Leaks

I'm wondering whether leaks are fairly common with CPAP therapy. I understand that an absence of leaks is best, but is this a standard that is difficult to reach? Are leaks below a particular threshold generally considered insignificant in terms of successful apnea treatment? In other words, if the AHI and HI are consistently below, say, 1.0, do leaks become secondary or perhaps not even a consideration? Or can leaks, independent of AHI and HI measurements, cause other more insidious problems that then result in a lower quality of sleep? Arousal, for example, comes to mind. I suppose that some people may be more sensitive to even slight pressure changes and I'm wondering whether even smaller leaks may be enough to cause slight pressure variations and, in turn, arousal in some people. Thank you in advance.

I'd like to know about leaks too. I'm trying to learn how to read the Sleepyhead data and have some understanding. What is an acceptable level for leaks? Is there an area on this forum where I can find a tutorial on interpreting this data? I'm trying to use a nose mask and chin strap. If I open my mouth while sleeping will it show up as a leak when I look at my data with Sleepyhead software? Thanks.

Leaks are a problem for two possible reasons:
a) Large leaks may impair your machines ability to match therapy pressure consistently and therefore affect the quality of the therapy and not prevent events. Also, large leaks may prohibit the machine from properly identifying events and therefore make your data untrustworthy.
b) Large or small leaks of any size may wake you up fully, or even just enough to bring you our of deep sleep. Some people do not wake it through leaks (like me). This is just as harmful to sleep quality as events. Leaks below "large leak" territory (Resmed is 24 L/min) can be accounted for by your machine and should not affect therapy pressure at the mask or data validity, but may be waking you up (even if you do not recall being awoken)

Good rule of thumb, post your data here and tell people how you feel. The odd leak in your data consistently below large leak, and you are feeling refreshed in the morning and not tired at the end of the day (sleepy tired) you are probably ok. I would just take a screen capture and post it, someone (Pugsy hehe) will pipe-up and tell you if it is something that you should be trying to chase down.

Nashpap wrote:What is an acceptable level for leaks?

Varies with machine use and how the leak is reported...total leak vs excess leak only.

Nashpap wrote:where I can find a tutorial on interpreting this data?

Look in the Announcements section of main forum page...top line...I have a "how to understand" thread.
I explain total leak vs excess leak in that tutorial.

Nashpap wrote:If I open my mouth while sleeping will it show up as a leak when I look at my data with Sleepyhead software?

Yes, most likely if you do it for very long. It's a leak...doesn't matter where the air is escaping from...mouth or mask...a leak is a leak and the machine can't tell what caused it. Usually fairly easy to spot on the leak line graph though when the mouth is the culprit....normally BIG jump in leak that lasts for several minutes.
Not all mouth breathing leaks mean the entire night's therapy is in the toilet though...all depends on how big and how long it lasts.

zmbee wrote:I'm wondering whether leaks are fairly common with CPAP therapy. I understand that an absence of leaks is best, but is this a standard that is difficult to reach? Are leaks below a particular threshold generally considered insignificant in terms of successful apnea treatment?

Again, same response...depends on which machine and how the leak is reported. See the tutorial above.
Yes, even excess leaks below a certain point the machine can normally compensate for. It's only when they (excess leaks) are really big and last a long time that therapy effectiveness come be in jeopardy.

Please understand how your machine reports leaks before going into panic mode.
ResMed machines are the only machines that report excess leak only as primary leak statistic.
Respironics, F & P and Devilibiss all report total leak and those leak numbers will never ever be 0.0 because of the mask's intentional vent rate being included.
So all you PR S1, F & P and Devilbiss users...don't hit the panic button when you see a 30 L/min leak number and you remembered that 24 L/min is large leak number to avoid for some machine...that's only the ResMed machine.

Respironics, F & P and Devilbiss all have different "large leak" territory beginning line in the sand numbers.
With the F & P Icon it is 60 L/min
With the F & P sleepstyle series around 100 L/min
Respironics is somewhere between 80 and 90 L/min depending on machine, mask and pressure
Devilbiss...I forget but I think somewhere in the line of where the Respironics large leak territory starts.

The only machine that has the 24 L/min red line in the sand is the ResMed machine.

Bear in mind any leak that disturbs sleep is unwanted even if it is technically below large leak criteria but because it impacts sleep quality and not because the therapy is in the toilet.

Pugsy, do you have all that stuff crammed into your brain, or do you have a cheat sheet next to your computer?

bavinck wrote:Pugsy, do you have all that stuff crammed into your brain, or do you have a cheat sheet next to your computer?

I do have some cheat sheets but not for that stuff. Cheat sheets mainly for technical step by step stuff since that doesn't change much. The SleepyHead tutorial itself is sort of a collection of cheat sheets so that I don't have to keep typing the same stuff over and over and over again because all of these questions have been asked and answered hundreds of time in the past on this forum. I haven't seen a new question in a long, long time. The Pugsy's Pointers Collection was an attempt to save my fingers because I got tired of typing the same response all the time. There really aren't (or haven't been) any new problems or questions...just new question or problem "askers".

The large leak numbers for each machine...that comes from past experience seeing reports from the various machines and reading the software tutorials that come with them. So, yeah, stored away in one of the corners of my brain. Some stuff I remember really well and easily and that's one of them...on the other hand I might forget what I had for lunch. Scary thought huh? It's funny but technical stuff stays stuck in my brain a lot better than mundane stuff.
Memory isn't perfect though...after all I just had my 62nd birthday 10 days ago.