New Issue Developing with Leak Rate

[Mycopsycho]

I started cpap treatment about two months ago and have been going along very well with low AHI (0.0 to 0.3) and a leak rate between 0.0 and 7.0 L/min. Then about 3 or 4 days ago, I noticed my leak rate jumped from 0.0 L/min to 16.0 L/min in one day. Then, it went to 26.0 L/min and the last two nights around 22 L/min. My AHI has also been a little higher at about 0.3 to 0.6, which I know is not too bad. A couple of days ago my sleep doc moved my pressure up from 8 cm to 11 cm with a plan to try and get me off of oxygen if possible. With the higher pressure, I find I'm sleeping better and deeper. At night I find I have been waking periodically to adjust my pillows (Swift FX mask) after sleeping on my side and that I notice I will have pressure in my mouth and then lose it and then it builds up again. I guess I'm swallowing air because there are no puffs coming from my mouth. My mask pillow (medium) is the original one that came with the mask two months ago. Any ideas of what might be happening here? See my profile for equipment list.

[Julie]

Just a question - how do you know you're not mouth breathing while asleep? You can't assume a bedmate can adequately judge even tiny amts and a trial of taping and/or going straight to a full face mask would be more effective in checking it out.

[Nord]

Hi Bernie...

I'm guessing that you could point to 3 things for the increase in leaks...

1. Increasing pressure will always challenge the seal especially on Nasal Pillows so you may have to adjust your straps and angles to account for pressure.
2. Side sleeping and moving with any mask is a challenge. With the FX and normally loose headgear... pushing on one strap loosens up that side too much and creates small leaks in addition to more pressure.
3. After 2 months... your FX pillows may be worn and softer. You may notice some discolouration as part of the aging process. (compare it to new pillows)... Tightening headgear and "O-ring Repair" may bring it back from the brink. (Do a forum search on FX and O-ring)

I am trying to deal with increasing leaks on my FX now...
Just some thoughts...

Nord

[brazospearl]

A few weeks ago I suddenly had an increase in leaks and finally figured out that a hole had developed in my hose, right where it connects to the mask. It might be worth a look.

[jdm2857]

Search on "o ring" and not o-ring.

[Mycopsycho]

Just a question - how do you know you're not mouth breathing while asleep? You can't assume a bedmate can adequately judge even tiny amts and a trial of taping and/or going straight to a full face mask would be more effective in checking it out.

You're absolutely right and I've thought of that as a possibility. My comment about this related to my experience during waking hours in the night but I could certainly be mouth breathing in my sleep. But my question is why now after two months of really good numbers?

[Mycopsycho]

Thanks, everyone. I'll certainly follow up on your suggestions.

[Janknitz]

I have pressures that go up to 15 with no problem with Swift FX or LT. My 95% average is over 12.

First, if your nasal pillows are over a month old, it may be time to change them out. They wear out and start to leak more over time. You can trade out the sizes that don't fit on the great pillow exchange. You may find the problem goes away with new, firmer pillows.

Second, you might try bumping your pressure up to 11 and THEN adjusting your mask. Hold the nasal pillows up to your nose, turn on the machine, then pull on the head gear and adjust it with the nasal pillows fully inflated.

Third, UFO13's suggestion is to sew some velcro hook tape (the stiff side) to the inside of the back strap on your headgear--this will keep it from slipping around in side lying. I sleep primarily on one side only, so I loosen the headgear a bit on the "pillow" side and tighten it a bit on the "sunny-side up" side for a better seal.

[sleepmba]

Your headgear may be stretching out. Maybe a headgear adjustment will help. good luck