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Request for Help with Leaks
#1
I'll apologize in advance if this post is somewhat lengthy. I've just started using SleepyHead so that I can better understand my bi-level machine data and, more specifically, whether leaks are a serious issue for me.

I use a ResMed AirCurve 10 VAuto machine with a ResMed AirFit P10 nasal pillow and chin strap. Last night I unintentionally pulled the chin strap off my head because the combination of my chin strap and nasal pillow strap were causing me some localized pain. This is a very rare occurrence, so I'm not too concerned about the pain, nor about removing my chin strap. What did surprise me, however, was the fact that my machine indicated a normal "Mask Seal" (a green smiley face, as opposed to the red frown face) upon waking. This surprised me because I know that, in previous experiences, removing my chin strap resulted in mouth breathing and large leaks. It's possible that, after 2 years of CPAP and BiPAP use with a chin strap, I've become accustomed to sleeping with my mouth closed, but I'm uncertain about this.

I thought that I would download SleepHead and view the data. I found that on several nights within the past 2 weeks the Max Leak rate was well over 24 L/min (near 50 L/min), the 95% Leak Rate was also over 24 L/min (near 35 L/min), and the Med Leak Rate was well under 24 L/min (near 5 L/min), even though I was wearing a chin strap. According to the SleepHead Wiki, these data could suggest that leaks are a serious problem for me. Yet, my AHI is consistently (with extremely rare exceptions) well below 5. I assume that these trends can be generalized to larger periods of time and therefore I'd like to determine whether they suggest that my therapy is being compromised. I suppose that this may depend upon the frequency and duration of the leaks.

Can someone help me to ascertain whether these data suggest that leaks are a serious problem and, if so, why my machine might be detecting a normal "mask seal"? Furthermore, are there better ways to view my data so that I can determine the effect that leaks are having on my therapy? Thank you very much for your assistance!
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#2
First, your machine is happy with the mask seal unless your leakage is in the large leak area over 30% of the time. Second, maybe you have developed the technique for sealing your mouth off from the rest of your airway. Third, unless your large leaks are of long duration or very numerous they are nothing to worry about and should not affect your therapy nor the events that are recorded.

Chin straps do not work for everyone (like me). They may not completely eliminate mouth leaks plus different chin straps appear to work in different ways. The chin straps that cup the chin work for some people but not at all for me. Some other chin straps can be used effectively under the lower jaw. This is what works best for me is a wide chin strap that puts some pressure all along the underside of my jaw.

Best Regards,

PaytonA
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#3
G'day rpt01, welcome to Apnea Board.

Just expanding on what PaytonA said, you'll get a green smiley if your leak was below the 24 L/min threshold for 70% of the night (or above it for 30%). I think this is setting the bar way too low, but apparently Resmed thinks its machine can deal with that amount of leakage. The 95% leak rate means that you were at or below that figure for 95% of the night, (conversely) above it for 5%. So the fact you got a 95% above 24 is not too much to worry about if your median is low (as yours is). You should worry if you get prolonged large leaks, but short duration large leaks are only a problem if they disturb your sleep (or your partner's).

Quote:Furthermore, are there better ways to view my data so that I can determine the effect that leaks are having on my therapy?

In my opinion SleepyHead is the best tool in the shed. You could use Resmed's own software ResScan, but I don't believe it offers much that SleepyHead doesn't, and it's slower, more cumbersome and less intuitive to use.
DeepBreathing
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#4
Hi rtp01,
WELCOME! to the forum.!
Good luck to you with your CPAP therapy and hang in there for more responses to your post.
trish6hundred
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