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Need help concerning possible mask leak
#1
Need help concerning possible mask leak
I’ve been using my ResMed airsense 10 for about 2 months with very good results. Suddenly, a few days ago, the machine began showing me a red frowning icon, indicating that the mask had excessive leakage. I carefully checked the Mask and hose, but was unable  but to detect any leakage. Just to be sure I connected a new mask and hose, but got the same icon. Both the Re Med site and The Sleepyhead software show excessive leakage. On the other hand, they both indicate that I'm only having 0.2 events per hour. Does this mean that the machine is compensating for any leakage by raising the air pressure? As I purchase my machine online I don't think I have access to any servicing. (I was unable to have a sleep study for various reasons, and hence I was unable to get a machine through insurance). Perhaps the icon is a computer error? It would seem to me that's a good report indicates that it is working all right, but I would appreciate your input.
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#2
RE: Need help concerning possible mask leak
Hi Jeffrey S

I think the issue would more likely be a mask issue rather than the machine. The resmed machines are really good quality and whilst others have complained of noise and smell before, I suspect the leaks are due to the mask.

I have only used the P10 nasal pillows and the FFM and as such do not have experience with the nasal masks. I have to note that I once soaked my small pillows in a soapy liquid and have damaged it and now it leaks quite readily. So I have used the medium and extra small now, remembering that soap liquid destroys the plasticity of the mask.

Might there be other reasons or maybe too much moisture on your face? I do find that the fit is better if I keep myself religiousness clean before using the mask at night.
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#3
RE: Need help concerning possible mask leak
Your best bet is check a couple things.

1. Is the setting for your mask type. FULL Face, Nasal or Pillows.

2. Run the mask fit utility make sure you get a smiley.

I really wish the display would show a real-time actual leak rate. There have been times where I thought I had a leak but looking at charts later didn't.

Occasional trips into large leak territory are one thing but if your percent of large leak is over 10% you need to fix something.
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#4
RE: Need help concerning possible mask leak
With a nasal mask or pillows you have a ready-made leakage path through your mouth. It doesn't matter how well the mask seals around your nose, pressure can still get out unless you have your mouth firmly shut. People have resorted to doing strange things with their tongue, wearing chin straps or collars, or even taping their lips. A full face mask will overcome the problem.

From memory the Resmed machines give you a red frowney if you're over the leakage limit 24 L/min for more than 30% of the night. When you're over the limit the machine cannot accurately diagnose or treat apneas and hypopneas.

You can get a lot of information about masks from our mask primer: http://www.apneaboard.com/wiki/index.php...ask_Primer
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#5
RE: Need help concerning possible mask leak
DeepBreathing is right. Mouth Breathing is the likely cause with a nasal mask. You should run the fit mast program on your AirSense 10 and see if you have any leaks.

If no leaks on the mask fit test and you still wake up with a red frown I'd say it has to be mouth leaks. It would really help if you posted a chart to confirm it.
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#6
RE: Need help concerning possible mask leak
Thanks all. I'm pretty sure I am NOT mouth breathing. I am, not new to CPAP (16 years), just new to this machine. As of Monday, my mask fit was perfect. On Tuesday I took a nap, and the red icon showed up. I tried the mask fit feature. It only showed green when I forcibly pushed the mask against my face. As soon as I let go, it went to red. I tried a different mask and hose, to no avail.I feel no leak in my mask or in the hose. I do have a bushy beard and mustache, but that has not been a problem until now. I was encouraged by the fact that my results show few "events" (0.2 or 0.3/hour), and my results seem to indicate that my machine is increasing pressure to compensate. But DeepBreathing said that the machine will not work properly with a major leak. That has me very concerned.

CPAP Statistics
41 days of CPAP Data, between Sat Nov 11 2017 and Thu Dec 21 2017
Details Most Recent Last Week Last 30 Days Last 6 Months Last Year
CPAP Usage
Average Hours per Night 06:08 08:15 08:08 07:56 07:56
Compliance 100% 100% 100% 100% 100%
Therapy Efficacy
AHI 0.33 0.52 0.48 0.44 0.44
Obstructive Index 0.00 0.02 0.06 0.07 0.07
Hypopnea Index 0.33 0.40 0.36 0.31 0.31
Clear Airway Index 0.00 0.10 0.06 0.05 0.05
RERA Index 0.82 0.22 0.10 0.09 0.09
Leak Statistics
Average Leak Rate 27.02 19.83 17.55 16.23 16.23
90% Leak Rate 34.80 36.00 25.20 0.00 0.00
% of time above Leak Rate threshold 61.06% 22.46% 9.78% 8.29% 8.29%
Pressure Statistics
Average Pressure 14.70 13.58 13.33 13.19 13.19
Min Pressure 13.00 13.00 13.00 11.00 11.00
Max Pressure 15.94 15.94 15.94 15.94 15.94
90% Pressure 15.34 14.56 13.58 0.00 0.00
Average EPAP 13.70 12.58 12.33 12.19 12.19
Min EPAP 12.00 12.00 12.00 10.00 10.00
Max EPAP 14.94 14.94 14.94 14.94 14.94
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#7
RE: Need help concerning possible mask leak
Quote:Leak Statistics
Average Leak Rate 27.02 19.83 17.55 16.23 16.23
90% Leak Rate 34.80 36.00 25.20 0.00 0.00
% of time above Leak Rate threshold 61.06% 22.46% 9.78% 8.29% 8.29%

