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how importanat are the leaks, if all else is good?
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kitley Offline

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Posts: 104
Joined: Mar 2012

Machine: resmed s9 elite
Mask Type: Nasal mask
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Humidifier: resmed s9 elite
CPAP Pressure: 7
CPAP Software: SleepyHead

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Sex: Female
Location: Ontario, Canada

Post: #1
how importanat are the leaks, if all else is good?
Just had my third night with my own machine...S9 Elite. My AHI for thoses 3 nights averaged 0.00, but this mornings I figured how to check the leaks. Even though I have a green smiley face for all 3 nights, my leak rate was 4L/min. I assume this means 4 leaks per minute. Is that ok as long as my AHI is good, and I feel good. With my loaner the girl gave me 2 pillow mask sizes...small and extra small. The small gave less leaks but then it became brittle and would not work. In a pinch I used the extra small...which I thought I would use up before switching to the small that she gave me. I hate to not use it, as a replacement will be about $40.00. Any thoughts as to whether this is ok to continue using? Thanks for any thoughts.
06-02-2012 07:53 AM
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zimlich Offline

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Posts: 392
Joined: Feb 2012

Machine: Respironics PR System One BiPap Auto SV Advanced
Mask Type: Nasal mask
Mask Make & Model: ResMed gel Nasal Mask
Humidifier: System One
CPAP Pressure: 8-20 ASV, 8 EPAP,PS 12
CPAP Software: Not using software

Other Comments: I use the Quattro FFM when necessary

Sex: Female
Location: Norfolk, VA

Post: #2
RE: how importanat are the leaks, if all else is good?
I don't use the nasal pillows, but if you are getting the smiley face I would not worry about your leak rate. It does not mean four leaks a minute, but gives your average leak over the night. Sorry I can't give advice about the pillows.
Good luck.
06-02-2012 08:17 AM
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big_dave Online

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Posts: 411
Joined: Apr 2012

Machine: PR System One DS560
Mask Type: Nasal pillows
Mask Make & Model: F&P Pilairo Q or ResMed Mirage Activa
Humidifier: PR System One
CPAP Pressure: 14 - 20
CPAP Software: SleepyHead

Other Comments: Former ResMed S8 Autoset II user

Sex: Male
Location: Eugene, Oregon

Post: #3
RE: how importanat are the leaks, if all else is good?
That is 4 liters of air per minute, which is outstanding. My own leakage is about 13 L/min. The machine works properly up to about 20-25 L/min, but I don't remember the exact figure.
06-02-2012 08:18 AM
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projman65 Offline

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Machine: Resmed S9 Autoset
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Sex: Male
Location: Tampa, Florida

Post: #4
RE: how importanat are the leaks, if all else is good?
0.00 AHI?? is that even Possible?
06-02-2012 08:25 AM
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kitley Offline

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Posts: 104
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Machine: resmed s9 elite
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Humidifier: resmed s9 elite
CPAP Pressure: 7
CPAP Software: SleepyHead

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Sex: Female
Location: Ontario, Canada

Post: #5
RE: how importanat are the leaks, if all else is good?
Thanks so much for your replies. So glad to hear it does not mean 4 leaks per minute. Actually the AHI of 0.00 was for last night only, not an average....my mistake. But the first night was 0.4, the next 0.1 I think...so almost 0. Hopefully my machine is giving the right data. I was quite surprised by it myself, especially with using the smaller size nasal pillows, that I know leaks a bit. Eventually I think I will buy a nose mask, due to all of my rolling around at night. I know every time I am aware of rolling over, I am having to adjust them to my nostrils again. That is what the tech started me on, and without coverage a new mask will cost up to $300.00
06-02-2012 10:06 AM
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mjbearit Offline

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Posts: 605
Joined: May 2012

Machine: REMstar Auto AFlex DS550
Mask Type: Nasal pillows
Mask Make & Model: RESMed Swift FX
Humidifier: Heated humidifier - 2
CPAP Pressure: 12.5-20
CPAP Software: SleepyHead EncoreBasic

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Sex: Male
Location: So Cal

Post: #6
RE: how importanat are the leaks, if all else is good?
(06-02-2012 10:06 AM)kitley Wrote:  and without coverage a new mask will cost up to $300.00

Wow! Have you checked out the supplier list? There is a link at the top of each page http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List
and Supplier #1 just as an example has a nasal mask starting at $57.00. If you are getting a $300 price, you might want to shop around a bit...just a thought!
Mike

As always, YMMV! You do not have to agree or disagree, I am not a professional so my mental meanderings are simply recollections of things from my own life.

PRS1 - Auto - A-Flex x2 - 12.50 - 20 - Humid x2 - Swift FX
06-02-2012 11:00 AM
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Sleepster Offline
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Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #7
RE: how importanat are the leaks, if all else is good?
(06-02-2012 10:06 AM)kitley Wrote:  Thanks so much for your replies. So glad to hear it does not mean 4 leaks per minute. Actually the AHI of 0.00 was for last night only, not an average....my mistake. But the first night was 0.4, the next 0.1 I think...so almost 0. Hopefully my machine is giving the right data.

