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What happened to ResMed air leak numbers?

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TidySangriaAntelope3496 +0 points · over 2 years ago Original Poster

My air leak numbers historically have ranged between 0 and 12 liters/min. On Dec. 4th the air leak jumped to 28, followed by leak of 20, 20, 6, and 19 liters per min on following days. The really weird thing is that where my air leak on Dec. 3rd was 4, it now displays 18 for that day. On December 2nd I recorded air leak of 5; Myair display now reads 13 for that day. On Dec. 1st I had 0 leak, but Myair display now says it was 13 that day. It's like the numbers changed randomly, but much higher. What happened?

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wiredgeorge +0 points · over 2 years ago Sleep Enthusiast

Since website programmers often need to justify their paycheck, they often make changes to the site software that are not really upgrades but just changes that usually don't work quite as well as the previous version of the software. Don't know if you noticed but MyAir website data display was just tweeked a bit. Suspect the data was jumbled. I look at this data every day but don't keep track of the numbers unless something seems really out of the ordinary and only use the L/Min for judging when a mask cushion needs to be changed as I get minimal leaks until the mask cushion is shot.

I "BELIEVE" the L/Min means Liters per minute. Seems to me even ONE liter of leaking air in a minute's time would create a small hurricane and guess I don't really understand what the leak thing means. If your mask leaked 20 liters of minute, think you might notice as that is a LOT of air and probably much more than a person could breathe. I know the machine compensates but to pump that much air would require a 5HP compressor and not a little CPAP machine. Hopefully someone smart can explain this as I can't.

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KindPinkGuanaco9781 +0 points · over 2 years ago

I am also concerned about this; these numbers seem way out of wack since this software change.

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wiredgeorge +0 points · over 2 years ago Sleep Enthusiast

Perhaps it is best said that AHI is the only really important number. Hours of sleep are also somewhat important as everyone has a different number in that regard where they will have gotten enough rest. The mask leak number is only important if your machine can't compensate for the leaks and the leaks would have to be pretty huge number for that to occur and the problem would reflect in your AHI I suspect. I guess if your AHI is good and you are sleeping long enough for your personal standard for enough rest, then all is good anyway and leaks are not really something that should be of concern.

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sleeptech +0 points · over 2 years ago Sleep Enthusiast

L/min does indeed stand for litres per minute. 1 L/min of leak is very little. ResMed leak data subtracts what it expects the controlled leak level to be before reporting leak. Controlled leak is the air that flows out of your exhalation port (something which should happen). This is why you can get a leak of 0 zero on a ResMed machine but you will never get that on a Respironics or a Fisher & Paykel machine. A leak of 0 - 5 is very small. Over 20 is starting to get sizeable but ultimately, unless the leak is massive the machine will compensate (all models that I have ever heard of do this), so all that really matters is your comfort. We always say that is a leak isn't bothering you it's not a problem. It is very unlikely that you will not be bothered by a leak that is big enough to be a serious problem.

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BrainsNeedSleep +0 points · over 2 years ago Sleep Commentator

I have complex sleep apnea. Leaks below the machine threshold for "large leak" notification are still significant to my treatment. Managing any and all leaks thus is important to my care and makes a noticeable difference to my daily functioning. Since others may also be similarly misdiagnosed as I was, maybe we should pay more attention to leaks and not shrug them off if they're not "bothersome."

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sleeptech +0 points · over 2 years ago Sleep Enthusiast

I would say that if leak is "important to my care and makes a noticeable difference to my daily functioning" then it is bothering you.

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Douglas +1 point · over 2 years ago

12 years ago I started using a c-pap machine w/ a "small" face mask. This worked perfectly and travelled with me all the time. 2 years ago the machine was replaced with one that monitors my sleeping and reports same back to res-med (?). Res-med keeps telling me the results are not good (leakage, hours of use, etc.). I informewd them that the problem was the change in machines. They say it is not their concern but that of my sleep doctor. I talked often with my sleep doctor to no avail. I now have a new sleep doctor (as of two weeks ago). Maybe things will improve! My question is have others had this problem (one machine & mask style working perfectly and another machine and mask style not working)? If yes, how did you address the problem. Thanks

OH yes. One sleep tech advised me to shave off my beard. I have had this beard almost every day since I was discharged from the US Marines (50 + years ago) . It is much a part of me as my dreams and will not be removed.