This tells me that you been having leakage problems for some time, with averages > 16 L/min for the past year. It's only in the last month or so that the leak rate has edged above the red line for a significant part of each night, but now it's right up there at nearly 2/3 of the night. You're not getting proper therapy under these conditions. I'd be interested to see a few nights' SleepyHead charts, which might be able to help us home in on the problem. It could also positively exclude mouth breathing which does show up as a fairly distinct pattern. In the absence of any more detail, I'm still betting on mouth breathing.
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#8
RE: Need help concerning possible mask leak
Previous night (Dec. 20)
Statistics
Statistics
Channel Min Med 95% Max
PressureTherapy Pressure (cmH2O)
W-Avg: 14.57 13.00 14.68 15.18 15.58
EPAPExpiratory Pressure (cmH2O)
W-Avg: 13.57 12.00 13.68 14.18 14.58
Minute Vent.Amount of air displaced per minute (L/min)
W-Avg: 9.15 0.00 8.88 12.25 28.00
Resp. RateRate of breaths per minute (Breaths/min)
W-Avg: 33.85 0.00 35.00 46.60 50.00
Flow Limit.Graph showing severity of flow limitations (Severity (0-1))
W-Avg: 0.09 0.00 0.00 0.51 1.00
Leak RateRate of detected mask leakage (L/min)
W-Avg: 23.08 7.20 22.80 40.80 80.40
SnoreGraph displaying snore volume (?)
W-Avg: 0.00 0.00 0.00 0.00 2.52
Insp. TimeTime taken to breathe in (Seconds)
W-Avg: 1.42 0.16 1.30 2.48 5.06
Exp. TimeTime taken to breathe out (Seconds)
W-Avg: 1.00 0.12 0.84 2.06 3.68
Tidal VolumeAmount of air displaced per breath (ml)
W-Avg: 302.76 0.00 260.00 660.00 1880.00
 
Total time in apnea 00:00:10
Time over leak redline 34.153%
Machine Settings
 
ModeCPAP Mode Auto for Her
Pressure MinMinimum Therapy Pressure 13.00 cmH2O
Pressure MaxMaximum Therapy Pressure 20.00 cmH2O
Antibacterial FilterAntibacterial Filter No
Climate ControlClimate Control Manual
EPRResMed Exhale Pressure Relief Full Time
EPR LevelExhale Pressure Relief Level 1cmH2O
Humidifier StatusHumidifier Enabled Status Off
MaskResMed Mask Setting Nasal
Patient AccessPatient Access Yes
RampRamp Enable Off
Smart StartMachine auto starts by breathing On
TemperatureClimateLine Temperature 27 ºC
Temperature EnableClimateLine Temperature Enable 2


Dec 19
Statistics
Channel Min Med 95% Max
PressureTherapy Pressure (cmH2O)
W-Avg: 13.17 13.00 13.06 13.66 13.80
EPAPExpiratory Pressure (cmH2O)
W-Avg: 12.17 12.00 12.06 12.66 12.80
Minute Vent.Amount of air displaced per minute (L/min)
W-Avg: 8.72 0.00 8.25 13.12 26.75
Resp. RateRate of breaths per minute (Breaths/min)
W-Avg: 19.14 0.00 16.20 37.60 50.00
Flow Limit.Graph showing severity of flow limitations (Severity (0-1))
W-Avg: 0.03 0.00 0.00 0.22 1.00
Leak RateRate of detected mask leakage (L/min)
W-Avg: 27.65 0.00 26.40 40.80 80.40
SnoreGraph displaying snore volume (?)
W-Avg: 0.00 0.00 0.00 0.00 0.98
Insp. TimeTime taken to breathe in (Seconds)
W-Avg: 2.15 0.18 2.26 3.18 5.66
Exp. TimeTime taken to breathe out (Seconds)
W-Avg: 1.80 0.06 1.92 2.74 6.80
Tidal VolumeAmount of air displaced per breath (ml)
W-Avg: 536.39 0.00 540.00 880.00 1720.00
 
Total time in apnea 00:01:14
Time over leak redline 59.789%

Dec 18

Statistics
Channel Min Med 95% Max
PressureTherapy Pressure (cmH2O)
W-Avg: 13.33 13.00 13.30 13.84 14.18
EPAPExpiratory Pressure (cmH2O)
W-Avg: 12.33 12.00 12.30 12.84 13.18
Minute Vent.Amount of air displaced per minute (L/min)
W-Avg: 8.46 0.00 7.88 12.62 29.38
Resp. RateRate of breaths per minute (Breaths/min)
W-Avg: 18.33 0.00 17.40 30.40 45.60
Flow Limit.Graph showing severity of flow limitations (Severity (0-1))
W-Avg: 0.02 0.00 0.00 0.13 1.00
Leak RateRate of detected mask leakage (L/min)
W-Avg: 21.45 7.20 21.60 25.20 42.00
SnoreGraph displaying snore volume (?)
W-Avg: 0.00 0.00 0.00 0.00 1.26
Insp. TimeTime taken to breathe in (Seconds)
W-Avg: 2.16 0.48 2.22 3.26 5.56
Exp. TimeTime taken to breathe out (Seconds)
W-Avg: 1.75 0.14 1.70 2.92 5.94
Tidal VolumeAmount of air displaced per breath (ml)
W-Avg: 530.41 0.00 480.00 940.00 1740.00
 
Total time in apnea 00:00:10
Time over leak redline 7.548%
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#9
RE: Need help concerning possible mask leak
Would you mind posting a few SleepyHead charts? According to the instructions at the bottom of one of the Advisory Members' posts. A graphic is worth a thousand words.... It may give info on exactly how the leaks are coming about...

If you grew or cut your beard even a few millimeters, it would change the seal on the mask....
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#10
RE: Need help concerning possible mask leak
Again, thank you. I'm almost embarrassed to say it, but my wife just replaced the gasket on my mask, and red turned to green. Apparently, problem solved.
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