What is the problem with excessive leaks if AHI is good?

[RonM39]

I have followed the mask fitting procedures on the Apnea Board Forum tutorial, but still get indications that I am getting excessive leaks. Is that really a problem if my AHI and other statistics are good?

[BoxcarPete]

More wear and tear on your machine's blower, more noise and air spraying can disturb a bed partner, sometimes if the leak is facing the CPAP user's eyes they can get dried out. Little things, mostly annoyances, but worth resolving if you can. Really bad leaks can affect the performance of your therapy; that dotted red line is the level above which ResMed does not guarantee full efficacy. I noticed when I used mine that the flow and respiratory numbers tended to be less accurate when leaking a lot, but I mostly was dealing with mouth leaks rather than mask leaks.

[SarcasticDave94]

Since the airflow is how the CPAP measures things and senses events, yes it's important to keep leaks at least below the threshold of 24 L/Min, it's personal redline. High leaks means you can't trust the results. However, I'd set the goal lower yet to 10 or less.

Correct mask choice, fitting, sizing is about the hardest job in CPAP.

Much like a car tire, you can't measure accurately or properly inflate it if there's a big hole in the sidewall.

[staceyburke]

It’s simple if there are large leaks the machine CAN NOT record the events. It detects apnea by resistance to the flow of air in the mask. If you have apnea the air stops going through the mask and that tells the Cpap there is apnea. If there is a large leak there is no resistance and it can NOT recognize the apnea. If you have a lot of apnea and a large leak your report would be 00AHI.

[flanksinatra]

From what I have seen on other posts. High leak rates can prevent the machine from accurately identifying apneas.

[Sleepster]

High leak rates can also disturb your sleep. I suggest you try a different mask. Your insurance company should have an arrangement with your equipment supplier that allows you to try out different masks. This is because it can be hard to find a good-fitting mask.

[RonM39]

StaceyBurke replied "It’s simple if there are large leaks the machine CAN NOT record the events." 
My Oscar data below shows that of my nine events during the night, five occured during the first five minutes I had powered up the machine, during which time I was having constant leaks and I certainly was not yet asleep. During the rest of the night I had four events, averaging about 0.5 events per hour. I am having a hard time understanding how my leak rate is detrimental to my health with these results.

[SarcasticDave94]

Because the data is inaccurate with a high leak rate. It is this simple. Perhaps the 5 events you mention might actually have been 15, except the CPAP can't sense those others. Admitted arbitrary numbers, but the concept is true.

Your large leak of 24.x% means that's the amount of time your leaks were over 24 L/Min. That's the machine redline indicating the blower can no longer keep up.

If your leak rate stays at the median 10.x the whole night, you'd be probably decently acceptable. But it didn't, it goes over that redline for long periods of time.

The OSCAR chart shows the mask leaks from beginning to end. Your adjustment or fit is wrong.

I've got a serious question you need to reflect on. Why did you post this inquiry if you're going to dismiss the informed answers? Why the argument that we're wrong. Bottom line is fix your large leaks. It's that simple.

Your user info lists a Fisher and Paykel mask. Do you wear it tight? Regardless of mask make or model, most people mistakenly think tight equals no leaks. And they're wrong. The Fisher and Paykel masks require loose adjusting or the cushion seal gets squashed, distorting it to where it increases leaks. Going loose will increase leak control and comfort.

I've used the Fisher and Paykel Vitera, and it needs to be adjusted loose, Simplus same. If you're adjusting loose, then it's the wrong size or not a good shape for you.

[Deborah K.]

Yep, your machine IS NOT ABLE to accurately report your apnea events because of the high leaks.

[Sleepster]

My Oscar data below shows that of my nine events during the night, five occured during the first five minutes I had powered up the machine, during which time I was having constant leaks and I certainly was not yet asleep.

The data is garbage. The CPAP machine needs reliable input to produce reliable output. The input is not reliable. Back in the infancy of computers we called this GIGO, garbage in garbage out.