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Interpreting Leak Numbers
#1
Question 
The AirSense 10 gives various report ranges. I assume the 1 day report is the most meaningful?

Also, Leak is defined as, Average of the 95th percentile values of leak during the selected period for days with usage only. It is measured as L/Min. What rate is considered as normal/optimal? Somehow an average 10 leaks/minute for a day seems to be excessive?

What exactly is the machine measuring to determine the leak rate?

Are there a commonly accepted ranges for excessive, acceptable, desirable, and so on?

If a chin strap is needed to help reduce the leak rate which one would give the best results?

(My wife is also new to CPAP with a range of 9-16. This question is for us both.)

Thank you.
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#2
I like using the 1-day report when I wake up. Later on I use SleepyHead overview charts to look for trends.

The leak rate is measured in liters per minute. Resmed machines report leakage after subtracting the mask's (assumed) intentional venting, and consider 24 l/min excessive leakage. If the total time of excessive leakage is more than 30% (I think) of the night's usage, the machine will display the red frowny face on the display. SleepyHead isn't so lenient in its summary message after data import. I'm pretty happy any night my leakage is below 10 l/min, though.

A chin strap is usually only needed if air is blowing out through your mouth; you will know because you will have a dry stuck together mouth. Chin straps (and soft cervical collars) are quite variable, and about as easy to chose as masks, I'm sorry to say.
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#3
Thank you for the reply. "L" - liters per minute, Oh-jeez of course, makes me feel Angry: silly. Less than 10 L/min makes sense now!

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#4
Unintentional leak = total leak minus mask vents leak rate at a given pressure
ResMed machines report unintentional leak, leak at or below the reported number for 95% of the night, not all long long
For analysis of what is going on through the night, you'll need the software detailed data graphs
ResMed consider 24 L/m or below as an acceptable number, of course, lower is better but in scheme of things, we shouldn't get worked out about numbers much, unless leak numbers above the threshold red line 24 L/m or interfere with our sleep

Chinstrap helps keeps mouth closed and minimize air escaping through the mouth (mouth leaks) while using nasal or nasal pillows masks. Keeping mouth closed is not required while using full face mask as this type of mask chosen by mouth breathers or sometimes given to them by lazy providers who doesn't want to spend the time or effort to fit their patients with the right mask, right mask is important for effective treatment, probably the most important

As for the "period" on the screen sleep report, I prefer "1 Day", also this match "events per hour" reported on the top of the screen with the rest of the data when you scroll down

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#5
The first thing to be concerned with is if you are seeing large leaks (red frown face on display) which are defined by ResMed as 24L/min or more. The problem with them is that the machine has issue determining what are apneas and what kind of apneas are happening. In addition the machine may not be able to properly apply the needed therapy since it will not be able to to keep up with the leaks.

Once you get few or no large leaks, then I would not worry too much about them for a while. Instead at that point focus on pressure settings to get your AHI under control (below 5). hen once your AHI is controlled, I would look back at the leaks and try to reduce them as much as practical. AHI is more important than leaks, but AHI may not be controllable with large leaks.

EDIT: Oh, chin straps are mostly just needed if you are experiencing mouth leaks, or mouth breathing - they work to solve the problem for some people, sadly not for me. If you can not solve the mouth breathing any other way, then you will need to switch to a FFM like the F10 which covers the mouth and solves the problem, but is not as "comfortable" as the nasal pillows.

MORE EDIT: Just noticed you are using a FFM, so you do not have mouth leaks and shouldn't need a chin strap. Mask liners may help if you are having noisy leaks.
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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#6
Thank you both. I have two learning curves going on. My wife has moderate ahi with pressure of 9-16. She is just starting, initially with DeamWear and now FFM SimPlus. My priority is to get her stabilized. Her leak rate last night was 82 L/min so we gotta little adjustment to do. Trial and a bunch of errors. She may need chin strap to keep mouth from dropping below mask opening.

I do not have a measurable ahi problem, but have bruxism and low O2 events. Rather than a nightly O2 generator we are trying to see if I can control the problem with CPAP.

Once we both stabilize our setting I will use a CMS 50F to monitor nightly O2.

So, I need her leak rate less than 10 then AHI less than 5.
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#7
Hi MikeV99,
WELCOME! to the forum! to you and your wife.
Hang in there for more responses to your post and much success to both of you with your CPAP therapy.
trish6hundred
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#8
"I need her leak rate less than 10"

Perhaps I should have said I'm thrilled when my leak rate is below 10. Anything below 20 keeps me 'not unhappy'. As long as the machine isn't recording large leaks over a minute long, I figure the therapy isn't compromised (too much).
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#9
Thank you for the additional info.

My wife's 1 day report Leak rate was 35 L/min last night with 4.3 events. However, her Mask Leak smiley face was happy. Her myAir leakage rate was 7 L/min. We are not quite sure how to interpret these seemly inconsistent results. She uses a SimPlus FFM. No where near 10?
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