Acceptable Large Leak Percentage?

[kenhh]

I have searched The Forum for the definition of an acceptable level (ie percentage) of large leaks.
There is plenty of advice on what constitutes a large leak, but I have found nothing about what percentage is considered acceptable.
Sometimes mine is as high as 10%, sometimes it is less than 1%. Is there a measurement that is defined as acceptable? Is it just based on how the user feels the next day?

I have tried a variety of masks; none consistently give a large leak percentage of less than 2%. Am I expecting too much?

Any advice would be appreciated.

[Crimson Nape]

A large leak is defined by the leak exceeding the CPAP's ability to maintain proper therapy pressure and volume. Anything above 0% should be considered as exceeding the maximum allowable.

[pholynyk]

If you want to go by the red frowny face, I think you get that when you are over the large leak threshold for 70% of the night.

Ideally, as Red says, you want to not hit that 24 lpm at all, but perfection is rarely found on this earth.

I can get the frowny face if I let my moustache get bristly after three of four days....

[staceyburke]

I’m using an iPhone not my computer but if you put your mouse under the title leak rate. You can pick dotted line and one of those is the max before it is counted as a large leak.

[Geer1]

Its kind of a tough question to answer.

10 lpm leaks for majority of the night are probably more disruptive to your sleep than a large leak (24+ lpm) for 1-2%.

Large leaks you would like to avoid at all costs but if they are just momentary while you pull on mask when changing position or something like that then it isn't really an issue.

It appears you use a FFM in which case you just want to settle with whichever one feels comfortable and minimizes leaks the most. Ultimately it comes down to whether you feel you are getting satisfactory results or not. Chasing 0% large leaks doesn't necessarily help your sleep quality so if you are happy with sleep quality don't worry about the leaks.

[Marc]

I'm disappointed this wasn't answered.  Asking a patient to have a 0% large leak rate is incorrect and ridiculous.  This is what I found - Less than 10% is acceptable, but the lower the better.

A lot of long-time CPAP users will say that the "30% time in Large Leak territory" is too generous and that Large Leaks will affect your therapy much sooner than that. So this may be a good rule of thumb for you to consider:

• If you are OFTEN in Official Large Leak territory for 15%-30% of the night, then you PROBABLY have a Large Leak problem that must be dealt with.
  

• If you are OFTEN in Official Large Leak territory for 10%-15% of the night, then you MAY have a Large Leak problem that must be dealt with.
  

• If you OFTEN have Official Large Leaks that last continuously for an hour or more, then you PROBABLY have a Large Leak problem that must be dealt with.
  
  

Read more at the OSCAR Wiki by googling this (I'm new and not allowed to post links yet):

Code:

OSCAR leaks - Apnea Board Wiki

[Rubicon]

IIWM I'd consider 3 points:

1.  A leak higher than 30 L/min cause then all the apneas are labelled UAs (unknown apneas);

2.  A leak rate at or above 24 L/min for 30% or more of the night, cause then the machine gives you a frown and I'm VERY sensitive about that (although that's pretty unlikely since I don't use a CPAP machine, ResMed or otherwise); and

3.  If there were a lot of leaks I'd do frame by frame review to see what effect they had on sleep.  Those leaks that appear to lead to awakenings, or even arousals, would need to be addressed, no matter what ResMed, wiki, or any internet opinion said.

[mesenteria]

Essentially, if the machine can 'treat' you successfully, then the leaks are only innocuous if they don't interfere with your natural sleep pattern and its duration.  Any leak of any description or duration that arouses you and that disrupts your sleep pattern or duration is not innocuous, and must be dealt with for your sake....if not by you, by someone with good will and know-how.

The machine has only so much capacity to capture air and to deliver it to you at the prescribed volume.  Naturally, the higher your treatment pressure, the less innocuous any given leak is likely to be, depending on its magnitude. At some point the machine simply can't gather enough air and keep you 'inflated' AND deal with leaks.  The engineering assumes that we'll all have leaks and tries to design a range of masks and machines to deliver what we need, even with leaks.

So, the only true reference to the word 'acceptable' is you and your interface with the machine, whichever version and brand it is.  The pressure settings, the way you sleep, the mask type, and any adjustments or accessories you make to ensure your machine delivers the volume of air you need and not reach its delivery limit.  If your nightly report shows spikes here and there, and you don't remember awakening, and none of the spikes surpasses the designed limit, you should rest easy and confident that you are being treated.  If you know you're not because of the way you feel each morning or later, then maybe there's a problem other than leaks.  It's a problem of incorrect pressure, incorrect delivery, discomfort, or a disorder that has heretofore not been detected.  Even so, you're in lots of company because a great many of supposedly treated people report, and complain, that they feel no better or actually feel worse after several weeks of treatment.

[djont57]

As long as my Large Leak is below 10%, I'm happy & so is my sleep.

[SarcasticDave94]

OK so why are those others incorrect?

If you ask a question on a forum, and answers about facts and opinions regarding your question are posted, why is it arbitrarily assumed by you that's it's not acceptable or attainable?

Have you tried to reduce the large leaks?

You tell us there's a range to your large leaks, so this indicates something is randomly going on. Mouth breathing on occasion, maybe. The mask gets out of place or slides around, again maybe.

Why bother asking questions if you've already decided what answers you'll accept?

You asked for answers on what's an acceptable large leak regarding CPAP therapy. That answer is really and truly this: no large leak is acceptable. Large leaks hinder therapy, and can very well affect how you feel. Those that answered you have been using PAP therapy collectively for decades. I feel confident they know what they're telling you are good, reasonable answers and advice.

Large leaks tell us your mask doesn't fit very well or you mouth breathe. If neither were true, you'd have no large leaks. So you must face facts. Correct the large leak issue so it doesn't register. Or don't. Do not come here to tell the ones trying to help that they must be wrong. Again, why bother coming here to ask if you already know the answer you'll accept?

PS I just looked at your info. You are or were on VPAP Adapt and PaceWave. These treat things like Central Apnea or other specific higher need therapies. The VPAP Adapt is similar to the ResMed AirCurve 10 ASV I myself used, just one generation older. Definitely you cannot accept large leaks. It'll wreck your therapy.