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Do any machines try to fix leaks?
#11
There is a lot of good information on leaks in the Sleepyhead Guide.
http://www.apneaboard.com/wiki/index.php...Head#Leaks

I would think you would wake up if experiencing a large leak, I know I would. I don't see how a machine can "fix" a large leak, even at a lower pressure.

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#12
Maybe, using a good epoxy would solve the problem... Smile
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
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#13
Too-funny ^

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#14
Frankly, I take a very simplistic view of leaks and pressure. The pressure is there to treat your Obstructive Apnea. Assuming that you have found the best pressure/range where you are being well treated. Why would one want to interfere with one's treatment by reducing the pressure to reduce leaks. Fix the leak so that it does not occur at your therapeutic pressure whether it is the set pressure or a machine generated one within the set limits.

in the case where no mask can be found that seals at your therapeutic pressures then maybe one must find a middle road that gives the best overall results.

Turning the pressure down in response to leaks is a very common (I believe) reaction. It was my first reaction when starting out. I received some advice from some smart people and never did it and I did manage to reduce my leaks eventually without reducing the pressure after i found this forum and started learning more.

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PaytonA

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#15
(03-28-2016, 08:50 AM)FrankNichols Wrote:
(03-28-2016, 08:26 AM)robysue Wrote:
(03-28-2016, 08:00 AM)FrankNichols Wrote: So, I was thinking, does any one know if any machines try to stop leaks?
The PR System 1 APAPs do indeed lower the pressure in the presence of an official Large Leak in an effort to see if the mask will reseal. Once the leak rate is back down to a more acceptable range, the Auto algorithm takes back over and will increase the pressure as needed. I assume that the new PR DreamStation APAPs behave the same way.

Thank you, it seems like such a good feature, I wonder why ResMed doesn't include it?

I don't own a Resmed machine. I didn't mention the ResMed machines because I didn't want to speculate about them since I have not had a chance to read the clinical manual for a Resmed in a long, long time.

As DeepBreathing points out, the Resmed machines do indeed respond to Large Leaks by lowering the pressure in an attempt to reseal the mask.

A big thanks to DeepBreathing for documenting this for me!



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#16
(03-28-2016, 11:46 AM)PaytonA Wrote: Frankly, I take a very simplistic view of leaks and pressure. The pressure is there to treat your Obstructive Apnea. Assuming that you have found the best pressure/range where you are being well treated. Why would one want to interfere with one's treatment by reducing the pressure to reduce leaks. Fix the leak so that it does not occur at your therapeutic pressure whether it is the set pressure or a machine generated one within the set limits.

Mask seals can be compromised by any number of things in the middle of the night when we're fast asleep: We turn over and bump the mask. We open our mouth slightly. Or a rapid increase in pressure in response to a cluster of events causes a seal that was "good enough" at lower pressures to spring a leak that's now officially in Large Leak territory.

For leaks that are smaller than official Large Leaks, the machines simply compensate for the leak by pushing more air through the system in order to maintain the current pressure level. But once the leak is an official Large Leak, the machine can no longer reliably compensate for the leak by pushing more air into the system in an effort to maintain the desired pressure. And so both the PR and Resmed machines are programed to decrease the pressure in the presence of official Large Leaks---leaks that are large enough and long enough to adversely affect the efficacy of the PAP data.

The idea is to try to fix the official Large Leak without waiting for the user to wake up and fix the leak.

For APAPs, the Auto algorithm immediately kicks back in as soon as the leak rate is decreased to the point where the machine can easily compensate for it.

For CPAPs, the pressure is ramped back up to the therapeutic pressure as soon as the leak rate is decreased to the point where the machine can easily compensate for it.

Quote:Turning the pressure down in response to leaks is a very common (I believe) reaction. It was my first reaction when starting out.

We're not talking about manually reducing the pressure by changing the pressure settings on the machine. We're talking about what the machine is programed to do when it detects an official Large Leak in the middle of the night.

If the machine just leaves the pressure at the current level when the leak rate is large enough to be scored as an official Large Leak, that will allow the official Large Leak to go on long enough for the efficacy of the therapy to be compromised, and potentially seriously compromised, if the person doesn't wake up and fix the leak in a timely fashion. And a lot of people can routinely sleep through an hour long massive, official Large Leak. (And some of them can do this while also complaining that minor leaks at the beginning of the night are so irritating that they find it hard to get to sleep.)

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#17
(03-28-2016, 12:34 PM)robysue Wrote: We're not talking about manually reducing the pressure by changing the pressure settings on the machine. We're talking about what the machine is programed to do when it detects an official Large Leak in the middle of the night.

If the machine just leaves the pressure at the current level when the leak rate is large enough to be scored as an official Large Leak, that will allow the official Large Leak to go on long enough for the efficacy of the therapy to be compromised, and potentially seriously compromised, if the person doesn't wake up and fix the leak in a timely fashion. And a lot of people can routinely sleep through an hour long massive, official Large Leak. (And some of them can do this while also complaining that minor leaks at the beginning of the night are so irritating that they find it hard to get to sleep.)

Thank you for the explanation, and yes, you understand my question exactly.

One other point that "bothers" me, is the comments I see about some times a machine seems to ramp up the pressure to compensate for the leak which in turn makes the leak worse, and so it has to turn up the pressure more, and it get stuck in this cycle until it can not keep up with the leak and the patient wakes up to a jet engine sounding roar.

I not sure what causes that, but I have read a couple reports of that happening, and it seems backwards to me, which prompted my question. Since the masks are designed to be inflated and when a blow out occurs, it seems that the worst thing the machine can do is ramp up the pressure.

I understand the reply also that when that a happens, chances are the membrane of the mask is popped out and so, lowering the pressure alone will not repair the leak - but raising the pressure also won't...

I don't know what the right thing to do would be, since either way seems wrong - hence my semi-joke of maybe epoxy...

Obviously, a major source of problems is leaks, since they are involved in many discussions here. So, I was just wondering out loud.

Thank you again for your informative answer to my comment.


I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
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#18
(03-28-2016, 10:02 AM)FrankNichols Wrote: does it mean it raises the pressure to attempt to keep the therapy flow/pressure up to compensate for the air leak?

no machine *ever* raises pressure in response to a leak.

they raise *FLOW* to *maintain* pressure. raising pressure would just be stupid, counterproductive, and could very well put you outside your treatment parameters.

someone will no doubt say that the grumblesnarf blowhard made back on 1997 did raise pressure... but we don't care, do we?
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#19
(03-28-2016, 11:36 AM)FrankNichols Wrote: Maybe, using a good epoxy would solve the problem... Smile

face glue?

(03-28-2016, 07:13 PM)palerider Wrote: no machine *ever* raises pressure in response to a leak.

they raise *FLOW* to *maintain* pressure. raising pressure would just be stupid, counterproductive, and could very well put you outside your treatment parameters.

someone will no doubt say that the grumblesnarf blowhard made back on 1997 did raise pressure... but we don't care, do we?

Which came first: Pressure or flow?

I don't know!
Just my personal opinion. My posts are not medical advice or a statement of fact. Please consult a qualified physician or other qualified medical personnel. Please comply with all applicable laws, codes, regulations, and protocols.
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#20
(03-28-2016, 07:53 PM)sdb7802 Wrote: Which came first: Pressure or flow?

Well, the blower creates the flow, and the resistance to flow in the mask creates the pressure.
Ed Seedhouse
VA7SDH

Your brain is not the boss.

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