The machine is showing that the therapy is extremely successful for you. And that's an understatement. Many of us wish we could get numbers that good.

Quote: I was quite surprised by it myself, especially with using the smaller size nasal pillows, that I know leaks a bit.

Nope, not to any significant extent. You have already an intentional leak rate on the order of 30 L/min. This is the air you feel jetting out of the vent holes. The machine measures the total leak rate, estimates this intentional leak rate and subtracts it to get your unintentional leak rate of 4 L/min. In other words, you are barely leaking more than the intended amount. I'd be delighted to have a leak rate this low. In my opinion, you'd be crazy to try to do anything to lower it.

Quote:Eventually I think I will buy a nose mask, due to all of my rolling around at night. I know every time I am aware of rolling over, I am having to adjust them to my nostrils again. That is what the tech started me on, and without coverage a new mask will cost up to $300.00

I started out with a nasal mask and switched to nasal pillows because, like you, every time I rolled over the mask would jar against the pillow and start leaking. Nasal pillows pretty much eliminated this problem.

Like you, I do find that the nasal pillows leak sometimes. I get a better seal by putting a dab of HPA lanolin in each nostril with a q-tip at bedtime. You can buy it in the drug store, on the baby isle. It's marketed as a salve for nursing mothers. The stuff works great, and keeps my nose from drying out, too.

A couple of other things you might want to try: A different nasal pillows mask. I started with the Opus, and then switched to the ComfortLite2. It leaks less, fits better, and is less noisy. The other thing is the routing of the hose. The hose would pull against my mask a lot and bother me so I routed mine up over my forehead where it attaches to the strap that goes across the top of my head, and from there it goes up and over the top of my headboard. Take a look at a photo of the ComfortLite2 mask and you'll see what I mean.

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.
06-02-2012 11:18 AM
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archangle Offline
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Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
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CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

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Location: USA

Post: #8
RE: how importanat are the leaks, if all else is good?
There are three leak rates. Some machines report one leak rate, some report another.

The "real" leak rate is called "Total Leak." This is the average of the total amount of air the machine pumps down the hose.

"Intentional leak" is the amount of air that leaks out through the air vents in your mask. This is what keeps you from suffocating. If you didn't have air vents somewhere, you'd be rebreathing the air over and over and would eventually use up all the oxygen.

The other leak rate is "Unintentional leak." This is total leak - intentional leak. It includes leaks around the mask and leaks through your mouth.

The machine tries to estimate the intentional leak based on the mask type and the pressure, and maybe some other things. It's only an estimate.

Unintentional leak can be zero. The machine can also misestimate the intentional leak and show zero for unintentional leak, even when you have a small amount of unintentional leak.

I believe ResMed tends to show unintentional leak.

For me, intentional leak is about 30 liters per minute.

I believe that you have to have a really bad leak for the frowny face to show up. Leaks that don't give you the frowny face can impact your therapy somewhat. Especially if you have bad leaks for just part of the night. I think Mr. Frowny is based on the average leak rate.

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06-02-2012 02:58 PM
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zonk Offline

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Machine: A10 AutoSet
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Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #9
RE: how importanat are the leaks, if all else is good?
The S9 is one of its kind in showing mask leak on the screen. 4 L/min is the 95% percentile leak which the S9 been at or below for 95% of the time and for the other 5% higher but no way of knowing how much higher without the ressacn download. Its a very small leak as the S9 acceptable leak is 24 L/min as any higher would skew the data. Having said if small leak causing inconvenience during the night constantly have to awaken to adjust the mask than need to be fixed bc it could result in fragmented sleep and preventing us getting into deeper sleep which we need for a restful sleep. Its one the reason imo how you feel is more important than the value of AHI bc I could feel lousy with zero something AHI and feel better with AHI 2 or 3 as more events get flagged in deeper sleep as opposed in shallow sleep
06-02-2012 04:02 PM
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kitley Offline

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Posts: 104
Joined: Mar 2012

Machine: resmed s9 elite
Mask Type: Nasal mask
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Humidifier: resmed s9 elite
CPAP Pressure: 7
CPAP Software: SleepyHead

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Sex: Female
Location: Ontario, Canada

Post: #10
RE: how importanat are the leaks, if all else is good?
(06-02-2012 11:00 AM)mjbearit Wrote:  
(06-02-2012 10:06 AM)kitley Wrote:  and without coverage a new mask will cost up to $300.00

Wow! Have you checked out the supplier list? There is a link at the top of each page http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List
and Supplier #1 just as an example has a nasal mask starting at $57.00. If you are getting a $300 price, you might want to shop around a bit...just a thought!
Mike

Thanks Mike...I had wondered about checking the prices on line. The only thing is...how would I know what size fits best? And, actually for that matter how would my provider know...cuz once it is opened it can't be returned to her?
06-02-2012 04:50 PM
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