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Please help with high leak rate
#31
RE: Please help with high leak rate
while waiting for a more expert response I'll give you my 2 cents worth. the leak in the last post looks like a mask leak to me. the top of the breaths or inspiration (above the zero line which you can add by right clicking on the graph title, dotted lines, zero) look smaller in magnitude than the expirations below the zero line. they're also flattish topped which may or may not be flow limited; the leak makes it uncertain.

you asked what bonjour meant when he said "The machine will not raise pressure for leaks, It raises flow to maintain pressure". I think it's pretty self explanatory but I'll try to rephrase. the machine will raise pressure against apnea and flow limitations to the extent of your max settings. the machine doesn't raise pressure against leaks. instead, it tries to compensate for leaks in order to maintain the target pressure that it determines by algorithm by raising flow (increasing volume, not pressure, in order to maintain pressure), that is, until it reaches it's limit to do so, generally 24L/m for resmed machines. the machine becomes increasingly inaccurate/inefficient above that red line.
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#32
RE: Please help with high leak rate
Yankees, look at a closer view of your large leaks. Expiratory mouth breathing may be there but I can't see enough detail. In the Flow Rate the expiration will be smaller than the inspiration, the area below the curve will be smaller than the area above zero. That is for a nasal mask. You are using a FFM and any mouth breathing is acceptable because it is into the mask. That means the leaks are mask leaks.
Gideon - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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New to Apnea? Helpful tips to ensure success
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#33
RE: Please help with high leak rate
yankees, what mask were you using March 2? your profile shows ffm but I think I remember you talking about nasal and cushions.
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#34
RE: Please help with high leak rate
Hello yankees123,
I have been using the P30i mask for about 9 months. I too prefer the large pillow but often use the medium as well. I have had a lot of problems with unexpected leaks that had baffled me. I am a side sleeper and recently discovered that many, if not all the leaks were caused by rotation of the mask frame about the point the climate line connects to the frame (at the top of my head). Even a relatively small rotation can result in a slight, difficult to detect leak, out of one side of the pillow. The straps on the mask had been tightened enough to provide what appeared to be a stable leak-free fit. Tightening up the straps even further (~3/8" on each side) noticeably increased the resistance to rotation and resulted in far fewer leaks. I initially discovered the rotation by noticing the space between my earlobe and the mask frame, measured by sliding two fingers up the side of the frame was no longer the same on both sides. When I had put on the mask it was centered but lying on one side can knock it off-kilter and result in a small leak. This may not be the source of you leaks but it may help.
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#35
RE: Please help with high leak rate
Thank you for everyone who responded.  Prior to trying the p30i I was using the airtouch f20,but wanted to try a mask that was not so large and cumbersome.  Last night I taped my mouth with a little more tape and I did get less leaks.  I do agree with grandpa -g that the mask does tend to rotate since I am a side sleeper I also have noticed this.  I believe that the leaks and events at the end of the night looks like from chin tucking since they are clustered.  I do wear a cervical collar but maybe it shifted.  I am going to continue tweeking the mask and will wait to hear if anyone has any further comments to help me .  
I am posting last nights chart.  If there are any further charts that would help please let me know.


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#36
RE: Please help with high leak rate
Just bumping to see if any advice
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#37
RE: Please help with high leak rate
Try the ResMed Mirage Activa Nasal mask. It is a bit old school and is big by today's standards, but it is very effective for an active sleeper. This was my daily mask for many years. It's secret is a large bellows with about 1/2 inch of allowable movement and with this bellows, it fits very securely on your face and lightly since it is all about the pressures making the seal, not the straps. As with any mask what works for me may or may not work for you.
Gideon - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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#38
RE: Please help with high leak rate
Never heard about this mask.  You are right this is definitely an old design.  Will keep trying a little longer with  p30i and will keep that mask for a future try.  Thanks Fred.  
Any other advice would be appreciated.
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#39
RE: Please help with high leak rate
I wonder if switching to a nasal cushion with your current frame would give you a better seal. 

I am relatively new to this, and am trying to figure out leak control myself. I have been having major leaks with Dreamwear nasal pillows. For the last few nights, I have tried out a ResMed n30i with a nasal cushion. The leak rate is considerably improved.

As best I can tell, the frame for p30i and the n30i are identical, so that users can interchange pillows and cushions with either frame.

Disclaimer: This suggestion might not be helpful to you, because I changed brands of headgear at the same time I switched from pillows to cushions.
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#40
RE: Please help with high leak rate
Well day four with the p30i mask.  I slept much better and leaks were under control.  Will see if this continues.  As Paul said I can always try the n30i cushion with my existing headgear.


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