Sleepyhead & leak data

I've seen several people post their screen shots of their leaks on SH and they have just one line....the purple one.

I have 2 - the purple and the tan one. I didn't see an option to get rid of the tan one (total leaks). How did they do that? The tan one is the one that doesn't matter anyway, right? It includes the air coming out of the vents...?

Also, what's the ideal number to see for leaks? I know it depends on several things and I am still switching masks...currently I will be using the Mirage Liberty at cpap pressure 12. I also got Lansinoh tonight to try so hopefully I will see better leak #'s!

Your machine reports total leaks. That the top leak line in SleepyHead....
Total leak is vent rate plus excess leak.
The bottom line is supposed to be excess only leak (like ResScan reports for their ResMed machines). It hasn't been polished. Mark was having trouble with the calculations involved for when people use APAP mode with the varying pressures and various vent rates...It's going to be close though..there is no "good" or "bad" number available for that leak line.

Instead concentrate on the top leak line...total leaks. Your leak number to avoid is somewhere up around 80 to 90 L/min.
Stay well below that and you are fine. EncoreBasic will actually flag a large leak but with SleepyHead we have look a little closer.

All masks have vent rates. It's in the mask paper work or there is a little graph that Resmed has offered.
http://www.resmed.com/us/assets/documen ... sa_eng.pdf

There's also always a little plus or minus normal variation anyway..5 or 6 L/min.

I'm also a little confused about the leak numbers from Sleepyhead. Average numbers for me are:
med-16.8
95%-38.40
max-56.40

Do those numbers seem a little high?

MarilynJune wrote:I'm also a little confused about the leak numbers from Sleepyhead. Average numbers for me are:
med-16.8
95%-38.40
max-56.40

Do those numbers seem a little high?

Depends on the machine.
For a Respironics PR S1 these are probably great numbers....Large leak territory begins somewhere around 80 to 90 L/min.

For a ResMed S9 machine whose large leak territory starts and 24 L/min...it doesn't look so good.

Median is a median average

95% just means for 95 % of the night you were at OR below that number. Sometimes that can look worse than it is because people tend to forget the OR BELOW part of the definition especially when evaluating the S9 reports.

I don't know what machine you are using but I suspect it is a PR S1 machine and if that is the case the worst it ever got (probably a brief spike with mask refitting) you are not even close to large leak territory where the machine can start to lose the ability to compensate for leaks.

Ok, so my leaks have been bad then.

Here is this month...(wearing the PR true blue nasal mask - one size too big)

4/1


4/2


4/3


4/4


4/5


4/6


4/7


4/8


4/9


4/10


4/11


4/12


And lastly......LAST NIGHT 4/13 (wearing the Mirage Liberty)


The reason for the break last night was because I woke up and my tube was disconnected from my mask. I put it back on but had no idea how long I had been breathing into the mask with no tube! Ends up it was for over an hour.

When I wore the nasal mask I didn't ever have that problem, but with the Liberty it has happened a few times. I think I roll over on the tube and it disconnects easily.

Holy Moley...those were indeed some massive leaks. Those up over 100 L/min very likely caused the machine to maybe even miss some events and for sure probably let some happen.

Now you know what to look for what a really good leak line looks like.
Now just figure out how to keep it from coming unhooked so easily.
Good job on last night and the mask change.

Thank you for your help!

I guess that's why I haven't been feeling optimal yet, huh?

I ordered the Tap Pap and hopes it works as well for me as it does for most. I hope it reduces the leaks too. I know that SOME of the leaks are from my mouth opening while using the nasal mask. I have yet to try a chinstrap or taping, but if I still have mouth-breathing issues with Tap Pap, then I will try one of those options. BTW...what do you tape your mouth with? First aid tape?

I am also going to order some kind of hose suspension unit because I do tend to wake up and fiddle with the hose when rolling over and I think that would eliminate it coming undone. I've looked at a few so far. Any recommendations?

Also, since I switched back to the Liberty last night, I experienced for the first time ever, what people refer to as the chipmunk cheeks....actually I felt like an inflated puffer fish!! If I opened my mouth only slightly then no problem, but a little wider and my cheeks puffed up - really annoying. Does that just come with the territory at a higher pressure? I was at 14 last night and I'm going to try 12 tonight. I didn't sleep that well just due to that, the hose issues etc, but the leak #'s looked pretty good for last night with the Liberty?

