leak questions

Lately I seem to have almost constant small leaks. I have replaced the mask cushion, but it has not helped. The 22nd was the last night with the old cushion, and the other chart is last night. My AHI is averaging less than 1, but the mask leaks are waking me up during the night. I have a pad a cheek mask liner on order, I'm hoping that will stop the leaks, especially the ones blowing into my eyes.

What is considered an acceptable leak rate?

My sleepyhead leak graph shows 2 lines which line shows mask leaks?





Gary

Gary,

Your equipment profile shows you are using a Quattro™ Air Full Face Mask with Headgear.

Your leaks are under control from a "quality of therapy" point of view, but as you say, the leaks are waking you up and some of them are blowing into your eyes. So something needs to be done about them so you can get some decent sleep.

You say you've got a mask liner on order. Maybe it will help. Until it comes in, you can try to make a homemade one by placing the mask on a worn out t-shirt and cutting around it with a decent margin on the outside. (Not too big and not too small). Then cut a hole in the middle for your nose (or nose and mouth) to poke through. And place the mask liner between the mask cushion and your face.

You ought to review JanKnitz's tips for taming the Mirage at http://maskarrayed.wordpress.com/taming ... e-quattro/ While her tips a for a slightly different mask in the Mirage family, the principles remain the same.

Also think about your bedtime facial care routine. If you've got a heavy beard stubble by bedtime, you may need to shave before going to bed. You may also need to be careful about what you wash your face with and you may want to wash your face an hour or so before going to be so that the face has time to thoroughly dry before it's time to mask up.

If you think the problem might be caused by your mouth opening and the lower jaw sagging and pulling the mask slightly out of place, you could try either a chin strap or an anti-leak strap from Padacheek.

Finally, if you simply can't get this mask to work, you might want to try one of the other masks in the Mirage family. Since the Mirage Air's forehead support does not seem to be very adjustable, you might do better with a FFM with an adjustable forehead support or maybe even a FFM that has no forehead support.

In terms of effecting therapy your leaks are well withing acceptable limits for your machine, your mask and your pressure.
When evaluating leaks using Sleepyhead..that top leak line is total leak which is going to include your expected intentional vent/leak rate. Stay below 90 L/min with that top line and you will be fine...We don't know exactly where large leak territory begins as it can vary between machines, masks and pressures but I would be surprised to see a large leak flag anywhere below 90 L/min given your mask and your pressure. We could use Encore to verify where the line in the sand happens to be should you start seeing closer to 90 L/min leaks...if you wish.

If the leaks weren't waking you up then we would just tell you that everything was well withing acceptable limits and not to worry.
So the leaks are bad news because they are disturbing your sleep...not because they are so bad your therapy is in the toilet.

All masks have intentional vent/leak rates. Full face masks will have higher vent rates than the other masks...higher pressures will also increase the vent rate as it goes up with the pressure...so your full face mask and that 16 cm pressure means that your vent rate is going to be higher to start with.

The Quattro Air mask shows a vent rate of about 45 lpm at 16 cmH2O, so you're a little above that. Your leaks aren't too bad, but you could stand to work on them a little.