Does a really large leak necessarily = shallow respiration?

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old dude
Posts: 643
Joined: Sat Jul 27, 2013 4:08 pm

Does a really large leak necessarily = shallow respiration?

Post by old dude » Fri Sep 13, 2013 7:43 am

OK, I had a really ugly night last night with large leaks. 46% according to Encore Basic and you can see the waveform chart below:

Image
The large leak territory is shaded in light grey.

Sleepyhead looks equally bad:

Image

It strikes me that on both charts when the large leak was at it's zenith around 130 L/min, my respiration got very shallow. Is this normal and to be expected? It could have happened before and I just never noticed. As a word of explanation, what no doubt happened here is that I had jaw drop right out of the bottom of my mask and it became dislodged from my face. This mask is the Quattro Air and is probably my favorite mask for a lot of reasons. Normally it throws good numbers; occasionally however it will ride up on my face and I'll awaken with the bottom of the mask in between my upper and lower teeth, and I'm sure that's what happened here.

I also notice that when the leak was at it's max the difference between the purple and green leak lines in SH approach 100 L/min. I thought that the difference between the two lines roughly equaled the built in vent rate for the mask itself which is around 45 L/min. Does everything just go out the window with a leak this big?

As an aside it's interesting that with all this leaking my AHI was still 1.24. Yes, I know that it is thought when leaks this large go on for so long AHI numbers are deemed unreliable, but normally when I have a bad leak night my AHI number skyrockets as well.

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Pugsy
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Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Does a really large leak necessarily = shallow respiration?

Post by Pugsy » Fri Sep 13, 2013 7:52 am

With leaks in the over 100 L/min range the machine simply can't sense anything reliably....so the flow you see as "shallow" is most likely just the machine barely being able to sense breathing at all.
Same thing with that low AHI with leaks well over 100 L/min...the events are most likely happening but the machine can't sense them and if it can't sense them it can't report them. They may or may not have happened...the machine threw up it's little arms in desperation and said "I can't handle this leak so I don't know what to report".

What you see being flagged (or not being flagged) during that time when leaks were pushing 130 L/min is totally unreliable data. Might as well not even been flagged.
Up to about 100 L/min the machine can still be fairly reliable...not perfect but fairly so.
Between 100 and 110 L/min it really starts running into trouble...over 110 L/min the data is useless and can't be trusted at all.
Pushing 130 L/min leak...from 120 to 130 L/min we can't trust anything the machine says except the big leak.

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