Good (or Acceptable) Leak Rates

[pcplus2]

Could someone provide some info on what is considered a good or acceptable leak rate for all three Sleepyhead statistics: Average Leak Rate, 90% Leak Rate and % of Time Above Leak Rate?  Am I correct in assuming that it is unlikely that anyone would have absolutely no leaks or is that achievable for some of you?  Wondering how to interpret my Sleepyhead data.  Thanks in advance.

[dosco]

Good question. I've been having some interesting struggles with leakage ... primary issue is that I discovered I'm a mouth-breather and as a result often have large "leaks" (when I open my mouth and the air shoots out).

I'm thinking zero leaks is not feasible.

-Dave

[pcplus2]

Me too Dave.  I've experienced the same thing.  I'm not really a mouth breather but I do occasionally get woken up with my mouth open and air streaming out (and my wife occasionally gets woken up by the noise of air streaming out of my mouth but she assures me it is nothing compared to my previous snoring).  My AHI is pretty good so I don't know if I need to worry about the leak rate or not.  The thought of dealing with a chin strap or taping my mouth shut kind of bums me out.

[Marillion]

Well, there will always be some leak stats as your mask has to let some air out through the vents so that your C02 doesn't build up! But it is when you are above a certain point that there are problems. I believe anything around 20-24L isn't classified as large leak territory but it can be uncomfortable when it happens to you for sure. We've all experienced it.

Personally, I can't stand it when I have air shooting out of my mouth. I use a chin strap which has (mostly) solved my mouth opening up but on rare occasions I have still woken up to it happening. The chin strap has not been that bad to adapt to. Not a big deal at all, if it worked all the time. But I would say it works 95% of the time for me.

I've ordered a different chin strap now that also covers your mouth at the same time, to prevent air leakages there. I have high hopes for it. Canada post tried delivering today but no one was home dang it! Hopefully I'll have it in my hands soon. I am hoping this will remedy any air leaking past my lips as I refuse to consider taping as an option.

[Gideon]

You 3 all have ResMed.
In SleepyHead on the Leak Rate chart,
right click on the left side (the words "Leak Rate")
Mouse Over "Dotted Lines"
Select "Leak Rate Upper Threshold"

This will set a dotted line at (I believe) 24.6 L/min
Above this value the machine will begin to loose the capability to identify events. While we don't "like" anything close to this line, everything below it is OK. This is Time over leak redline on SleepyHead. This number and the graph is all that I look at.
The real question is when does time above this line become a problem. Realize that spikes, short excursions above this line are typically not harmful. I know of no hard and fast rule on this, some users use 10% above the line, some 15%.

What will make you comfortable.

[Rcgop]

Could someone provide some info on what is considered a good or acceptable leak rate for all three Sleepyhead statistics: Average Leak Rate, 90% Leak Rate and % of Time Above Leak Rate?  Am I correct in assuming that it is unlikely that anyone would have absolutely no leaks or is that achievable for some of you?  Wondering how to interpret my Sleepyhead data.  Thanks in advance.

You are correct, we all have leaks to some extent. Here's where I think the MyAir app has merit. They use a 70% threshold and up to a point, the machine can keep up with the leaks and provide acceptable therapy pressure. 

While no leak is acceptable if it wakes you or is a bother some leaks are a non issue. 

I show my 70% leaks at zero every day for the past 3 months and yet my data has shown some leaks over the threshold. They are very short in duration and have little affect on therapy. If they don't wake me I forget them.

[Marillion]

You 3 all have ResMed.
In SleepyHead on the Leak Rate chart,
right click on the left side (the words "Leak Rate")
Mouse Over "Dotted Lines"
Select "Leak Rate Upper Threshold"

This will set a dotted line at (I believe) 24.6 L/min
Above this value the machine will begin to loose the capability to identify events.  While we don't "like" anything close to this line, everything below it is OK.  This is Time over leak redline on SleepyHead.  This number and the graph is all that I look at.
The real question is when does time above this line become a problem.  Realize that spikes, short excursions above this line are typically not harmful.  I know of no hard and fast rule on this, some users use 10% above the line, some 15%.

What will make you comfortable.

Great info.  Thanks Bonjour!!

[PaytonA]

With Resmed machines 0 leaks are attainable since Resmed mathematically estimates the unintentional leak rate. That is the leak rate in excess of what the vents are providing. I have had a number of nights (although not recently) where my leakage data read as follows:

Median - 0
95% leak rate - 0
Max leak rate - 0

Have not had a night like that for a while. One other thing about leak rate charts. Some of the rapid spikes are not real leaks and it has to do with the mathematics of estimating the leak rate.

With my Resmed, I like to keep my leaks so that 95% of them are below 10. I like to see my median at 0 which it is a fair amount of the time. I am fairly anal about my leak rate.

I know of people who have a 95% rate of over 30 that are happy because it gives them good results and they have other issues that do not benefit the leakage. The answer is to not obsess over your leakage rates as long as your 95% is under 25 and there may be situations where even that is not possible.

Best Regards,

PaytonA

[Marillion]

Thanks Payton. Great explanation.