No matter what I do, I keep getting leaks

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Turntex
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No matter what I do, I keep getting leaks

Post by Turntex » Sun Oct 22, 2017 4:46 pm

I am on day 23 of BiPap use. I have worn my mask and used my machine faithfully the entire nite for the entire 23 and have no plans to stop. I certainly still feel a lot better (I noticed results the first night) and still have not had a headache upon waking which was an every day thing prior. I use an AirCurve 10 Vauto with min Epap of 15 and max Ipap of 25 with a PS of 4. Unfortunately due to chronic nasal congestion, I can not breath through my nose all night long so I must use a FFM. I started out with an AirFit F20, then tried an AirTouch F20. Then on suggestions here from Pugsy, I tried an Amara View. I hate the Amara since it was too uncomfortable to me and I could not get a good seal. I could not get the AirTouch to seal well either. Granted, I tried a medium where my AirFit is a large. Thought a medium might fit better since based on their guide, I am right between. I have not tried an AirTouch in large yet.

I have tried with straps in various tightness starting with loose and increasing a little. I now have it really cranked down to the point it is like a vise almost and hurts my neck. I bought a Padacheek neck and side cover thing as well as a mask liner. I really like the mask liner as it is more comfortable. It did not help or hurt my leaks though. I always leak at the bottom by my chin and it wakes me up numerous times during the night, fighting with the damn thing! What happens is when I relax, my jaw moves back and down and creates the area for a leak. Of course when that happens, my pressures also go up due to obstructions so it is a double whammy. I need some suggestions please on how to deal with this! I have to make XPAP work as it makes a big difference for me.

I guess one thing to ask is how much leak is too much? Is is common to always have some noticeable leaks? Should I just not worry about them? I don't have access to my SH data at the moment but will post something later tonight.

Any suggestions on either a mask that I should try or some technique to eliminate the leaks. Thought about getting some silicone caulk out and caulking the damn thing to my face! Just kidding of course!

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AMESS
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Re: No matter what I do, I keep getting leaks

Post by AMESS » Sun Oct 22, 2017 4:58 pm

I am on my 7th mask in 7 weeks. All of them leaked-badly. Finally found Res Med Air Fit with memory foam that is very good. Can finally say if I have to like a mask its this one. NO leaks on res med leak scale. Two days in a row now. Fits snuggly around the nose. Think this is the only one with memory foam. BAd news-nose piece has to be replaced once a month. Memory foam stops doing its thing. Okay if you have ins, no good if you dont.

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Pugsy
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Re: No matter what I do, I keep getting leaks

Post by Pugsy » Sun Oct 22, 2017 5:14 pm

Any leak that wakes us up is unacceptable no matter if teeny tiny or big enough to run a train through.
Anything that disturbs our sleep is unwanted.

Have you tried a mask liner? Often they can help diffuse those small leaks that are annoying enough to wake us up but not really big enough to cause problems affecting the effectiveness of the therapy.

These machines can compensate for some leaks. ResMed says up to 24 L/min before they will issue a large leak flag.
In reality they will still do a decent job up to around 30 L/min...above 30 and the machine starts having trouble figuring out what to call an event and we see some unknown apnea flags. Above 35 L/min and it gets iffier with sometimes nothing being flagged when just a minute or 2 ago with lower leak there was. So it can miss events and there in can be a problem because we don't know if it just missed one or twenty.

I almost always have some large leak flagged. Usually very brief though and rare that it is over 35 L/min and more importantly I sleep right through it all so I don't care.

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Turntex
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Re: No matter what I do, I keep getting leaks

Post by Turntex » Sun Oct 22, 2017 5:19 pm

I mentioned in my OP that I am using a Padacheek mask liner. I really like it since it makes the silicone feel better on the skin but has not helped with leaks. I have it in my head that all leaks are bad. maybe if I can convince myself that leaks are common and not to worry bout, I will end up sleeping through them. Right now it is the perfectionist thing in my being concerned with less than perfect seal!

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Pugsy
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Re: No matter what I do, I keep getting leaks

Post by Pugsy » Sun Oct 22, 2017 5:23 pm

Sorry...brain didn't see the mention of the mask liner...only saw strap pad.
Bad brain...

Just how much leak are you seeing?

Anything near this bad??? Believe it or not but I slept through this mess. This is bad even by my lax standards.

Image

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Turntex
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Re: No matter what I do, I keep getting leaks

Post by Turntex » Sun Oct 22, 2017 6:56 pm

Here is an overview of last night's fight!

Image

Janknitz
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Re: No matter what I do, I keep getting leaks

Post by Janknitz » Sun Oct 22, 2017 7:12 pm

If it's any consolation, a FF mask is particularly hard to stop leakage because there's so much surface area to deal with. When I was primarily wearing a FF mask, I decided to just live with the leaks that were at my chin, because the air wasn't blowing in my eyes and I just could not completely stop the leaks.

Trying to deal with FF leaks reminds me of a funny story I was told about a carpenter who worked on the Keck telescope which is up at about 13,000 feet on Mana Kea on the island of Hawaii. The story was used to illustrate the cognitive issues that very high altitude can cause. Apparently this carpenter was complaining because he measured once, he measured twice, he measured again and again, but no matter how much he trimmed a board, it was still too short.

So it is with a mask. The tighter you tighten it, the more it leaks. Counterintuitive, but true. If you look at my Taming the Mirage Quattro techniques, you will find that the best approach is to tighten as little as possible, to get the cushion to fully inflate and mold to your face.

