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What is Normal Average Leak Rate?
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PaytonA Online
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Post: #31
RE: What is Normal Average Leak Rate?
Taping your mouth does not guarantee no mouth leaks. We have had a number of reports of mouth leaks even with the mouth taped. A full face mask will guarantee (once you have conquered the external leaks) no mouth leaks that will affect your therapy.

Merely keeping the lips together even with the jaw closed will not necessarily stop mouth leaking. I think that it depends on the pressure at the time. If your pressures are very low, just keeping the mouth closed may be enough to stop mouth leaks but at medium and high pressures not so much. At medium to high pressures (the pressure range is my thinking) you must make a tongue seal at the back of your mouth in order to keep from mouth leaking and no amount of merely keeping your mouth closed will stop the leaking. Keeping your mouth closed (in my opinion) does make it easier to make the tongue seal work due to it being closer to the roof of your mouth to begin with.

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PaytonA
08-13-2016 11:43 AM
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Sleepster Offline
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Post: #32
RE: What is Normal Average Leak Rate?
(08-11-2016 09:59 AM)Newbee2016 Wrote:  So average leaks on a good night is around 20LPM with the Wisp.

But note that even on that good night the leak rate jumps from its baseline of 20 L/min to around 35 L/min for a period of what looks like about 45 minutes.

On your bad night that jumping behavior is much worse.

This is a case where an average value doesn't tell you much. It's like having your head in the freezer and your feet in the oven. On average, you're okay!

Those jumps indicate mouth-leaking. Unless you fix that problem it doesn't matter how many hours you sleep with your machine on, or how low your AHI is. Your therapy will always be less than optimal. On a bad day, much worse.

When a chin strap doesn't work, a full face mask is required. There are no other options. Taping is a foolish and ineffective treatment. The fact that no doctor or respiratory therapist will recommend it tells you all you need to know.

The problem with a nasal mask is that there is high pressure in the throat and low pressure in the mouth. There's a "valve" formed by the meeting of the back of the tongue with the roof of the mouth. There's high pressure on the throat side, and low pressure on the mouth side. If the valve won't stay closed, air escapes from the throat into the mouth. A full face mask insures that the pressure on each side of that valve is the same. It therefore makes no difference if the valve remains open or closed. Either way, the throat remains pressurized, the air splint is maintained, and the CPAP machine delivers the therapy it's designed to deliver.

Sleepster
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
08-14-2016 07:44 PM
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Lanco Offline

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Post: #33
RE: What is Normal Average Leak Rate?
So, I'm going to try something new. I see there is an alarm feature on my auto cpap. The instructions in the manual say "When alarm is turned on, the audible alarm will activate with warning messages showed on the LCD display."

It seems to me this may be the answer to my questions here. What do you think? Or if it turns out I have too high of leaks that that would affect the warning message enough that it wouldn't be correct?

Anyway, I'm going to try it tonight. Don't really look forward to being woke up if that happens but this may be the missing link of info I've been looking for. Fingers crossed.

In looking at the brochure it shows it's a low pressure alarm. What does this mean?
(This post was last modified: 08-14-2016 08:49 PM by Lanco.)
08-14-2016 08:36 PM
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Sleepster Offline
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Post: #34
RE: What is Normal Average Leak Rate?
The alarm goes off if you remove your mask while the machine is on. Some people take their mask off while they're sleeping, have no memory of it, wake up without it on, and wonder what happened.

Sleepster
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
08-14-2016 09:41 PM
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Lanco Offline

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Post: #35
RE: What is Normal Average Leak Rate?
Sleepster

Do I understand you correctly that with a face mask it would pretty much solve any issues I am having?

I'm quite sure I don't want to even bother with a chin strap. I tried one 16 years ago for a few nights and it either didn't work and or I did not like it one bit.

What problems come with using a face mask?

I'm thinking that if one has a cold which I rarely get or if my sinuses are just acting up I could still get proper cpap therapy breathing through my mouth if necessary.

Thank you for your assist.
(This post was last modified: 08-14-2016 10:05 PM by Lanco.)
08-14-2016 10:02 PM
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icyura10 Offline

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Post: #36
RE: What is Normal Average Leak Rate?
(08-14-2016 08:36 PM)Lanco Wrote:  So, I'm going to try something new. I see there is an alarm feature on my auto cpap. The instructions in the manual say "When alarm is turned on, the audible alarm will activate with warning messages showed on the LCD display."

Give it a whirl... I can see situations where your mask could become dislodged for say 10 seconds or so and you'd naturally resolve it.

