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intermittent sky high leak rate - Printable Version

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intermittent sky high leak rate - BB63 - 07-31-2020

Please take a look at the posted screen shots of my latest sleep data. I have intermittent sky high leak rates. But, my mask itself does not appear to leak. If there was a perfect fit, it would be my mask fit. I have a mask mod, which worked beyond my expectations. A I made a hanger for the hose, there is ABSOLUTELY no weight on my mask due to the hose pulling it in either direction. And, I've switched to slimline hose, to boot. And, as I roll from side to side or onto my back, there is no leak that I can perceive.

Previously, I used a cushion for years and it got stiff and inflexible, requiring me to overtighten the straps. However, that's not the case now!

I have caught myself several times just before falling asleep, the pressure forces my lips apart slightly. It's probably worse if I am fully asleep and not conscious of the leakage. And, very rarely, I wake up in the night or in the morning with extremely severe dry mouth.

Is there anything in the posted data to indicate a mask leak problem, other than pressure pushing my mouth slightly open as I sleep?

All input appreciated.


RE: intermittent sky high leak rate - mesenteria - 07-31-2020

As depicted in your chart, I don't see anything to worry about.  Do you have a 'large leak' indication above the top of the leftmost marginal information, out of view?  What I see is periodic leaking, but it's only bad if the machine can't compensate or if it arouses you often and interferes with the stages of sleep.

RE: intermittent sky high leak rate - BB63 - 08-01-2020

I posted the data for the wrong day, so sorry.

Please check out the attachment in this post, which shows 2 sleep sessions. I know it's a bad idea, but sometimes necessary for me.

I was concerned about arousals because I think I should feel more rested based on the data seen from the cpap.


RE: intermittent sky high leak rate - BB63 - 08-01-2020

I did try taping my mouth closed to eliminate the possibility of the air leak being due to the air pressure forcing my lips open. Both failed, almost before I could get into bed, masking tape and packing tape just don't work Too-funny

My data for last night showed the same trend with the intermittent very high leak rates.

I do know how to stop the leakage if it's caused by pressure forcing my lips apart during sleep. I developed the technique years ago when I got stuck with a full fave mask from a loaner cpap. But, not sure it it's safe and proper. I developed it years ago, in an emergency situation when there was no other option and it served me well, but I haven't used it since!

RE: intermittent sky high leak rate - staceyburke - 08-01-2020

check the hose for leaks, any leaks with the humidifier? If you have used Oxygen, is the bleed port open?

RE: intermittent sky high leak rate - BB63 - 08-01-2020

Hi Stacey,

The hose is new but I did tape it closed temporarily and checked it for leaks with a spray bottle of mildly soapy water. I did stress it to expose a leak that might not otherwise be detected. I don't think it' leaking, however, I'll unwrap another new hose and try it tonight!

RE: intermittent sky high leak rate - Sleeprider - 08-02-2020

Why do you continue to live with the high flow limitations? In your original therapy thread, both bonjour and I encouraged you to activate EPR. http://www.apneaboard.com/forums/Thread-First-night-with-OSCAR-what-does-it-mean This simple measure will reduce the pressure needed to treat your apnea, with much better results for hypopnea and RERA. Leaks aside, your therapy is not nearly as comfortable as it could be by simply turning on EPR full time at 2 or 3. It would probably even help with leaks.

RE: intermittent sky high leak rate - BB63 - 08-02-2020

I have added EPR, though not as quickly as suggested. For me, I like to understand exactly what happens when I consider a change-whereas others might just 'do it' blindly and look for results in the post OSCAR plots. Basically I like to 'sleep on it' rather than rushing into it.

And, the datalogging CPAP and OSCAR are very new for me, it's like being thrust into the future. I am learning fast, thanks to reading the forum-it is a resource that is priceless! But it takes me time to assimilate, at least for me like .

I just checked my settings, I am at 9 to 13 for pressure, EPR ON, EPR is set to 1.

Please don't confuse my seemingly lack of a timely response as anything other than cautionary. And, I very much appreciate all input from you and bonjour!


RE: intermittent sky high leak rate - Sleeprider - 08-02-2020

If you have questions, ask. We can help you understand why we make the recommendations we do. Maybe go back to the other thread and post some close-ups of your respiratory flow rate. Much of it will have a flat or downward sloping inspiratory peak. EPR is simply the same bilevel pressure as provided by an Aircurve 10 Vauto, but limited to 3-cm pressure difference between inhale and exhale. What it means for you is, as you trigger IPAP, the Airsense 10 follows your inspiratory flow rate with more pressure support to make the inhale easier and less flow-limited. This can reduce the effort of inspiration, reduce the flow limitation and directly treat and prevent hypopnea and RERA. Then, as you cycle to exhale, the EPR will reduce pressure making expiration effortless and comfortable. The contrast in pressure between inhale and exhale is more important in treating upper airway restriction, while CPAP pressure maintains a stable airway against obstructive apnea.

RE: intermittent sky high leak rate - Dormeo - 08-02-2020

I want to chime in here about flow limitations and mouth leaks.

BB63, your flow limitations are very significant.  If you zoom in on your flow-rate graph, you will see that many of your inhalations fail to show a normal smooth curve but instead show a plateau, peak, or dent.

FLs are usually caused by a limitation in your airway that restricts the flow of air as you breathe in.  A common cause for the limitation is the relaxation of tissues lining your airway.  When FLs are present, you start inhaling, can't easily complete the inhalation, and have to exert additional effort.  This can be problematic in two ways.  First, over the course of a night, you are having to work harder at breathing than you should, and that can just plain tire you out.  Second, the efforts to overcome FLs can disrupt the normal sequence of sleep stages, leaving you feeling unrested during the day.

EPR provides an increase in pressure as you breathe in, and this can reduce the amount of effort your inhalation requires.  You need to get up to an EPR of 3 to see what that does for you. 

I was in a position similar to yours and wound up moving to a bilevel machine that can provide even greater EPR (actually called pressure support for the bilevel.)  With pressure support of 4.8, I've seen a huge reduction in FLs and a corresponding improvement in my daytime feeling of restedness.  I'm attaching FL graphs with EPR of 3 and pressure support of 4.8.  With luck, you will see good improvement going to EPR of 3 and won't need to switch to a different machine.

For leaks, I'd suggest you invest in a box of Somnifix tape.  It is designed for use on your mouth.  It has a firm hold but can be removed comfortably.  It is non-irritating to the skin.  The one tip I'd offer is to purse your lips before you apply the strip.