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Borristhefish +0 points · over 2 years ago

Hello, I started 5 years ago with what I was given. Trying not to break forum rules. I liked the mask. The cushion is soft and you can unplug the hose. I had a new study and a new mask was given. The new mask has magnets to clip the straps. Vs the first mask has me just grabbing the strap to connect it to the plastic part that holds the cushion so new mask goes on quicker and its a really big change in weight and shape, the cushion is or was at first OK. I gave it two months as minor things like waking up and the cushion was out. And waking up and repositioning the cushion to make a seal. I am not new at this so I gave it time. Then decided go back to the old. I realized the first mask was what I prefer the softness and mask fit I had missed. So my answer is are you sleeping well with both masks. Do you have leaks pre new machine? You are being monitored so the data reported reflects the machine. Did the pressure get set higher. Some people need a chin strap to prevent leaks. How old in months is the mask / cushion ? After a while whatever the vender states its time to replace. Did you give your new mask time as in get used to it because my first mask is more comfortable in the cushion which after not using it for a while was obvious after going back. But when I first started day 1 never had a cpap I struggled as the cushion was to small the vender sent one size larger and that made perfect. The new mask. I just don't like the cushion so it effects my sleep. You have the option of trying a new type but give it a while figure out why you don't like any mask. Some cushions are thin and more flexible. Also This makes the assumption that I saw in your question as well machine change? Unless I am mistaken titration levels / machines and masks are compatible so I am thinking that's why on paper so to speak its not an issue per vender. Take there word to be safe but on your end find a mask that does not leak. Something changed did the machine get set right? keep going its your health so take care of it.

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wiredgeorge +1 point · over 2 years ago Sleep Enthusiast

Thanks for your service! Nobody has accused a Marine of not knowing his own mind! OK, ResMed; what is you typical AHI and leak rate? How many hours of sleep is normal for you? ResMed is not responsible for the prescription on your machine; your sleep doc is and the DME who gave you the equipment is responsible for the mask and its fit and setting up the machine. I personally had to BUY OUT OF POCKET a few masks I tried till I settled on the one I currently use. I had previously been using a F&P Simplus fairly successfully but had to find the right size cushion and had to use mask pads to keep the leaking air out of my eyes. My leak rate wasn't great but wasn't so high that it affected my AHI. Since I served as a member of the UNITED STATES ARMY about 45 years ago, I learned to adapt, improvise and overcome. That meant, for me, an Amara View mask with the correct sized cushion as I too have a beard. I found it easiest to get good mask seal by shaving right under my lower lip but it doesn't hurt my good looks any AND the beard covers my double (well triple) chin. I get ZERO mask leaks some nights and the mask is more comfy than the others I tried. AHI is what is important and if you are doing good there, then you need enough sleep to keep you perky. This varies by individual; I sleep 4.5-6 hours generally and feel great. Others need more and others need less. Do not rely on medical professionals to get you 100 percent right; you are your own best point man and learn to adapt, improvise and overcome!

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KindPinkGuanaco9781 +0 points · over 2 years ago

I am still concerned about these ResMed readings because my machine shows a green light on mask fit and then when I check my numbers online the next day, my mask leak is enormous--as high as 40 m/L, which is way above the guidance of keeping leaks to less than 24 m/L. This doesn't jive; I called my provider and the technician told me not to worry about it because my pressure is only 10. This makes no sense to me.

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BrainsNeedSleep +0 points · over 2 years ago Sleep Commentator

After many years of misdiagnosis, I don't take kindly to being told "not to worry" without any explanation or satisfactory resolution to my questions. With all due respect, I encourage you to insist on getting an answer to YOUR question that makes sense to you.