The truth is, however, it doesn't really work 100%. There will STILL be leaks. But if you can get the leaks by your chin instead of your eyes, and minimize the leaks, sometimes that's all you can do. And chin leaks I could sleep through if not too noisy--when the face farts start, however, it's time for the next round of mask fights.

I do suggest you try a couple of things when mask fitting. Lie in your normal sleeping position (or the worst of them if you move around). Use the mask fit feature to fit at your max pressure. And make your jaw kind of slack like it is when you sleep. Fit to that face position. It will probably never be perfect, but that may minimize the leaking. Liners help, but they don't eliminate the leaks either in cases like this.

When my sleep clinic saw my graphs, they said "you have a lot of leaks, but the machine is doing a good job eliminating your apneas. Keep on keeping on."

If there's any possibility of moving to a nasal or nasal pillow mask it will be MUCH easier to eliminate leaks because there's so much less surface area you have to fight with.

Keep up the good attitude. It's good that you are not letting perfect be the enemy of the good.
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Pugsy
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Re: No matter what I do, I keep getting leaks

Post by Pugsy » Sun Oct 22, 2017 7:18 pm

Hmmm...tex 0 leaks 1.
That's a lot more than a little brief fragmented leaks. 3 segments that are fairly prolonged and fairly deep into large leak territory.

I wish I could help you with some miracle hints on fitting a full face mask but I really have very minimal experience with them.
I didn't even own a full face mask the first 6 years of my therapy and then I tried the Amara View and I could use it if I had to..so I kept it just in case but in 2 years I still haven't needed it. I used it 1 week just to see if it was doable and that's the extent of my full face experience. But my pressures went over 20 when I was using it without any large leaks to speak of.

Just curious, your nasal congestion issues...does that happen every night or just some nights?

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Turntex
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Re: No matter what I do, I keep getting leaks

Post by Turntex » Sun Oct 22, 2017 7:32 pm

My nasal issues are every night, unfortunately. Part of it is I am addicted to afrin. Yeah, I know, bad crap. Been using it for a very long time though. ENT tried helping me get off it but was not successful. He prescribed Flonase back when it was still RX and that made things even worse. Even during the day I have a hard time breathing through my nose. Never had any Dr. say it was deviated septum but did have one want to do a partial turbinectom (or something like that) but after reading about it, decided I did not want to go that route.

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Okie bipap
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Re: No matter what I do, I keep getting leaks

Post by Okie bipap » Sun Oct 22, 2017 8:19 pm

Have you tried using a soft cervical collar? When I don't use one, my leaks go way up. My wife is the same way.

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Re: No matter what I do, I keep getting leaks

Post by dr_pib-registration-pending » Sun Oct 22, 2017 8:23 pm

Stick with it. If it doesn't work for you, it's not done getting adjusted.

When I started therapy, years ago, I couldn't get a good enough seal with a full mask. I had to get prescribed allergy medication to allow my nose to open so I could use a nasal mask. Then had to get a chin strap to keep my mouth closed.

Like you, the relief of the headache symptom (and others) helped me know that this therapy was needed and I just kept soldiering on from one problem to the next. It was a long, hard fight! Lots of mask manufacturers, models, sizes, strap tightening methods, etc.

My sleep partner tells me that I do still have some leaks at night, so I know that overtime, I've developed a tolerance so they don't bother my sleep. For me, that's the clue, if it bothers my sleep, I've got a find a different solution.

My favorite mask is not very popular. My doc and DME remark everytime they see it in my file. I mention that to encourage you to continue the mask search. As I think you've learned, just because it's popular or new doesn't mean it's going to work well on your head.

I'm much less of an expert about this, but I think that your high pressure setting, if titrated to, by your machine, could make sealing leaks especially challenging for you.

Be encouraged! Keep making adjustments and seeking advice!

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AMESS
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Re: No matter what I do, I keep getting leaks

Post by AMESS » Mon Oct 23, 2017 6:46 am

Some leaks are okay. Today I had some minor leaks but had 0.6 events. 86 on Res med score. Not bad.

tuzacat
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Re: No matter what I do, I keep getting leaks

Post by tuzacat » Mon Oct 23, 2017 5:22 pm

I know you have tried some of Pad-a-cheek's products. Here's a link to the one that solved my leak issue with the F20: http://www.padacheek.com/PAC_AntiLeak_Strap.html
She makes them for the F20 - just have to mention it in your notes. I also noticed when trying the small if my mouth dropped open in my sleep it would fall out of the mask. Problem was solved going to the next size up.

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OboeVet
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Re: No matter what I do, I keep getting leaks

Post by OboeVet » Tue Oct 24, 2017 3:28 am

I was fortunate that my leaks went way down when the maximum pressure setting was reduced. Then the F&P Simplus FFM brought to zero nearly all the time. (Until last summer when I grew a beard, that is.)

As others have said, keep on trying different solutions until you reach the optimized best for you.

Don Dodson

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OboeVet
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Re: No matter what I do, I keep getting leaks

Post by OboeVet » Tue Oct 24, 2017 3:35 am

OboeVet wrote:I was fortunate that my leaks went way down when the maximum pressure setting was reduced. Then the F&P Simplus FFM brought to zero nearly all the time. (Until last summer when I grew a beard, that is.)

As others have said, keep on trying different solutions until you reach the optimized best for you.

Don Dodson

Sent from my SM-N950U using Tapatalk
Forgot to add: using Rx Fluticasone and OTC herbal product called Sinatrol daily year round. Sleep without my furry four-legged pal in the room has helped my nose stay open, also. I use saline nose hosing if allergies get riled or get URI.

DED

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