flatter is Better.

On both these nights, you got leak problems McSnoresalot. Maybe from mouth leaks? Maybe from a mask shifting around when you moved?

McSnoresalot wrote:not sure if the graphs are supposed to be flatter or if the spikeyness is the norm.

Flatter, Mac, Flatter.

The software is showing unintentional leak, so it is pretty much all over the place. Compare yours to mine below.
But to be fair, some of yours is acceptable. Notice how I got a chance to brag on mine.

you got leak problems McSnoresalot

Hmmmmm, maybe so - graphs were WAY spikey-er with the comfort gel nasal mask & the Ultra Mirage FFM - pretty sure those leaks were from rolling onto my side and dislodging the seal. With the (invisible camo) Sleepweaver - I don't notice (wake up) when I roll on to my side or stomache as much so maybe there is some leaking going on - still don't think it's mouth leaks though (no dry-mouth).

I could try cinching the headgear up more - I prefer it a as loose as possible, my pressure is averaging around 16.5 so I expect leaks are going to be an on going deal.

What are the numbers on the left of the graph and what should they be under? The bar on top is mostly green - green good, yes?

Mac

McSnoresalot, you got problems with Facehugger, graphs are definitely to spikey. green is not good, if you get close to green, you got reall really big leak. You might want to search for the intentional leak for the invisible, camo mask and compare that number to the graph. Please don't let this problem distract from your entertaining posts, we all need some laughs Kathy

McSnoresalot wrote: What are the numbers on the left of the graph and what should they be under? The bar on top is mostly green - green good, yes?

Green is good but it has to a horrible, horrible leak not to show up as green. Can't go by green line.
Gotta go by the leak line itself.

Numbers on left are graph scoring for L/min of leak. Since your software is reporting unintentional leak you want that line and number to be as close to 0 as possible. Allowing for some minor variables and some leak, somewhere around 20 L/min would be the most I would be comfortable with at your pressure with your mask. Look at the line, not at the number because the number is just an average... Watch for flatness and minimal jumping around.

While the nights that you have posted aren't grossly bad and probably not bad enough to impact data severely, you still need a straighter and more stable leak line just to make sure that everything is as good as it could be. Hate to go through all this work and not be having the best possible outcome.

Oops, thanks Pugsy. didn't catch that you were reporting unintentional leak, cancel my useless advice, only good for intentional leak. But don't forget the stories

mayondair wrote:Oops, thanks Pugsy. didn't catch that you were reporting unintentional leak, cancel my useless advice, only good for intentional leak. But don't forget the stories

Actually given the mask and his pressure even with the software reporting unintentional leak, I don't think Mac will ever get a near zero line. I think a flat 10 L/min with his mask and pressure would be more realistic goal for him than zero. I expect that the vent rate for that mask at these pressures is going to be up there and when the machine reports the leak it seems to use a generic number as its base and really only gives us a WAG to go on. This is why the line itself is more important than the overall number. Where ever it tends to be the lowest, it needs to not bounce around so much.

If the software were indeed reporting total leak (like we normally see on Respironics reports) his leak line would be very, close to that 80 to 100 L/min mark and thus way more than acceptable.

For those wondering about the Unintentional leak or Total leak I have mentioned. Encore Pro 2.xx defaults to show Unintentional leak which is similar to ResMed machines but we can change the software default to show Total leak if we wish. Then we would of course have to do the math and subtract the vent rate at his pressure from the total leak. The machine doesn't know which mask is being used and so it doesn't give an exact base figure. But it is close and the most important thing is the line stability anyway.

To add to what Pugsy said:

If you are using Encore Viewer software as opposed to Encore Pro, then only total LPM is shown, so you need to look up what your mask's intentional leak rate (sometimes called "acceptable leak" rate or other things) is at a particular pressure, SUBTRACT it from the leak rate on the chart, to see if leaks are a problem or not.

The green line at the top generally indicates that your machine is able to compensate for the leaks you are having, but as those leaks get pretty high I personally think the accuracy of the data is compromised so even when the green line is present you may not be getting the best therapy if your leaks are too high.

Interestingly, I've had a lot of leakage since I've been using the Quattro instead of nasal pillows. My leaks are not often so high that I question the machine (but I do see the dreaded black line for "large leaks" on occasion). As a result of these smaller leaks, my pressure is higher on average, and my AHI's are LOWER becuase of increased pressure. And I feel a little better then I was feeling using nasal pillows with lower unintentional leaks.

Thanks Pugsy,Good explanation., I use Encore Viewer, and do look at total leak average, I dont often get zero after subtracting Intentional leak, close sometimes, and not spikey, but I only use11-15. I agree that the line is more important esp with Mc Snoresalots high pressure. I hope all this technical talk doesnt interfere with his stories.

