HELP

Shutchis1951 · Post by **Shutchis1951** » Thu Mar 20, 2008 3:34 pm

I am concerned about my readings especialy my leak rates. I have been using my snapp nasal mask and can't do mouth taping, but I do mouth breath. I have issues with my Liberty mask nose pillows won't stay in nostrils and part of mask over mouth has too many leaks.

My readings using Snapp mask:

HI: 3.9, 5.0, 4.2, 1.9, 6.1, 4.7
AI: .4, 1.4, 1.1, .9 2.9, 1.3
AHI: 4.3, 6.4, 5.3, 2.8, 9.0, 5.6
Leak: .62, .42, .74, 2.20, .60, .70,
press. is always 9.2

Should I get another mask or do you have any other suggestions as to what I should do. I am tired and I sleep on my side and toss and turn a lot during the night.

bdp522 · Post by **bdp522** » Thu Mar 20, 2008 5:55 pm

If you can't tape or use polident strips or a chin strap to stop the mouth breathing, you need a full face mask. With the leaks you have the data is not reliable. You may be having more events than are recorded. Leaks with your machine should never go over .40 l/s.

Brenda

mindy · Post by **mindy** » Thu Mar 20, 2008 5:59 pm

I'm not familiar enough with the Resmed to comment on leak rates. But if you know you mouth breathe and can't tape, here's a possible solution:

http://www.cpapchinstraps.com/

by RipVW. It does note that it doesn't work with all nasal masks but if this won't work for you, you might be able to come up with something similar. I've alread read posts about other solutions such as a strap that runs under your chin and up and over your head. There are lots of great mask tweaks so you could try searching. I prefer Google to this site's search engine. For example, if I wanted to look for snapp mask posts, I'd enter in Google:

snapp mask leaks site:cpaptalk.com

and

mouth leak fixes site:cpaptalk.com

or any one of a number of other possibilities.

Good luck!
Mindy

mindy · Post by **mindy** » Thu Mar 20, 2008 6:04 pm

Here's a reference on NIH web site about chinstraps with the abstract below it:

http://www.ncbi.nlm.nih.gov/pubmed/15165532?tool=scanb

From Sleep Med. 2004 May; 5(3):261-7

Mouth closing device (chinstrap) reduces mouth leak during nasal CPAP.Bachour A, Hurmerinta K, Maasilta P.
Department of Pulmonary Medicine, Helsinki University Central Hospital, P.O. Box 340, Hus FIN 00029, Finland. adel.bachour@hus.fi

BACKGROUND AND PURPOSE: Mouth leak occasionally complicates continuous positive airway pressure (CPAP) therapy, which leads to discomfort. While a chinstrap prevents the mouth from opening during sleep, its efficacy in diminishing mouth leak has not been studied. PATIENTS AND METHODS: Fifteen patients with mouth leak complaining of mouth dryness and nasal obstruction underwent two consecutive overnight polysomnographies, one with a chinstrap, in random order. Cephalometry with and without a chinstrap was randomly performed on six patients. RESULTS: With the chinstrap, both mouth leak and the arousal index decreased significantly, from (mean+/-SD) 42.9+/-23.5 to 23.8+/-13.3% of total sleep time (TST), and from 33.4+/-18.6 to 23.6+/-9.3/sleep hour, respectively. However, snoring time showed a concomitant increase from 6.7+/-14.3 to 24.0+/-13.2% of TST. The arousal index was significantly higher during leak periods, and its changes correlated positively with changes in mouth leak. Cephalometric measures showed a significant decrease in anterior lower facial height. CONCLUSIONS: The chinstrap, by closing the mouth during CPAP, reduces mouth leak and therefore the arousal index in most patients. Nevertheless, the indices remained unacceptably high. The chinstrap may also increase snoring and, in rare cases, can worsen the respiratory disturbance index. Consideration of these potential effects is important before instituting regular home use of the chinstrap.

PMID: 15165532 [PubMed - indexed for MEDLINE]

alnhwrd · Post by **alnhwrd** » Thu Mar 20, 2008 8:00 pm

Your leaks are way too high. I don't use either of those masks, but I do have the Elite, and if the correct mask is selected in the clinician's menu your leak rate should be under .10. I do not think that the Snapp can be selected, but you can choose the STANDARD setting which should get you close. Is there any chance you could try a Full Face Mask?

Shutchis1951 · Post by **Shutchis1951** » Thu Mar 20, 2008 9:59 pm

I have mask setting set for standard.

I usually have any chin straps on the bed beside me in the morning.

I am thinking I will try a FF mask I thought I would try mirage activa mask. Any thoughts on this one?

alnhwrd · Post by **alnhwrd** » Thu Mar 20, 2008 11:10 pm

Some people like the Activa, some hate it. Masks are such an individual preference. The Activa is supposed to be good for people that move around alot in their sleep, but I have no experiance with it one way or another. Again, you can use the search function on this site to look for previous threads from people who have used it and posted their opinions on it. You can do this with any mask you are interested in. If you are mouth breathing, then the Activa will not address this problem, it is just suppossed to be a bit better at staying in place that others.

ozij · Post by **ozij** » Thu Mar 20, 2008 11:47 pm

Shutchis1951 wrote:I am concerned about my readings especialy my leak rates. I have been using my snapp nasal mask and can't do mouth taping, but I do mouth breath. I have issues with my Liberty mask nose pillows won't stay in nostrils and part of mask over mouth has too many leaks....<snip>

There is no way you will be getting proper therapy so long as air is gushing out of you mouth.

People have posted tips for making the Liberty more usable, and there is a similar mask be a different company called the Hybrid.

Resmed claims its newer Full Face Mask, the Quattro can be tweaked to fit 95% of the population. The Activa it not a full face mask.

Mask fitting may take patience and time, even money - but its crucial for your therapy.

O.

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