Help with Leak rates

[mikeinstlouis]

[attachment=7631]Hi All

I hope this is the right place to post Sleepyhead screenshots!!

I am a physician, just on day 4 of my CPAP trying to learn all about this fascinating topic!

I am trying to interpret my data.  I have read a lot of the great tutorials on here!  Very detailed.

I am using Phillips Nasal Pillows and I am still unsure how to interpret the leak rate.  I realize that it says Large Leaks 0% but I want to make sure that the program is reading my machine.  I see leaks go up (and I know that some leaking is normal...just want to make sure this is "good enough"

I will attach my screenshot.  Any help would be appreciated!!!

Mike

[Crimson Nape]

Hi mikeinstlouis -

First, this actually belongs in the Main forum. I will ask that it be moved there to help others.  

Now on to business; How do you feel?  Do you feel air starved at this low pressure?  Most people feel better around 7cmH₂O.   Since a Philips doesn't respond as fast as a Resmed, I would probably bump your starting pressure to at least 5.5cm.  This should start addressing your Hypos.  

Good luck!

[mikeinstlouis]

Thanks for your replay and it was moved.

This is the stuff that I need to hear!  I do have a lot of hypos and did not know that bumping up my baseline would help!  How do you learn these things.  I don't think they even had CPAP when I was in medical school!

Mike

[pholynyk]

Now on to interpreting the leak rate graph... You will notice you have two lines. The top one is the actual volume of air leaving the machine, averaged over the period of a breath or two (or maybe more...). This is the data reported by a Respironices machine. The lower line is derived by subtracting off the (assumed) venting rate of your mask, as calculated by SleepyHead. You can adjust that to fit your mask in Preferences if you like; it isn't really critical to your therapy. The main point is that Respironics machines only flag a large leak when the total flow is somewhere above 70 litres per minute, and you are well below that.
Other people who have a ResMed machine will only have one line in their leak graph because ResMed subtracts off the assumed mask venting rate from the total flow and reports the remainder as leakage, and also declares a large leak when the excess air flow exceeds 24 litres per minute.
I hope that is clear enough to explain what SleepyHead is doing with what the machines are reporting.

[mikeinstlouis]

Thanks!  I am a bit confused.  I assume the top is the total leak. Intentional and unintentional.  What is the bottom? Is the bottom simply my unintentional leak and does everything look OK leak wise?

Thanks!
Mike

[Walla Walla]

Yes the bottom is the unintentional. Check the link below called Beginner's guide to sleepyhead. This will explain all the charts and data.

[mikeinstlouis]

I read it.. it's easy to understand if you know all the background and terminology which I do not as that is not my field of Medicine but for us newbies, please be patient because we don't understand all of that yet.

[Walla Walla]

Wasn't blowing you off. I just thought you'd like to read it. Also if you look at this link it should help you with the terms. http://www.apneaboard.com/wiki/index.php...efinitions

[sheepless]

mikeinstlouis, I reply from my own similar experience when I first started getting into this stuff.

there's a learning curve; some unfamiliar terms, lot's of variables, hardware and software to learn, physics and 'mechanics' of respiration you probably understand but many of us don't, and a lot of folk wisdom based on peoples' experience and innovation. what works for some may not work for others. getting to adequate treatment is art as much as science; trial and error is required.

little of this info is readily accessible in laymen's terms anywhere else including and maybe especially from cpap user/sleep doc/sleep clinic/dme provider interaction.

in contrast, you will find a great deal of this info here, by reading threads and the linked resources, and by raising questions and posting your own sleepyhead data. it takes time and patience to wade through and absorb. unfortunately this doesn't always come easily as many of us are physically and mentally impaired by sleep deprivation. concentration and patience commonly suffer, particularly for those of us not yet satisfactorily treated.

you'll find as in all life there are all kinds of people here. some, for example, that are brief in their replies, even terse, and others that err on the side of many words and detail (like me and this reply that's probably a bit of overkill). you'll find lots of sympathy and kindness too, as well as the occasional terse reply or spirited disagreement. some are more technically knowledgable than others. info stated as fact may be debatable. it's an internet forum after all. but everyone has something to offer.

I don't mean to be condescending or preachy. I'm sure I'm not telling you anything you don't already know. just a reminder to be as open and patient as you can be too; and that most if not everyone here is here to help and get help. give it a little time. a month or so from now you will be much more familiar with all this and you'll be responding the newbies!

[mikeinstlouis]

Thank you for your kind words, Sheepless.  


I will admit that the reply did annoy me.  I obviously had been doing a lot of reading and the reply to read the 120 page sleepyhead wiki caused me to just join a  different and more "user friendly forum" 

I am a physician so not a total idiot.  I did read the whole thing on a plane trip to Iceland this weekend and although I have read the wiki article about leaks at least 5 times I am still confused.

I have other questions now that I will try to post in the "appropriate forum"  God forbid that I post something in the wrong place.  I have read some snooty replies from members asking other questions that I just don't get why people have to behave that way and I am still not sure this "forum" is for me.

But thank you for your kind words.  Hopefully there will be some kind and patient members that actually like to help us newbies and not look down their noses at us!