Okay -- going out on a limb here trying to learn.....

Shouldn't his base rate actually be lower on the chart for the Sleepweaver over some of the other masks he's used since it actually has a lower fixed leak rate (or vent rate) than the other masks??

I say this because at a pressure of 16 the posted fixed leak rates are:
Quatro FX -- 48
Activa LT -- 40
Sleepweaver -- 35

Or is my thinking flawed???

mayondair wrote: I hope all this technical talk doesnt interfere with his stories.

Somehow I don't think this technical stuff will stop the stories. I think he posted the graph to humor me since I requested it.

Mac has Encore Pro and he never changed the leak default. What he is seeing is all excess leak. Doesn't hurt a thing to have it this way, just as long as he realizes that it isn't nearly as good as he originally thought it was. I hate to bust his bubble but he reported some time in Large leak time % off the machine data screen. So sometimes that leak is a whole lot worse than what he is showing now. It takes a leak big enough to sink the Titanic to get reported as Large leak % on the LED screen. Totally useless feature. Wish Respironics had gone with AHI breakdown instead. Would have at least then been useful. But then, they didn't ask me....don't know why.

Pugsy wrote:

mayondair wrote: I hope all this technical talk doesnt interfere with his stories.

Somehow I don't think this technical stuff will stop the stories. I think he posted the graph to humor me since I requested it.

Mac has Encore Pro and he never changed the leak default. What he is seeing is all excess leak. Doesn't hurt a thing to have it this way, just as long as he realizes that it isn't nearly as good as he originally thought it was. I hate to bust his bubble but he reported some time in Large leak time % off the machine data screen. So sometimes that leak is a whole lot worse than what he is showing now. It takes a leak big enough to sink the Titanic to get reported as Large leak % on the LED screen. Totally useless feature. Wish Respironics had gone with AHI breakdown instead. Would have at least then been useful. But then, they didn't ask me....don't know why.

Good thing he posted graphs to humor you, he'll get sorted out and his leaks under control now that he knows we're on to him.

Tip10 wrote: Shouldn't his base rate actually be lower on the chart for the Sleepweaver over some of the other masks he's used since it actually has a lower fixed leak rate (or vent rate) than the other masks??

I say this because at a pressure of 16 the posted fixed leak rates are:
Quatro FX -- 48
Activa LT -- 40
Sleepweaver -- 35

Or is my thinking flawed???

No your thinking is right on. We just have to look at what is being reported and take your thoughts a bit further. Encore Pro offers 2 choices. Encore Viewer offers 1 choice.

Total leak which would include a "base" or vent rate and excess leak (Encore Pro choice and only choice for Encore Viewer)
or Unintentional leak which is all excess leak. (Encore Pro default setting which can be changed to Total leak)

Problem with Respironics machines is that it has no way of knowing exactly which mask type a person uses and with either way of reporting. Resmed machines at least get to get a closer estimate for Vent rate allowance (or base) before subtraction, by the mask selection feature.
So Mac's machine doesn't know what his base vent rate really is. It just takes a calculated number and that's what it uses. It is close but it is not spot on.

A while back I did a little experiment with the 2 reports. Unintentional and Total Leak. I toggled back and forth between the 2 and compared leak averages over the same 7 days. The "base" rate used by the machine varied between 28 L/min and 30 L/min. Okay that is wonderful but at my pressure my mask vent rate is 34 L/min... So obviously the number that is the machine calculated vent rate is not very close. I can't subtract 34 L/min vent rate from a Total Leak average of say 29 L/min (and I have seen it often and even 25 Total leak) and get a less than zero leak rate average.

In other words, the leak rate average shown is a close WAG. So I don't put a whole lot of stock in that average or even vent rate numbers for different masks. I just say look at the line itself. That is the starting point wherever it is and little bumps are okay but lots of big bumps not okay, doesn't matter what the overall average ends up being.

Hope I haven't confused you more... I sometimes do that. What is clear in my head gets muddled up when I type.

Pugsy, I just started using E.Pro today and I don't understand all the settings.

How does E.Pro "know" how much leak is intentional vs. unintentional? I haven't found a place to enter the mask's intentional vent rate. If he's not using a Respironics mask, is it just picking some default number? Do you think it would be better for Mac to set E. Pro to show total leak rate so he isn't counting on the software to make computations?

Mac, many who have used Sleepweaver, including me, report it's exceptionally comfortable but hard to get sealed. Still, from what others have posted, if the total leak doesn't exceed around 2X the intentional vent rate, the machine can still treat obstructions and flag events. If that's correct, you could get effective therapy at an unintentional rate as high as 35. But some of the night you're above even that, so your therapy and report may not be accurate. Obviously zero unintentional would be best, but what Pugsy suggested about trying to get it below 20 allows some headroom.

I have not been able to get SW to work for me.