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What is Normal Average Leak Rate?
#21
In doing my research trying to find out how the Easy Compliance Software assess data I checked out the previous models. Previously this device was distributed in the US under the branding of Carefusion Puresom, and the Probasics ZzzPAP.

The graph below was from ZZZpap software. Notice the red line on the leak rate graph at 70 lpm. I now take it that anything over this is considered a large leak. Just guessing, but this makes sense especially after seeing Newbee2016's data. The Apex software does not have this red line.

Assuming that Newbee's data shows good results, I am guessing that I am sleeping with my mouth open, I have mask leaks, or there is a defect with my mask or cpap.

I also assume I may need to get a chin strap or a face mask. Drats!!

[img][Image: zzz-ware-detail_zpslqqh3iwf.jpg][/img]



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#22
To be fair to the Respiratory Therapist on my first contact he suggested a chin strap and or face mask but I wasn't sure I sent a clear enough graph and all the other stats needed. Later I sent a more clear graph and stats that I thought might help to see if I really needed a chin strap or face mask because I sure don't want one unless absolutely certain that I need it for good health. This is when he said regardless of the leaks anything under 5 for an AHI was good.
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#23
Hi Newbee2016

I decided to see what your exhaust flow for your mask was. Here is the graph from the owners manual. I see by your "good" day your pressure was around 8. I can't tell if that is your average from one night of course. It shows that if the pressure is 8 then your exhaust flow is around 24. (this is identical info for my Apex Wizard 210 mask for me. My average is around 8.2 cmH20 and the exhaust flow is also about 24 lpm. If I understand this all correctly it looks like basically your mask doesn't leak and you must keep your mouth closed. It also seems to me that if I was sleeping with my mouth closed and/or had no leaks that my graph should look about the same as Newbee's, around 20 lpm. As it is my average leak rate is about 52.8. Am I thinking about this in the right way or are there more factors involved.

[img][Image: WispPressureFlowCurveChart_zpsru0u3t0v.png][/img]
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#24
As it is i plan on getting this nailed down so not only I understand the data and am getting proper therapy but so others will have the info they need. Especially since the Apex XT Auto Cpap sells for $385 new and $225 for a low hour factory refurb. This price could help a lot of people get an Apap with software so they know if they are getting proper treatment.

I wonder how many people are using a cpap nightly and not getting proper therapy?

From what I can tell I was getting possibly improper therapy for 16 years and blamed my sleepiness and falling asleep in a chair and drowsiness while driving on high blood sugar. I plan to find out now for sure.

I am hoping that some of the new info presented in some of these posts will allow the more educated members to ascertain what's going on here and how to read the graphs that the software produces.
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#25
Quite a lot, I'd say, judging from how often people turn up on this forum having just got a new, data-capable CPAP machine and finding out that the pressure settings they've been using are not at all optimal.



(08-12-2016, 12:49 AM)Lanco Wrote: I wonder how many people are using a cpap nightly and not getting proper therapy?

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#26
That's the conclusion that I would draw. My condolences on needing a chin strap. Some people do find that after they use them for a while, it "trains" their jaw not to drop, and they are then able to stop using them.

The only thing that gives me pause is that I would expect you to be waking up with a dry mouth if you are leaking that much air through your mouth. Probably the only way you are going to be certain about this is to get a chin strap, try it, and see how it affects your leak numbers.

(08-12-2016, 12:39 AM)Lanco Wrote: It also seems to me that if I was sleeping with my mouth closed and/or had no leaks that my graph should look about the same as Newbee's, around 20 lpm. As it is my average leak rate is about 52.8. Am I thinking about this in the right way or are there more factors involved.

[img][Image: WispPressureFlowCurveChart_zpsru0u3t0v.png][/img]

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#27
(08-12-2016, 12:49 AM)Lanco Wrote: I wonder how many people are using a cpap nightly and not getting proper therapy?

From what I can tell I was getting possibly improper therapy for 16 years and blamed my sleepiness and falling asleep in a chair and drowsiness while driving on high blood sugar. I plan to find out now for sure.

I am one of those who got improper therapy for several years before I found this forum. My AHI numbers were good so I was happy. Got on Apnea Board and found out about things like available data, and software to help view the data and then found out that I had been having high leaks due to mouth breathing/leaking for years without realizing it. Finally got it straightened out with a FFM and have not looked back. Some of my symptoms were the same as yours and they went away.

Best Regards,

PaytonA

Admin Note:
PaytonA passed away in September 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#28
Hi Lanco

Yes, I somehow don't breath through my mouth or the numbers would have gone up. I haven't since the 1st night of using the nasal mask. Tried letting air out through the mouth and the air pressure/velocity built up making me very uncomfortable. I would also have difficulty conversing - sounding like an incoherent chipmunk - and can't make a conversation so I think the jaw just clamps up. You may wish to try a makeshift band of sorts and see if helps before buying one.

Generally speaking, not sure if mustaches or beards will add to leakages and I'm sure there are workarounds or different masks solutions available.

I do wake up at night due to leaks blowing at the eyes or cheeks and it's usually due to my having turned to the side against the pillow, causing the mask to shift. I run my hose through the strap at the top of my head (has an opening for that & use a rubber band to further hold it in place) so it doesn't gets entangled with the blanket and pulls the mask down.

Seems the wisp is not meant to be very tight fitting but enough for the nasal pillows to just puff up under pressure against the face and upper lips forming a seal. As many have shared, its not meant to ride all the way up the nose bridge. Any other mask with a forehead guard/frame would probably help mitigate this latter issue once it's been set correctly. I don't own one, so can't really tell if that really works in practice.

I usually put the whole mask on and lift (stretch) the mask off my face/nose with the machine on to get a good clearing of dust (if any) out of the mask and then rest it back on the face before I start breathing. Others probably have their own routines or regiment. So in effect, my straps aren't set so tight that I can't do that.

Hope the above helps.
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#29
OK, I tried an experiment last night. I read on another forum where some have experimented using waterproof tape to seal the mouth as a short test while some have used it long term and favor it over a chin strap. My idea was that I must have an open mouth and wanted to see how much the leaks would drop.

To my amazement, it didn't go down. But instead stayed almost flat at just under 60 all night. My AHI went up but only to a 4.00, my cmH20 went higher in a few places than normal and I woke up with a sensation in my stomach that was not pleasant. After I ate I did some belching that seemed to clear that up. So, I guess air was forced into my stomach.

This really blows the test results I expected. Now, I'm thinking that a chin strap will not help nor will a face mask.

I am beginning to think that perhaps since my numbers didn't go down that maybe the leaks I'm getting is normal. Or who knows what.

What ideas can you give me for this collection of strange data? Sigh, why couldn't this switch to an apap been simple. The more I research the more that doesn't add up and I am totally frustrated. I guess I need to talk to my repiratory therapist again and see if we can come up with an idea of what's going on and what data equals good therapy.
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#30
At least you seem to have ruled out the mouth breathing part. Go with it for a few nights and see if it's the same. For the leak reading to stay flat would appear to indicate that the setup has such a base leak rate, although 60 lpm seems high. I have yet to exceed 51 lpm (and that's when I had a major leak event which spiked the reading). Hopefully someone using the same APEX Wizard mask can share their experience.

I find my AHI definitely shoots up if I didn't stick to good sleep hygiene - like eating supper late in the night before bed, or snacking, etc. My "bad" night chart posted earlier was due to a few drinks that night.

Even with such precautions, there are days when things really go south and I wonder what happened. It takes a few days to settle down.




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