"please keep me updated about oximeters "
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Leaks
I have been noticing that alot of you are putting quite a bit of time and energy into the leak average part of your data. From a tech veiw I don't think this is necessary. At least not as much as I have seen. As long as your AHI is low, you are not snoring, and the leak is not bothering you I would not worry about it. The formula I use in a lab setting is this. 4x the pressure=equal leak allowance for any nasal mask. 5x the pressure=leak allowance for Full face masks. For Mike's setting at 12 cmwp I would allow a leak of up to 48L because he is on a nasal mask. The goal is to keep the events as low as possible. Everyone is different. Some people need a higher leak to stabilize the pressure. The leak average will drive you insane. Believe me I have spent needless hours trying to lower leaks when the events were pretty much gone.
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Replies to This Discussion
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Permalink Reply by Mike on
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I know I obsess about leaks because it's my understanding that the machine's tally of the Apnea and Hypopnea events becomes more unreliable the higher the leak rate. in other words, we have no idea that the AHI the machine reports is the true AHI if the mask is leaking too much. I don't know what the mechanical or technological reason for this is, just that I have it on good information from folks who include the technical support team at Respironics.
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Permalink Reply by Judy on
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That is also my understanding. As good and smart as these xPAPs are, they, at least supposedly, *wicked grin* are not as smart as a good RPSGT and therefore are limited in just how much leak they can compensate for before the data they supply is unreliable. Ooops! Time. Gotta go!
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Permalink Reply by RockRpsgt on
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I did not know that. I based the post an the lab setting. Sorry guys. Every one have a great weekend.
I am off to chicago for some R&R. No sleep for 3 days. YOu know what I mean. Wifey's orders! Rock hinkle has left the building!
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Permalink Reply by Daniel on
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Everyone is correct on this, especially Rock. It is true that if xPAP leak data is excessive, the rest of the data is unreliable. When leak rate is very high, the device cannot detect your breathing. Think of the auto off feature as the most extreme example of this. You take the mask off while the device is running. Massive leak ensues. Device logic says: leak is so large for such a sustained period of time, I'm going to assume mask has been removed and shut down. Smart Start is the opposite. The slightest amount of back pressure will cause the device to turn on. If the leak rate approaches "Mask must be off the face" levels, the device is going to have a hard time detecting the back pressure of an exhale. Therefore the data will be off.
Encore software flags this unreliable level as "Large Leak" in the stats. If the data doesn't say Large Leak and you are able to sleep through the night without being disturbed by leaks (dry mouth or eye, awakening from sound or the sense of air blowing on you), then forget about leaks. Everything will be fine.
For ResMed devices, if your leak rate is consistently above the 24L/min line, you've got the same problem.
Daniel
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so to clarify, you're saying that with ResMed devices, if your leak rate is consistently above the 24L/min line, you have the equivalent of what Respironics calls "Large Leak"?
Daniel said:
For ResMed devices, if your leak rate is consistently above the 24L/min line, you've got the same problem.
Daniel
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Yup, yup. 24 L/M is the upper limit for a Resmed. Assuming you are using the proper Mask Selection. And doing your own match if using a non-Resmed mask.
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Permalink Reply by Duane McDade on
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I will say this once 0LPM is the acceptable leakage anything else will alter the pressure that fixes your Apnes and Snoring anything else is just mumbo-jumbo. Leaks are never good......never. I have used every mask there is in the last 7 years and the only mask that does not leak and big extra bonus is silent and does not have to be so tight it hurts.....is the swift L.T. If you don't need a full face you got to try is device. I don't work for Res Med. I just think all of you people need to know that there is a something that works good all the time. I gain nothing for telling you this except the pearly gates stuff. PEACE! LOVE!! Big D.....im out.
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Permalink Reply by Rock Conner RRT on
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The other Rock is right. Pondering these little details can make you crazy. If your symptoms are relieved & you are sleeping like you oughtta, step away from all this microanalysis. Use CPAP like pillows & blankets -- to serve you at sleeptime.
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Yup, yup, both Rocks is right. We tend to forget and assume the questions are being asked 'cause on accountta the asker isn't sleeping any too good yet and usually that means the mask or the leaks.
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When I first started doing titrations I obsessed with the leaks. Thank god someone finally set me down and explained things to me.
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Permalink Reply by Richard Neider on
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I agree with Duane on the Swift LT. I was having leaking problems with other masks and have minimal leakage with the LT. This mask will let you sleep on your side whereas most others masks leak too much when doing such.
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Yeah, well, Rock Hinkle, don't get tooooo complacent about leaks!! I went TWO YEARS w/way too high a Leak BECAUSE the sleep techs who titrated me and the sleep doctors who were "treating" me weren't at all concerned about my Leak rate despite my asking about them many times. I was always told that today's xPAPs compensate quite nicely for leaks.
Yeah, well, "we" didn't achieve success UNTIL the RPSGT at the last sleep lab I went to picked up on it and said right off the bat that my leaks were too high. The sleep tech who did my actual titration came in midway thru the night with a chin strap for me. The addition of the chin strap, not the titrated pressure, was what FINALLY brought me success (the titration was "off" by 1 cm AND the dolt of a sleep doctor almost forgot to include the addition of 2L of 02 on my script). Duh! He was just a PITA anyway. Had he not ordered the titration study he would have been a COMPLETE waste of my time.
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