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I'm attaching a flow graph/leak rate graph from SH showing a transition from "normal" to "leaking." I'm using a P10 mask most every day, occasionally sneaking in the Dreamwear Gel Pillows (which I'll probably use when I've depleted my P10 stockpile). Lately, the leak numbers that I've been seeing have headed towards the ditch, even after switching to new pillows, new headgear, and taking the toothbrush to the screen. I usually get 5-6 days of virtually no leaks after replacing the pillows and at least doing the hot water wash of the headgear, and I know I've done the mouth breathing thing before, though not as consistently (presuming you're going to tell me that's what it is). If you would, in addition to telling me what, tell me how you know. For example, is "up" inhalation or exhalation? Thanks in advance.
Hard to tell for sure, but increased leak rate correlates with diminished flow volume, so a mouth leak is likely. The signature of a mouth leak is a leak that has a flat top that is near the limits for a "large leak". The flow rate shows a flow limit at 3:33:30, so this may also be hypopnea. In spite of the leak the machine is still fully detecting and responding to respiratory flow, so if this is not disruptive, it is probably not too harmful to therapy.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Thanks. There was no event recorded near this time frame. I do get awakened sometimes and not know/remember what it is, though I have correlated some arousals to centrals, though not always. My AHI is very good, very rarely above 1. But I haven't yet achieved "rested" and "refreshed" after doing this for 4 years, mainly because my defective brain won't hardly let me do more than 6.5 hours on good days.
A flat top is what I presumed was the signature of a mouth leak, but can you elaborate on "a flat top that is near the limits for a "large leak""? I'd expect the flow from the machine to always be "positive," and the breathing would be "plus or minus" on top, and a leak a "big plus." Maybe I just don't understand the scaling that SH is using.
A typical mouth leak is a flat-topped leak over a period of time as compared to a sharp spike which indicates a mask leak. As you can see, the one imaged here early in the night is not very consequential. In the case of judging the severity of leaks, the close-up images are not as useful as just looking at the whole night.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
I am going to jump in and speak for Sleeprider (not that I think that he can not speak for himself). By flat top I think that Sleeprider meant when your leak rate curve goes above 25 l/min and stays there for a while. The un-expanded leak rate curve shows a flat top rather than a spiky one.
What your flow rate curve looks like on the second set of graphs is a little flow limitation.
Ah, I see (I think). So it isn't the flow wave form flattened out, it is the leak curve, then. The flow wave form flattens out when the "normal" flow + leak + inhale hits the machine limit, then?
In the "good" nights I described, I've had leak graphs very similar to that. On "bad" nights, I have several of those flat topped leaks, usually making the median greater than 0.
The flow rate graph showing flattened tops indicates flow restrictions which the Resmed auto units view as precursors to obstructive apneas. It is your flow limitation not the machines and there are no other qualifying events.
Well, I guess that settles that . . . one night with cervical collar, one night without. I bet you can tell which is which.
I bought one of those adjustable Futuro ones, fits fine and works (obviously). I did wake up with a sweaty neck this morning, though, and wondered if any of you have one that might be cooler.
Thanks for the advice thus far. I'm not chasing bad AHI's or compromised therapy, just eliminating a potential source of mystery arousals.
![[Image: 3IJrg96.png?1]](http://i.imgur.com/3IJrg96.png?1)