I'm not a sleep tech but whatever your pressure, you shouldn't be having such a leak issue, and if you are, then something is wrong: the software reporting, the software/machine sensor of leaks, the mask fit, etc. I would GO to the DME provider and politely insist on an explanation that DOES make sense, or a fix. If they are unhelpful, tell your doctor because they are the ones who refer to DMEs, and if they get enough complaints about one, they sometimes change! Of course, that assumes you have choices in your area, and you may not.

If you do not get satisfaction from the DME or your doctor's office, then I would get on the phone to ResMed and very nicely ask for someone to help answer your questions. If that doesn't help, you can try tweeting @ResMed that you have a problem that no one is helping with, and that might work! @ResMedMick has on rare occasion responded. They're nice people :-)

Sorry, I wish I could give you the one-line answer that fixes your issue!

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wiredgeorge +0 points · over 2 years ago Sleep Enthusiast

Got a note from "MyAir (ResMed)": quote:

myAir Score

We've changed the way your mask seal scores are calculated to align with how your healthcare provider assesses your mask leak. Most users will only experience small differences in their nightly scores (+/- 3 points), however you may notice a larger increase or decrease if you're having issues with your mask fit and seal.

Additionally, we've changed how mask on/off events impact your score. You can now have up to two events before your score is impacted, so no more losing points if you need to get up to use the restroom!

unquote

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KindPinkGuanaco9781 +0 points · over 2 years ago

Thank you wiredgeorge and BrainsNeedSleep. I did see this mystical explanation from ResMed and I will be contacting them directly. I did actually email the cpap technician at my physicians office with the past two weeks' worth of leaks, which are concerning, and she returned my call to tell me not to worry about it since my pressure is only 10. I am going to get to the bottom of it and appreciate both of your responses. I work in an peripheral role in medicine and I am quite disgusted by how sleep apnea patients are often left to their own devices to try to figure so many things out. This is most certainly not how other chronic conditions are managed. Not only are the treatments difficult to assimilate to, understanding whether or not they are working and what needs to be adjusted should not fall on the shoulders of the patient. I am not sure I would understand how to read the sleepyhead data yet I am wondering if I need to move to this next step since it appears questionable the reliability of the my air data. This is a condition that one is informed of by the data as well as how you feel. Thanks all for listening.

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wiredgeorge +0 points · over 2 years ago Sleep Enthusiast

You use the term, "should not" but consider your feelings on the matter won't change the fact that sleep medicine and associated equipment support are not very center stage and don't get top notch medical support. It kind of makes sense to me to self-educate and learn to captain your own therapy as the people that are paid to often come up a tad short as you have figured out. Ask your CPAP technician (or your sleep doctor) if they ever look in at a forum(s) such as this one and I bet I can guess the answer.

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KindPinkGuanaco9781 +0 points · over 2 years ago

Last night's data on mask seal--18 points out of 20 but yet the graph shows a leak of 20 mL. This doesn't compute and as far as I can see since Resmed did this software update the leak rates have doubled mysteriously. I do have an inquiry in to several places about this and will post if I hear anything that makes sense.

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sleeptech +0 points · over 2 years ago Sleep Enthusiast

Your problem sounds like the kind of thing that needs to be dealt with hands on. Is there someone you can see who can help with your mask fit. It's not possible to do much via a forum.

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S2S +0 points · over 2 years ago

ResMed did an update that they said would change everyone's numbers. L/min is always there, even if you don't have a leak at all. It changes with the mask you use, it appears to be a lot more with a Nasal mask and even more with a FFmask. It must be something to do with the vent sizes as I often do not have any leaks at all and still get a L/min number. All that you need to worry about is if it take a big jump from your normal reading. I would just take a note of where it normally sits now and only worry about it if it goes up a bit. Even then, if it is an APAP you are using it should adjust the flow to make up for a small leak. ResMed themselves said that everyone would have higher numbers using MyAir since December.

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KindPinkGuanaco9781 +0 points · over 2 years ago

Yes, I did see the notification from ResMed. But for leak numbers to more than double when my leak rates were previously well within range? This makes no sense. To get 18 out of 20 points for the mask seal and then to have a leak rate reported greater than 24 m/L? Something's amiss here.

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