Sorry for so many questions

Wow....those large leaks looked like what I went through with my FFM,

Your leak numbers for last night were great.

If you are mouth breathing with the nasal pillow mask...let's first make sure that the mouth breathing is bad enough to really worry about. I sometimes mouth breath but it doesn't last very long and rarely goes into large leak therapy and I sleep right through it. So let's make sure you have something that needs fixing before we start worrying about what fix to use.
You might be surprised and it not be the problem you are expecting.
If it is a problem...I have thought about how to do some taping with the Tap Pap should someone need it and I think we could just tape the sides on either side of the bite guard thingy that comes out the lips. You will see what I mean. It's less than an inch across so it doesn't take up the entire lip area unless you have teeny tiny lips.

Hose management stuff...I am not much help because I have never used one. I have an old iron headboard with scroll work so I have tried routing through...it works but I don't like it. I prefer to just route the hose up around the bed pillow and bring it down to my face that way.. It's overhead sort of but laying on the mattress. That's the way I have always done it and suits me the best.
But there are a lot of ideas in here. You could probably rig up something simple from stuff laying around the house.
viewtopic.php?t=10640

Hello pugsy, New to CPAP but I'm learning a lot from your posts. I will need to purchase a machine soon when my DME trial is up. In a message above you mention that "large leak" territory has different thresholds for the resmed & respironics machines. Can you explain why they're different? Is this an advantage to choose a respironics over a resmed? Thanks

Gearhead wrote:Hello pugsy, New to CPAP but I'm learning a lot from your posts. I will need to purchase a machine soon when my DME trial is up. In a message above you mention that "large leak" territory has different thresholds for the resmed & respironics machines. Can you explain why they're different? Is this an advantage to choose a respironics over a resmed? Thanks

No, the way a different brand reports their leak doesn't mean anything as far as treatment. It's just a number manipulation.

I do prefer either the Respironics full data machine or the ResMed S9 full data machine for other data accumulation over say the F & P or Devilbiss full data machine.
Respironics and ResMed have easier to use and easy to obtain software.

The fact that one machine uses a different "Large leak territory" number than another machine brand doesn't hurt the therapy offered or make one better than another. It's just a different number for the person using the machine to learn to watch for.

As to why they are different??? That's the manufacturer decision based on what they expect their machines to report and be able to compensate for minor leaking. Different measuring systems...different ways of compensating for leaks which I think that is the likely reason but I have no way to know for sure. All that is part of each brands closely guarded algorithm which they have patents on and don't like to readily share.

Respironics machines report total leak under normal conditions...that being the mask vent rate plus any excess leak.
Now there is a way to use Encore software and change the way they report but it really isn't an issue.

ResMed prefers to subtract a generic vent rate for which ever mask selection is used and then report only excess leak.

With both ResMed and Respironics...the leak number isn't a dead spot on number anyway.
There are inherent minor plus and minus values with every mask's published leak rate and in ResMed's case they are using a generic value or average for all their masks in whichever category...like they take all their full face masks and get the vent rate average for all of them and use the vent rate at pressure used as starting point.

Remember...ResMed isn't going to figure the vent rate for a Respironics mask.

Large leak territory numbers are just guidelines...it isn't a brick wall.

I don't use a Resmed nasal pillow mask right now...yet my mask selection choice is still "nasal pillow" on my S9...the vent rate for my current nasal pillow mask isn't exactly the same as it was when I was using the Swift FX which is a Resmed product.
My machine doesn't know that though...it's still using the generic nasal pillow vent rate for its calculations.

So do you see what I am getting at....leak numbers are guidelines and not set in concrete as this is exactly what was going on. It's close within normal variances that go with any mask vent rate.

So it doesn't matter how or what a machine uses such and such number as large leak territory marking line...it's sort of a rather floating line or can float a bit.

I'm trying the Mirage Liberty tonight. Went to the DME and will have the mask for a 30 day trial. I have to say right off that the mask feels so much more comfortable than the Mirage Quattro. I'm hopeful. I could never tame the eye leaks with the MQ. It seems that ResScan software only distinguishes mouth leaks. That wasn't a problem for me with the MQ. It seems a person needs to be a contortionist to get the straps figured out! I had the mask on for about 1/2 hr today and felt no eye leaks. I think there will be a learning curve with this mask.

The DME also mentioned that one of her clients, who has Graves Disease, is super sensitive to eye leaks and started using goggles and is having some success that way. She also said that the client also uses a Mirage Liberty.