Leaky?? Amara View Mask

[sleepychar]

After many months of hardly any leaks with my Amara View Mask, SleepyHead has been reporting significant mask leaks almost every night for the past 3-4 weeks. The thing is, when I first put the mask on, I check carefully to see if it is leaking and I only settle down to sleep once I am convinced there is no leak. Last night I paid special attention for the first 10-15 minutes and I could not detect ANY leaks from around the mask. However, SleepyHead reported a leak starting at about 6L/min from the time I first put on the mask. I realize that 6L/min isn't a big leak - there were other significant leaks throughout the night upwards of 30-35L/min - but I am trying to understand what is going on and why SleepyHead is reporting even a 6L/min leak when I can't feel it even when checking carefully. I understand the leaks later during the night when the mask might get slightly re-positioned or hose pulled from tossing and turning but not the early leaks right from the beginning. Even those I am now suspicious of since significant leaks were occasional but not frequent previously. Now they are occurring most nights. Can some of the leak be coming from possibly a pinhole in the hose or someplace other than right around the mask when it is on my face? This is very frustrating after being successful for quite a long time with this mask. I changed to a new mask cushion about a week ago and problem persists even with new cushion. The mask frame is about a year and a half old. I just ordered a new one but it hasn't arrived yet. Any helpful input will be appreciated.

[Okie bipap]

The amara view mask is difficult to control the leaks. When I used one, my leaks were worse than they were with some of the other masks I have used. When you look at your sleep report on the machine, do you have a red frowny face? If not, your major leaks are less than 30% of the night. If the leaks are not disturbing you, I wouldn't worry about it. Your machine can handle a leak of 35 l per minute without affecting your therapy.

[Pugsy]

How old is the headgear?
When I start having consistent large leaks throughout the night my first suspect is the headgear being stretched out a bit...kinda loose and floppy that seems to loosen even more as the night goes on.

[sleepychar]

Thank you Pugsy and Okie for your responses. I have been very successful with the Amara View up until perhaps the last month or so or even less. Although I replace the cushion whenever it starts to get leaky, this time that did not work. I have ordered a whole new mask kit so I will see if that helps. The strap is not that old because I replaced it not that long ago. I am still messing with the mask and hoping I can get it back to where I was happy with it. This is very strange that all of a sudden this started happening. Since I just ordered a new mask, I won't be able to get another one for about 6 more months so I sure hope I will be able to get past this. I'm hoping this is just going to be a passing blip and will resolve itself.

[Chris8243]

You're not alone. I've also been using Amara View (full face mask) for just over a year and have been having trouble the past couple of months with leaks - or at least what I call leaks - with gushes of air around the mask waking me up. It didn't seem to show up in the reports, or I am not looking at the right thing. Tried a fresh cushion, didn't make a difference this time. Other times when I changed the cushion even though there was no issue, it felt so mush better.

My remedy, which has been working for a week, is a smaller cushion. I've been using a medium size, just got a size small last week. It felt a little awkward at first, like trying to wear a hat that's a little too small. But now I'm used to it and sleeping through the night again.

I haven't lost weight, it was my idea to try the smaller mask. The medium is the size according to the guide, but the DME was fine with me trying a small.

Just an idea!

Another thing which helped for comfort is thanks to Okie Bipap - who sent me a template for making a mask liner from an old comfy T-shirt. It also seems to help with leaks.

[Pugsy]

The 6 L/min baseline excess leak....This happens sometimes with some masks. I have seen it myself.
It doesn't always stick on 0.0 like we think and know is really happening.
We know because we verified that there wasn't a hole in the hose or circuit somewhere else.. like make sure the anti asphyxia valve isn't stuck open a little.

There's always going to be little normal variances in resistance with any mask even in the same model of mask.
This will affect the excess leak numbers a little. The machine doesn't subtract enough vent rate when it does its calculations for excess leak.

When I see this happen I just mentally think of the baseline (whatever it is) as my 0.0 line for that night.
Gives you a new red line at least mentally to use in your evaluation.
So 30 L/min reported leak ends up being 24 L/min ...in your head anyway.

If the leaks aren't disturbing your sleep...I don't know that I would worry about them until they exceeded 40 L/min and if they did and it was very brief...I woudn't worry about them then.
Your machine will start flagging UAs first if the leak is causing a problem and letting events happen and it not know what to call them.
If you aren't seeing any UAs...you are probably still in good shape in terms of therapy effectiveness.
Now when the leaks get REALLY big...like 50 L/min...the machine might not even know anything is going on but between 30 and 40...it can still sense something happening and report something.

And for me...duration of the big leak is very important...is it 5 minutes or 30 minutes kind of thing.

So 2 major factors when evaluating leaks
1...and most important to me...are they disturbing my sleep no matter what the size.
2...duration of the trip into large leak territory...is it brief or prolonged.

[ClayL]

I find that I have to readjust new head gear after the first few months and more often after that. I only have to tighten the straps 1/8 of an inch or so.
I had a sleep study a couple of weeks ago and they suggested I try the newer Dreamwear full face mask. I liked it so much I am getting one. The sleep tech said it is one of the easiest masks for them to adjust for patients.

[klm49]

I have been using Amara View for over a year and I find that the elbow that the hose hooks to leaks where it goes into frame. It makes enough noise that it will wake me up and I tried to move it around till it stops. I finally came up with a solution. I take Silicone sealant and seal it in place where I want it. I don't need it to swivel around anyway. No more leaks! The leaks weren;t enough to show in Sleepyhead but it made enough noise to wake me up many times a night.

