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Ahh, that new machine smell
#1
So my last Airsense AutoSet 10 committed suicide - a major short happened seemingly out of the blue and fried the electronics. So, now I have a brand-new machine, and ahhhh what a difference!

I actually think something was going wrong with my previous machine for awhile because I was getting much higher leaks than normal over the last month (as reported in my summary stats on the machine every morning), and unrealistically low AHI's. These leaks were unaffected by changing all of the usual parameters (hose, pillows, humidifier tank, etc). I also wasn't experiencing that "Ahhh refreshed" feeling the next morning that I associate with my earliest days of PAPing. Now after one night with a new machine I feel awesome!

It's great to feel like this again, and I suppose my point with this post is, "If you think something is wrong, then something probably is" (assuming you're experienced enough to know how to troubleshoot and optimize your setup and have already done so). Don't ignore and accept it. This board is all about taking charge of your own therapy, and for the last month I took a backseat, accepted sub-optimal performance, and paid the price in how I've been feeling when I should have been hounding my DME for a new machine. I also wasn't tracking my data in SH because I got lazy - if I had been, I would have seen that leaks were out of control, which should NOT happen with nasal pillows. Also, the leaks reported on your machine and in whatever online upload service it has, are pretty much useless. You have to look at the raw, untreated data to know for sure.

(stepping off soapbox) Sleep-well
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#2
That's an interesting tip. I wouldn't never thought of leaks as an indicator of machine failure.
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#3
So how should we interpret the SH leak data? What are the important numbers, and what are considered "good" numbers?
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#4
(04-13-2016, 11:41 AM)Mosquitobait Wrote: That's an interesting tip. I wouldn't never thought of leaks as an indicator of machine failure.

I'm not saying definitively that leaks were a sign of machine failure, but if you can't address leaks with all the usual suspects, it would seem something more ominous is going, perhaps inside the machine.

(04-13-2016, 12:01 PM)tmoody Wrote: So how should we interpret the SH leak data? What are the important numbers, and what are considered "good" numbers?

It varies greatly depending on your setup and mask type. For nasal pillows, I believe you should be able to achieve near-zero leak, thus I treat any non-artifactual leak in SH as something that can be addressed. In general, machines can compensate for leaks up to 24 L/min by increasing flow, but I would rather my machine be working purely on my apneas than trying to compensate for leaks, which are preventable.
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#5
(04-13-2016, 12:50 PM)Possum Wrote:
(04-13-2016, 11:41 AM)Mosquitobait Wrote: That's an interesting tip. I wouldn't never thought of leaks as an indicator of machine failure.

I'm not saying definitively that leaks were a sign of machine failure, but if you can't address leaks with all the usual suspects, it would seem something more ominous is going, perhaps inside the machine.

(04-13-2016, 12:01 PM)tmoody Wrote: So how should we interpret the SH leak data? What are the important numbers, and what are considered "good" numbers?

It varies greatly depending on your setup and mask type. For nasal pillows, I believe you should be able to achieve near-zero leak, thus I treat any non-artifactual leak in SH as something that can be addressed. In general, machines can compensate for leaks up to 24 L/min by increasing flow, but I would rather my machine be working purely on my apneas than trying to compensate for leaks, which are preventable.

Thanks

SH displays leaks and other info as min, med, 95%, and max. And if you hover over the row label, it shows "W-avg". I'm not sure what to do with all that info, especially the 95% one. I tend to look at the W-avg, which I assume means "weighted average," although I don't know how it's weighted.

Anyway, I don't mean to hijack the thread; I'm just trying to understand leaks. I'll search for other threads before starting a new one. Thanks for your help.
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#6
(04-13-2016, 12:50 PM)Possum Wrote: It varies greatly depending on your setup and mask type. For nasal pillows, I believe you should be able to achieve near-zero leak, thus I treat any non-artifactual leak in SH as something that can be addressed. In general, machines can compensate for leaks up to 24 L/min by increasing flow, but I would rather my machine be working purely on my apneas than trying to compensate for leaks, which are preventable.

it varies greatly depending on what type of MACHINE you have, not what type of mask you have.

the 24lpm is *ONLY* for resmed machines, not other brands.

for respironics, as long as the leak isn't flagged as "large leak" then the machine thinks the leak amount is ok.
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#7
(04-13-2016, 03:01 PM)palerider Wrote: it varies greatly depending on what type of MACHINE you have, not what type of mask you have.

Fair enough - we both provided an incomplete answer... Leak actually depends on both the mask type AND machine. Different mask types tend to leak more than others as they have different amounts of total surface area to seal. A full-face mask obviously has a much greater surface area to seal and thus will tend to leak more than a nasal cushion or pillow. If I wore a full-face, I would likely tolerate higher leak rates than I do with a nasal pillow, which theoretically should not leak at all unless you open your mouth, or the pillow is old and too soft.
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#8
Hi Possum,
It’s great to hear that you were able to get a machine so soon, and that it is working much better than the other one.
Thanks for the very interesting posts.
trish6hundred
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#9
(04-13-2016, 04:07 PM)Possum Wrote: Different mask types tend to leak more than others as they have different amounts of total surface area to seal. A full-face mask obviously has a much greater surface area to seal and thus will tend to leak more than a nasal cushion or pillow. If I wore a full-face, I would likely tolerate higher leak rates than I do with a nasal pillow, which theoretically should not leak at all unless you open your mouth, or the pillow is old and too soft.

leak *probability* increase as the sealing area increases, but ffm do not, in and of themselves, have more normal leaks than a nasal mask, or pillows.

as long as the leaking isn't disturbing your sleep, and it's within the machine's operating parameters, it's ok, no matter what mask it is.
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#10
(04-13-2016, 05:32 PM)palerider Wrote: leak *probability* increase as the sealing area increases, but ffm do not, in and of themselves, have more normal leaks than a nasal mask, or pillows.

as long as the leaking isn't disturbing your sleep, and it's within the machine's operating parameters, it's ok, no matter what mask it is.

If the probability of occurrence of Event A is greater than that of Event B, then one could reasonably conclude that over a given interval of time, Event A occurs "more often" than Event B.
Therefore, one might expect to get more leaks, in general, with a FFM mask than a nasal pillow, since a FFM has a "higher probability" of generating leaks due to its higher sealing area. I wasn't suggesting that they have a higher baseline leak..

And, I disagree that leaks, in general, are fine. If they can be controlled through further optimization of your setup, why wouldn't you want to proactively address them BEFORE they exceed the normal operating parameters of the machine and end up reducing the effectiveness of your therapy?

In any case, this has deviated far from the intention of my original post, which was to encourage members, new ones in particular, to keep an eye on their data and use it to be empowered patients.
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