Having a fire klaxon in the bloody machine go off to wake you up so you solve a leak problem seems an extreme way to solve this considering your objective is to sleep.

It's kind of like the nurses in a hospital coming in every 3 hours to awaken you to take your vitals when you're trying to sleep...

I'll be interested in your results and thoughts with this approach.

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08-14-2016 11:20 PM
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Sleepster Offline
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Post: #37
RE: What is Normal Average Leak Rate?
(08-14-2016 10:02 PM)Lanco Wrote:  Do I understand you correctly that with a face mask it would pretty much solve any issues I am having?

Provided it fits you correctly, yes. The conventional wisdom is that full face masks are harder to fit because they are more likely to leak. I don't think that's as true as it used to be. Newer materials and designs, along with the variety of styles available, have made them easier to fit.

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
08-15-2016 05:16 PM
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chill Online

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Post: #38
RE: What is Normal Average Leak Rate?
In my usage of the P10 pillows, Eson nasal, and Simplus full-face mask, the full-face is more prone to leaking and starting to leak mid-way though the night. The Eson less so and the P10 almost not at all. But I often get my best sleep with the Simplus regardless of the leaks waking me up.
08-16-2016 01:33 AM
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Newbee2016 Offline

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Post: #39
RE: What is Normal Average Leak Rate?
(08-14-2016 07:44 PM)Sleepster Wrote:  
(08-11-2016 09:59 AM)Newbee2016 Wrote:  So average leaks on a good night is around 20LPM with the Wisp.

But note that even on that good night the leak rate jumps from its baseline of 20 L/min to around 35 L/min for a period of what looks like about 45 minutes.

On your bad night that jumping behavior is much worse.

This is a case where an average value doesn't tell you much. It's like having your head in the freezer and your feet in the oven. On average, you're okay!

Those jumps indicate mouth-leaking. Unless you fix that problem it doesn't matter how many hours you sleep with your machine on, or how low your AHI is. Your therapy will always be less than optimal. On a bad day, much worse.

When a chin strap doesn't work, a full face mask is required. There are no other options. Taping is a foolish and ineffective treatment. The fact that no doctor or respiratory therapist will recommend it tells you all you need to know.

The problem with a nasal mask is that there is high pressure in the throat and low pressure in the mouth. There's a "valve" formed by the meeting of the back of the tongue with the roof of the mouth. There's high pressure on the throat side, and low pressure on the mouth side. If the valve won't stay closed, air escapes from the throat into the mouth. A full face mask insures that the pressure on each side of that valve is the same. It therefore makes no difference if the valve remains open or closed. Either way, the throat remains pressurized, the air splint is maintained, and the CPAP machine delivers the therapy it's designed to deliver.

Thanks for those insights on the charts. I've got still more experimenting to do. A long journey this road it is ...

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08-16-2016 03:13 AM
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Lanco Offline

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Machine: Resmed S9 Autoset, Apex XT Fit
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Mask Make & Model: Apex Wizard 210 & Profile Lite, Wizard 220 FFM, Nuance
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Post: #40
RE: What is Normal Average Leak Rate?
So, a light bulb went off in my head. I figured I could find out once and for all at least what my normal leak rate should be with no leaks from the mouth or mask. So I did a test with two masks, the Apex Wizard 210 and Profile Lite, and I did it awake, sitting in a chair keeping my mouth shut and making sure there were no mask leaks. So guess what? First, knowing that my software does not record data for the first 15-20 minutes so a person can get settled in bed, I then checked 10 minutes worth of leak data. The Wizard showed 54-56.6 lpm and the Profile Lite showed 54.4-56 lpm. Essentially the same. The interesting thing here is my Average Leak for I believe 42 days is, what do you suppose? 54.2!! That gives me some relief at this point knowing that this is a good reading. (still can't figure out how Newbee2016 only shows around the 20's in comparison), but now I can see whee my Highest Large Leak being 74 and for between 1-3 minutes, depending on which chart I am using is essentially no problem, it appears anyway, in my mind.

This further supports what i found in the previous ZZZ-ware software where a red line was used at the 70 lpm mark.

I am further going to contact a couple sources to verify I am correct as now I feel like I'm almost smart enough to ask some of the right questions and maybe understand the answers.

Also, tonight I plan on using the large leak alarm setting now that I'm convinced I either won't hear it or it will go off very little but verify the large leak data.

Any thoughts on this?

[img][Image: 82216WizardProfileTestLeak_zpsaheesgxq.png][/img]
08-23-2016 03:47 AM
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