[sleepychar]

Thank you everybody who has responded. Problem is still ongoing but I keep trying new things. I am wondering if there isn't some leakage around the swivel port thingy and I guess I will find that out once my new mask arrives. It could be the straps aren't adjusted just right yet since I received the new headgear a couple of months ago. I can't remember if this problem started when I got the new headgear or not. I will keep adjusting. The weird thing, to me at least, is that I did so well with this mask for so long before this started happening. I was actually confident enough to offer some advice here to some people who were having trouble with the Amara View. Of course there were always nights here and there with significant leaking but nothing as consistent as this has been. I do overlook if the leak isn't too big or hasn't lasted too long. Most of the time the leaks do not wake me up. In fact, I think I have noticed that the sounder I sleep, that is when the big leaks occur so maybe I have changed position in bed or something that is pulling on the hose. But I can't help wondering what's different now from previously where I was only experiencing brief and not very large significant leaks. Last night there was one leak for about 22 minutes out of 5.75 hours of sleep and the leak rate only went up to just over 31L/min. So I am not overly worried about that sort of leaking. I had taken a xanax before going to bed so it didn't wake me up. I have learned to overlook alot of the blips and not obsess about every little leak. It does concern me though when I get that SleepyHead message that I have had very significant leaking and I should go see my DME for assistance. That has happened a couple of time recently. I am using a liner made from the template provided by our wonderful Okie Bipap and it does make the mask more comfortable though I don't notice it affecting the leakage one way or the other. I will take a look at the Dreamwear mask again if this doesn't resolve with the new mask. I had looked into it some time ago and I can't remember exactly what it was but there was something in the reviews that made me think I wouldn't like that mask. I will have to wait another 6 months now before ordering a new mask since I had just ordered one and I am waiting for it to arrive now.

[Pugsy]

SleepyHead sometimes makes mountains out of mole hills with its assessment that you aren't doing so well in some area.
I take what it says with a grain of salt. Or more often don't even bother looking at what it says and instead just rely on my own evaluation of the leak results.
My leak graphs are rarely pretty. Sometimes I get lucky and get to pat myself on the back but not often. It's dumb luck though. I don't change my routine at all. The only exception is if I see many nights in a row with a really, really crappy leak result and that usually means headgear has stretched out. I sleep through the leaks though. When I see several nights in a row with half the night in large leak territory I go wash the headgear in hot water and if that doesn't resolve the issue then I put on a fresh new headgear.

[sleepychar]

Thanks, Pugsy. I will relax a little about this. CPAP is good but not perfect as far as finding a mask that is tolerable and not too leaky. I plan to just keep on keepin' on as they say.

[Okie bipap]

For some of us the search for the perfect mask is very elusive. I have gone around 20 masks since I started treatment. So far, I have found a few that I am fairly comfortable with: the F&P Simplus, Philips Amara View and DreamWear Full Face Mask, ResMed F20 and finally the F30. So far, I like the F30 the best if I can corral the leaks. For me, the DreamWear leaks less but the F30 feels more comfortable on my face. I have also tries several nasal pillow and nasal masks, but when I sleep I am a mouth breather. I don't do so during the day, only when I sleep. If a new mask comes out that looks interesting, I will probably try that out of curiosity.

[Pugsy]

If a new mask comes out that looks interesting, I will probably try that out of curiosity.

I like to try new things too. Just for fun and break the boredom if nothing else.
But the mask has to spark at least a little interest in me first.
Didn't bother with the F30...didn't spark enough interest to compare it to the DreamWear FFM. The headgear was the major turn off for me with the F30. Way too much crap on my head.
Now when the N30 comes out...depending on the headgear and my mood at the time...it might interest me enough to try it.
I don't normally do anything that touches the nasal bridge of my nose area but I might make an exception just to try it.

Next experiment on the books....the Bleep/DreamPort. I have waited 2 years on that puppy....got a little more wait and then I can try it.
In the meantime still eyeballing the P10 and the Gorilla tape trying to figure out some way to tape it to my nose.

[Chris8243]

The weird thing, to me at least, is that I did so well with this mask for so long before this started happening. I was actually confident enough to offer some advice here to some people who were having trouble with the Amara View.

Me too! I probably went at least 10 months with no real issues & then suddenly noisy air leaks that were waking me up every night. Honestly never looked at the leak data, wasn't worried about that as much as I wanted to sleep through the night. Persvered but then skipped a night just so I could sleep thru without the stupid mask waking me up. That worked but of course not the solution. Back at it but frustrated every night putting it on, trying to adjust, etc. One night the mask just hurt my face, before I even tightened any straps. Just holding it there, thinking "my poor face." Full face mask so all around my mouth (my cheeks) hurt. Ughhhh.

So I just tried Dreamwear. Didn't work for me. So now I got a fresh everything for Amara View and for the past few days, all is right with the world again.

[weroberts75]

I did so well with this mask for so long before this started happening.

I was fitted with an Amara View over two and a half years ago, and it worked like a dream for about six weeks. However, over time it pulled my lower jaw back and my facial geometry was changed.
I was never able to successfully wear an Amara View again without leaks. For what its worth, though, my lower jaw was initially too far forward due to mouth breathing, and it's in a better position now.

My real issue is that my nose and upper jaw did not fully develop during adolescence due to excessive mouth breathing.
On a face with average dimensions, the issue that I had with the Amara View would never be a problem.