What does this research mean for the field?

The classification of excessive CPAP leak varies widely depending on the manufacturer's definition, ranging from 0% to 40% in the same patient cohort, highlighting a lack of standardization that impairs leak management. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To investigate how different manufacturers define excessive leak in nasal CPAP therapy and its impact on treatment adherence.

May 20, 2026

B80-2-04 Discrepancies in Continuous Positive Airway Pressure Excessive Leak Definitions Among Manufacturers

Key Points

To investigate how different manufacturers define excessive leak in nasal CPAP therapy and its impact on treatment adherence.
Analyzed data from 39 patients undergoing in-lab polysomnography for nasal CPAP titration.
Calculated total, intentional, and unintentional leak based on manufacturer-specific criteria after CPAP titration PSG.
Conducted correlation analyses to examine relationships between leak variables across different manufacturers.
Excessive leak classification significantly varied among manufacturers: 40% for ResMed, 4% for Philips Respironics, and 0% for Fisher & Paykel (p ≤ 0.001).
Strong associations were found between leak variables for ResMed, Philips Respironics, and Fisher & Paykel (rho: 0.71-0.81, p ≤ 0.001).
DeVilbiss leak variable showed no association with the other manufacturers.

Abstract

Abstract Rationale Although nasal Continuous Positive Airway Pressure (CPAP) remains the gold-standard treatment for obstructive sleep apnea, excessive leak management is a common challenge. Excessive leak is an important CPAP side effect that can impair CPAP treatment and adherence. CPAP leak is described by different manufacturers using different leak variables and different excessive leak definitions. We hypothesized that the classification of excessive leak within a cohort of nasal CPAP users differs according to the specific criteria of different manufacturers. Methods Thirty-nine patients who underwent in-lab polysomnography (PSG) for nasal CPAP titration were analyzed. For each CPAP titration PSG, total leak was determined. Intentional leak was calculated using the pressure-specific intentional leak for the mask used. Unintentional leak was determined by subtracting intentional leak from total leak. CPAP leak variables used by different manufacturers were also calculated: 95th percentile unintentional leak (ResMed), duration of leak exceeding intentional leak x 2 (Philips Respironics), duration of leak exceeding 60 L/min (Fisher & Paykel) and 90 L/min (DeVilbiss). CPAP leak from each patient was classified according to the manufacturer’s excessive leak definition, except for DeVilbiss that does not define excessive leak (Table 1). Correlation analyses were performed to assess the relationship between leak variables. Results Anthropometric characteristics and CPAP leak variables are described in Table 1. The classification of excessive leak varied widely according to different manufacturers: 40% (ResMed), 4% (Philips Respironics), and 0% (Fisher & Paykel) (p ≤ 0.001). Leak variables used by ResMed, Philips Respironics, and Fisher & Paykel were associated (rho: 0.71-0.81, p ≤ 0.001). DeVilbiss leak variable was not associated with the other 3 manufacturers. Conclusion Excessive leak definition among different manufacturers widely disagrees. The lack of consensus in excessive leak definition impairs the implementation of excessive leak management strategies. This abstract is funded by: CAPES

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Cite This Study

Rosanelli et al. (Fri,) studied this question.

synapsesocial.com/papers/6a0d4fd2f03e14405aa9b47a https://doi.org/https://doi.org/10.1093/ajrccm/aamag162.6379

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