Acceptable leakage amount

[sleepytimegal]

Hi fellow apneacs,
I've been sleeping on my back since I started cpap about a year and a half ago. Sleeping on my side didn't seem to work so well. But I got tired of sleeping on my back all the time and decided to give sleeping on my side another go. I got a special apnea pillow which is somewhat helpful and am using the Airfit P10 mask which is supposed to be a good side-sleeping mask (according to Google). 

The problem I'm having is that my leakage (according to sleepyhead and Resmed) has increased quite a bit. I look at both results daily - Resmed doesn't have graphs but gives you a score. 

I went from approx. 7 leaks/min (on my back) to around 16 (on my side) according to Resmed. Today, acccording to Sleepyhead, 95% of the time my leaks were not over 16.80 with the highest being 22.80.

This bothered me and I thought I should return to my back, but my DME therapist said that it's only a problem if your score is in the twenties because the machine will compensate for it unless the leak is over 24. She said to watch and if it was creeping up I should go back on my back, but if it stays in the teens, then no problem.

I don't always believe everything she says, so thought I would check with you guys. Would you be concerned if your leak rate was that high?

[Crimson Nape]

Have you tried replacing the pillows? For me, increased leaking is usually a sign they are wearing out.

[sleepytimegal]

Yes, Crimson Nate, the pillows and hose are relatively new and the increase in leaks resulted from switching from my back to side. It doesn't seem like I move around on my side, but apparently I do. When I wake up the pillows are in place though. That's why it seems strange. Mainly, I'm just wondering if the leak numbers are acceptable to continue on my side.

[Crimson Nape]

While the number of leaks are important, how much over the 24l/min are you per leak? I see you don't have #SleepyHead listed in your profile. Does the software that you are using provide this data?

[Walla Walla]

If your leak rate is below 24ml/min your fine.

[sleepytimegal]

Crimson Nate, I do use SleepyHead - I'll have to update my account to show that. My sleepyhead data says my maximum leak was 22.8 L/min and that I didn't have any major leaks. I guess that's pretty close to the maximum. But 95% of the time it was not over 16.

[Hojo]

While your leaks are 'acceptable', I have noticed that I get a bit higher AHI when I have more leaks.  That being said, for me it is a trade off as I'm trying to get the bridge of my nose to heal from wearing a FFM.  I will accept a higher leak rate while my nose heals.

[sleepytimegal]

HoJo, The bridge of my nose is very sensitive too, so am lucky I don't have to wear the FF masks. In the beginning I thought I would, but trained myself to not breathe through my mouth. I'm wondering if part of my leak problem is that when I'm on my side I don't keep my mouth closed as well. I think maybe that's it, because the nasal pillows seem very secure in my nose and I've never waken up with them bumped out of place. 

Thanks for your help and input. I'll continue on my side and just keep checking my stats to make sure I'm under the leak limit.

[mesenteria]

I can sleep on my side with my AirFit N20 nose cover, but as I slip into sleep my head sags a bit and my chin drops toward my chest.  It's a tiny movement, but the air flitting across my eyelashes brings me awake because I know it's best not to have any leaks.  

I have learned to accommodate for this by exaggerating my head position to that orientation and then placing my head on the pillow fully.  If the mask doesn't leak that way, it won't as I fall asleep.  This seems to work.  Figure out how the leaks happen, adjust yourself to force that to take place with you in preparation, and then relax.  Let nature do the rest. 

[sleepytimegal]

Thanks Mesenteria. I am trying to figure it out and I believe it does have to do with positioning. I will experiment tonight.