Losing mask seal around 1:00 a.m.

[Suetois]

I'm back with another problem. I've been trying to get CPAP to work for me since November. Lately I've had a handful of successful nights, and I feel so *awake* in the morning when it works. My problem is that my mask seals just fine at bedtime and for the first few hours that I'm asleep. Then, usually between 1:30 and 3:00, it starts leaking like crazy and I wind up messing with it for most of the rest of the night. Anybody have any idea what the problem might be? I've been thinking that maybe I snore more heavily then and disrupt the mask seal because of that.

Also, will the software that would allow me to see if there's something funky going on with my breathing right about then work on a Mac? I'm running OS 10.6.6. If it will work, I think it's time for me to start investigating things in some detail.

[CPAP Seal]

Facial sweat/oil might be the reason. Try wash your face before sleeping as this will decrease the build up of facial oil.
Also start with washing the mask once a week

[jdm2857]

Both Encore Viewer (Respironics software), and ResScan (ResMed software) will not run on the Mac OS.

If you have Bootcamp (or one of the other similar products) that allow you to run Windows on an Mac with an Intel processor, you can run the software on your machine under Windows.

[katcw]

I wash my mask interface every day, or wipe it with a non-alcohol wipe specially made for cpap masks. And I wash my face just before bedtime. But this happens to me, too. I'm on bi-level bipap, and wonder if my need increases the pressure to maximum, disrupts the mask, and then doesn't drop down after the moment has passed. If I hit the stop then start again, it goes into ramp mode and I can go back to sleep.

My understanding is that Encore Viewer, at least, will not work in Linux nor Mac. There are some folks on the board that are working on changing that.

[nanwilson]

Mask liners! Look up padacheek, Karen is a member here, and remzzzs...or make your own out of well washed t-shirts. The fabric keeps the oils from your face away from the mask. Padacheeks liner can be tossed in the washer but remzzzs are more a one or two time use. I tried both and made my own but padacheeks liner is way better.

[Ebdmd]

I feel for you.i just started cpap and have been having the same problem. I just ordered padacheek antileak strap and will look into the liners. It has been rough when the mask starts going crazy at 3. I can deal with the little leaks but the major ones are killer.

[cflame1]

Just a thought... is it a REM sleep face relax thing?

[katcw]

Just a thought... is it a REM sleep face relax thing?

Maybe -- I don't know how to tell if I'm in REM sleep from my Encore Viewer data. What to look for?

Thanks!

[DoriC]

Are you adjusting your mask at max pressure?

[Suetois]

Katcw, that's just what I've been doing--resetting the pressure to my minimum of 8. When I do that, the mask seals again for awhile (so I don't think it's a problem with skin oil), but then I think the pressure goes back up after I fall asleep, and PpPPPpppPpb again.

jdm2857, thanks for the information about the software. I very much appreciate it.

I'll give the face washing another try. I tried that a couple of months ago, but that was with a different mask, so maybe it will make a difference this time.

Cflame1, I was kind of thinking that it might be REM related because of the way it starts a few hours after I go to sleep. I don't think there's any way to tell when REM is happening without an EEG though. However, if it's REM related, a chin strap might help.

Thanks for the ideas guys.

[Suetois]

DoriC, I did that a couple of times to get the headset right. It's a real PITB though on my machine, or maybe I'm just too impatient. You have to step through several levels on the machine to set the min pressure to the max pressure and then to return it to min so you can use it. I also have to pester my husband to help because I can't read the display screen while I have the mask on. I can't wear my glasses, and I have too much astigmatism to see the writing without them. I swear, I did *not* think that I'd still be trying to work this out after 4 months. (In fact, I naively thought I'd be strapping on the mask and *presto* instant success. LOL.) So it's inconvenient, but I'll try it at bedtime tonight and see if it helps.

[jdm2857]

Maybe -- I don't know how to tell if I'm in REM sleep from my Encore Viewer data. What to look for?

Only an EEG can tell if you are in REM. There's no way to tell from CPAP data.

[HoseCrusher]

I have used respirators at work for years. We have always held on to the notion of face fatigue setting in after about 4 hours. Protective respirators are usually put on very tight and to guard against this fatigue we only work with a respirator for around 2 hours. When working in dangerous areas that require a respirator, leaks are not tolerated.

With xPAP use, a small leak is not immediately dangerous to your health, so some leaks can be tolerated. To guard against face fatigue, I would suggest that the mask be tensioned only enough to seal at your maximum pressure. If you are loosing your seal due to face fatigue, this would be a good way to deal with it.

On the other hand, it is possible that your face changes slightly during REM sleep. If that is the case, you could "snug" up and then just apply a little extra in the hopes of keeping the seal as your face relaxes.

[Pugsy]

Maybe -- I don't know how to tell if I'm in REM sleep from my Encore Viewer data. What to look for?

As jdm said, the machines can't tell us if we are in REM but sometimes people that do have a history of having a lot more events during REM sleep (per sleep study) can see a rough correlation with events in small groups coming in a time frame that corresponds with the normal REM pattern time line. Usually REM starts between 90 to 120 minutes after sleep onset and progresses with cycles during the night with most being in the wee hours of the morning. Doesn't give us a definite statement but just a general idea and possible explanation for why sometimes we see a pattern for some groupings.

[robysue]

Two comments:

1) If you don't want to deal with BootCamp (and paying for a copy of WIndows) on you Mac, one possible work around is to buy a cheap, used older PC or PC laptop. Encore Viewer runs best on a 32-bit PC (cheaper kind) AND it works just fine on the old WIndows XP machines. So buying a cheap, used older 32-bit XP machine to use as a dedicated machine for using Encore Viewer is another possibility. [That's basically what I finally resorted to, although my dedicated machine is a newer netbook my brother-in-law had no use for, so he sold it to us at a reasonable price.]

2) You are using an APAP range, right? How wide is the range? What's your 90% pressure look like? Maybe the mask leaking at higher pressures might be easier to eliminate if your minimum pressure were not much lower than your 90% pressure. So another possible solution is to increase that minimum pressure a bit.