I have my sleep monitored through my Resmed BIPAP machine. It sends the info in through wireless technology and I get a sleep score every day. It gives a score for MASK LEAKS PER HOUR and AHI (events per hour). Last night, I slept soundly for 6 hours which for me is great. I feel great today, btw...
I had 34 mask leaks per hour which they must feel is pretty bad. I had ZERO AHI events. I had 61 mask leaks per hour the previous night when I also slept great. Had ZERO AHI events. Seems there is little correlation between what is considered miserable mask seal and effective therapy.
I use a full face Simplus mask and mask pads. Leaking is not annoying as it is without the pads and I get no air in my eyes. I sleep much better using the pads.
Can anyone comment on the correlation between mask seal and effective therapy. Am I fooling myself on this issue but the mask leaks just don't seem important. COMMENTS?
Hi @wiredgeorge. There is a certain amount of mask leak that is considered normal. This amount is determined by the manufacturer of the mask and is referred to as the "intentional link" value. The Simplus mask is made by Fisher & Paykel. First, ResMed's software is likely geared toward their masks and the intentional leak values associated with those masks. Second, many modern machines, including those made by ResMed, can compensate for some amount of mask leak. While your score for mask leak may be poor according to the software, and it is possible that your mask seal could be a little better, as long as your AHI is controlled and you are doing well, I wouldn't think you should be concerned. Many patients I have worked with have had mask leak values higher than what may be considered optimal, but their therapy was effective and controlling their sleep apnea. If you are comfortable with your mask, feeling better, sleeping well, and your AHI is controlled, congratulations!
Thanks Dan! Your thoughts on this were pretty much my subjective experience... just feel kind of guilty, I guess for have such miserable mask seal scores. At some point, I may try a different mask from Resmed but my mask isn't bad. Since the first I had was miserable and was a major source of disgusting noises from leaking, this Simplex mask works much better but I suspect if I tried several masks I would find one even more effective. I am not fussy as I can tolerate these things pretty well.
Wish more folks would share their opinions/perspectives rather than pop in with a single question and then disappear. There are not many sources for support and education that work as well as this forum.
Can you tell me how you set up the technology you use to get sleep information every day. I am new at this and at a complete loss as to how to get started. My machine has a chip in the back, but my doctor (who I know longer use) led me to believe that only he can get the information from it.??? Thanks in advance for your hep.
Hi, how you access your sleep data depends on what brand & type of cpap you have. If it is a ResMed brand, you sign up for an account at myAir.com. But the information is quite limited compared to what you can access directly by going into the Clinical Setting window of a ResMed device. I don't know what woks for other brands, but for my ResMed AirSense10 & my hubby''s AirCurve10, if you press and hold the round button and the Home button for about 5 seconds, whie you are on the Home screen, it will switch to Clinical, and then you scroll to Sleep Report. That gives a lot more information, including 30 day averages. (Just don't tell your RT you're doing this -- it really freaks them out :O). I am the type of person who does better with my compliance when I have more specific details. Hope this helps!
@wiredgeorge It's my understanding that the ResMed Leak reports 'Liters' per minute, not 'leaks' per hour. If you click the 'Tour your Dashboard' and at bottom 'Learn more...', it gives info on all the categories. The theshold I saw for full face masks was 24 L / min. of expected expiration & incidental leaking. So your leakage scores are probably not as bad as you thought. But I have noticed like you, that AHI and amount of leakage do not necessarily correspond in tandem.
my husband has a full face mask because of his beard and I had to move down the hall. I couldn't stand it. Its like listening to a 747 engine or a trumpet in bed. Just awful noise and vibrations and squealing. Couldn't get any sleep with it. He sleeps right through it all night. any suggestions. He has a gote type beard not all on his face
Hi AmiableLilacAardvark1624. A squealing, vibrating mask is usually a pretty good indicator of leak and possibly poor mask fit. Mask liners may help with this, and you can do an internet search for CPAP mask liners to find some available options. Aside from mask liners or changing to a different mask, attempting to adjust the headgear can sometimes help.
When I first started therapy, I had a beard. Mask seal was bad, then changed masks and it was better but I had the straps pulled so tight on my full headgear it was very very uncomfortable and had mask marks on my face for hours in the morning! If I didn't have the mask cinched up tighter than a drum, I got air in my eyes and puffing out around my cheeks where it made disgusting noises and the air in the eyes was annoying. One point Dan didn't bring up was that folks that are saddled with high pressures from their machine fight mask leaks a lot more than folks with low pressures.... my high pressure is 25. I did a lot of investigating and learned that mask seal shouldn't rely on an over tight headgear but that was the only way I could minimize leaks until I found the mask liners. All the issues went away as far as leaks and I can now let my headgear be retained at a comfortable level... no more marks on my face! The added benefit is that I now have grown my full beard back and there are no noises from the mask. I did a search for mask liners and my specific mask and found the right ones which look like a piece of cotton cloth about 4x4" with a hole shaped like the open space in my mask. The liners were more or less the breakthrough that allowed me to use this equipment comfortably and quietly.
Hi Guys, So, I've been using the resmed machine with a full face..it was the one where my nostrils stayed out??! Anyway, I switched to the resmed f20 full face with magnetic clips (for her) and voila! No noise!! Literally, it makes zero noise! However, I do have some leakage....it always seem to fall between 15 and 19..I guess that's not too shaby...women, I really recommend the resumed f20...it really kicks ass!
For me, there seems to be no relationship between leaks and events. I have been on CPAP for 10 years and every time I plot leaks and events I cannot find a correlation. One night I had 95 leaks (bad hose connection) and events were less than 5. Another night I had 0 leaks and 9 events.
I am now plotting just events on a spreadsheet and since using a ResMed f20 Air Fit mask and that and a tweak to my ramp time by my DME I have seen a 36% decrease in my events over a 5 month period. By the way leak readings were so inconsistent. In a 30 day period on MyAir web site they went from 17 at the beginning to 9 on the last day with 9 nights of no leaks and the rest below 5.
If you have a ResMed CPAP there are some interesting comments in the Clinician Manual.
"Note: Under conditions of high leak with EPR enabled, AHI detection may not be optimal." "Apnea-Hypopnea Index—average AHI during the selected period. AHI and AI are calculated for times of low leak only." "Happy Face for Leaks: Good—if the 70th percentile leak is less than 24 L/min."
So it seems that ResMed does not trust the machine to correctly identify apnea events when there is a high leakage rate, which it looks like they set at 24 L/min or higher. And, for that reason it appears they ignore the high leak rate periods of time during the night. It is my observation using SleepyHead that there seems to be very little indication of apnea events based on the flow signal trace during these high leak periods. If that is the case, then it seems like the process of ignoring high leakage periods, would tend to increase the reported AHI, because periods of time where there are very few apnea events are being ignored.
