Leaks - how much is too much?

Hey all! Last night was my first decent (read: 6.5 hours) of sleep so far since I got my S9, and I feel pretty good. Nice shiny 0.0 AHI last night

I'd like to know about leaks... I'm not positive what I'm looking at. This morning for example:

Leaks
Median: 0.0
95th Percentile: 3.6
Maximum: 20.4

I'm sure the maximum is a spike, and 95% of the time I'm below 3.6 L/min... is that good? bad? ugly?

Those leaks are GREAT---particularly for someone who's only a few days in!

Ditto to what Robysue has said.
You are doing great.

What is your pressure setting?

Sheriff

*whew* thanks for the reassurance! What numbers should I be mindful of?

Sheriff, I'm set to 13 cm/h2o, and my machine ramps up from 6 to 13 over about a half hour, and stays steady at 13 all night. Also, here's my license, registration, and proof of insurance. And there's nothing duct-taped in the trunk trying to scrape its way to freedom.

Kilgore Trout wrote:*whew* thanks for the reassurance! What numbers should I be mindful of?

In regards to leaks. Remember ResMed machines already subtract the intentional vent/leak rate so what you see is all excess leak. ResMed says it can handle up to 24 L/min before it questions therapy and event scoring.
Of course you want to stay away from that 24 L/min.

If you have the software you can see the actual leak line as it goes up and down through the night. Occasional spikes are common and usually easily explained. You just don't want a prolonged spike that is large enough to impair therapy.
I, myself, don't pay a whole lot of attention to the leak number except in passing. I just like to look at the overall leak line to see if it is fairly straight and I don't have long periods of time when leak line is showing a larger than wanted leak. I might have 6 hours of perfect leak line and 30 minutes where things go wild. This might elevate the leak average a bit but I can see that overall, the leak was quite acceptable and I don't worry about the leak number or average.

The percentile leak that ResMed reports needs to be as close to zero as possible. Yours is already quite good at less that 4 L/min. I wouldn't worry much about leak unless I started seeing that percentile number in the double digits and anything close to 20 means serious work needs to be done.

Trout: I was thinking your 95 percentile was the pressure setting the machine was putting out 95% of the night. Apparently after reading the other posts, it was the leak rate... (95% of the night). So it does look good.

As far as the things in the trunk.... you wouldn't mind if I looked would you...?

Sheriff Buford wrote:I was thinking your 95 percentile was the pressure setting the machine was putting out 95% of the night. Apparently after reading the other posts, it was the leak rate... (95% of the night). So it does look good.

There can be a 95% pressure number if ResMed is in APAP and in auto mode.

There is also a 95 % leak number which does mean that for 95% if the night the leak was AT OR BELOW that number. Just like with 95 % pressure number on APAPs.

I've gotten the software form the link in Uncle_Bob's sig as suggested, and I've been checking my data every morning. The leak line stays pretty flat most of the time with occasional spikes that flatten out pretty quick. Looks like I'm good to go there. Thanks everyone!

Related question: Can you get a leak rate number on the machine screen or is that only available from the card and software? Right now I can get an AHI number and a mask fit mister-smiley/frowny-face indication on the screen. Was wondering if there's a setting to change this to an actual number or if I have to download my card data to get a leak rate number. Thanks!

snardo: I asked this question a few days back. I was told that if you hold the Info button along with the scroll button down for 3 seconds you get a few more readings on the screen. I tried this the first time this morning. It did show some sort of leak rate, but I haven't figured it out yet. I was hoping the screen would show the number central apnea incidents and the OSA incidents, but it didn't. That's all I really need to know on a day to day basis without downloading software and such.

snardo wrote:Related question: Can you get a leak rate number on the machine screen or is that only available from the card and software? Right now I can get an AHI number and a mask fit mister-smiley/frowny-face indication on the screen. Was wondering if there's a setting to change this to an actual number or if I have to download my card data to get a leak rate number. Thanks!

There is a way to show the leak rate on the LED screen . Exact steps I don't know since I don't use Resmed machine.
Perhaps that is another feature the helpful DME turned off...

See if you can find what you need in the clinician manual... do you have one? If not forum member Uncle_Bob has it available in his signature line. Check his profile to see it.

Or this visual aid may help. If not, post back and Resmed users will explain step by step how to get to that leak rate on screen.
http://www.apneaboard.com/ResMed/ResMed ... Setup.html

if you hold down the info and the other button next to it for a few seconds you get to a different menu system. Turn the dial knob anti clockwise to the sleep report menu. Press the dial knob and that highlights the first item. You can then scroll up and down in that menu to see all the items in it. Eg usage, Leak, AHI, AI, centals. There is more in that menu than shows on the screen at once so you have to continue to scoll down to get what you want. To get out of that menu you scroll down to "back" or "home" and press the dial button to put that into effect.

Well, my awesome leak ratings are possibly gone for a bit.. could you tell me if this looks problematic? FWIW, I woke up with a pretty dry mouth a few times during the night and this morning. Yesterday and today both look like this.

(that first bit is trying my FFM, which I didn't like at all, and couldn't get a good seal)

Yes, that leak is a problem. Roughly half the night your were very close to that red line or above it where ResMed says it probably can't handle things.

Leaks and mask comfort.. hard to get sorted out. Still for just starting out, you had half the night where leaks were well controlled. So that is a positive. Just keep working on it. You want to stay as far away from that red line as possible for as long as possible.