still struggling

Hi All,
I am struggling with mask fit and CPAP in hopes someone will have some thoughts. I was diagnosed with severe sleep apnea 49 events an hour so I am trying really hard to be compliant.
I am using a full face, as a mouth breather cant seem to handle anything else Resmed F20 both with and without memory foam. The machine ramps up from 4.5-13 depending on what is needed.
I am having problems keeping the mask on longer than 3-4 hours and seem to get a lot of leaking. I struggle to adjust and wind up going back to the lab for multiple adjustments. I don't want anything more evasive like chin straps etc, and sleep on my back. I am not sure if its leaks or something else I do at night but the numbers don't impress me. Over the last two months I am running between 3-4 hours with 2 nights of 5 and 6. Events are reduced to 1.8-4.4. last night was a record 6.55 hours but 19 events each hour. My leaks are always high in the high 30s. I am frustrated don't want to give up. Also my smile muscles hurt every morning . I would welcome any help. I live in CT and there doesn't seem to be any local support groups. I have talked to the provider resmed the vender and the dr and still cant figure it out. The only other mask I used was the amora view which really hurt my facial muscles.

jchilds582 wrote:Hi All,
I am struggling with mask fit and CPAP in hopes someone will have some thoughts. I was diagnosed with severe sleep apnea 49 events an hour so I am trying really hard to be compliant.
I am using a full face, as a mouth breather cant seem to handle anything else Resmed F20 both with and without memory foam. The machine ramps up from 4.5-13 depending on what is needed.
I am having problems keeping the mask on longer than 3-4 hours and seem to get a lot of leaking. I struggle to adjust and wind up going back to the lab for multiple adjustments. I don't want anything more evasive like chin straps etc, and sleep on my back. I am not sure if its leaks or something else I do at night but the numbers don't impress me. Over the last two months I am running between 3-4 hours with 2 nights of 5 and 6. Events are reduced to 1.8-4.4. last night was a record 6.55 hours but 19 events each hour. My leaks are always high in the high 30s. I am frustrated don't want to give up. Also my smile muscles hurt every morning . I would welcome any help. I live in CT and there doesn't seem to be any local support groups. I have talked to the provider resmed the vender and the dr and still cant figure it out. The only other mask I used was the amora view which really hurt my facial muscles.

At what pressure are you fitting the mask for leaks? I am wrestling with issues similar in which I don't get leaks at the beginning pressure but get leaks when the pressure spikes. Maybe narrow the pressure range to something like 8-13 or 10-13 with no ramp?

The way I understand what you have said is that you are using an APAP of 4.5 to 13. That is a very wide range of pressures and that makes leaks more likely. A ramp is something totally different, a ramp is where the machine starts at a low pressure when you turn it on then slowly increases to a base pressure over time to make it easier to get to sleep. IF you are indeed using an APAP you would need to download sleepyhead for free and install it and get some nightly information posted for people to look at. If you so a search for sleepyhead thee are a number of posters who have given detailed instruction on how to get it and use it.

Fundamentally I would narrow that range, it's not very likely you need that much variation in your therapeutic pressure. Personally, I find anything more than 2 cm h2o causes disruptions to my sleep quality so I generally do best just sticking with CPAP. You will probably differ

Use the mask fit option on your machine. It will ramp up to the highest pressure your machine is set to. Check the fit for leaks, then lay down and see how it works. When I first started and had problems with leaks, I would put the machine on fit check, make sure my mask wasn't leaking, and get into bed with the machine still running in the fit check mode. After two to three minutes, the machine would start running normally.

Okie bipap wrote:Use the mask fit option on your machine. It will ramp up to the highest pressure your machine is set to. Check the fit for leaks, then lay down and see how it works. When I first started and had problems with leaks, I would put the machine on fit check, make sure my mask wasn't leaking, and get into bed with the machine still running in the fit check mode. After two to three minutes, the machine would start running normally.

I was under the impression the machine would only go to your average pressure. Do they all go to maximum pressure?

I would look into the various mask liners. I had a lot of leakage issues till I found those.

MaxINTJ wrote:

Okie bipap wrote:Use the mask fit option on your machine. It will ramp up to the highest pressure your machine is set to. Check the fit for leaks, then lay down and see how it works. When I first started and had problems with leaks, I would put the machine on fit check, make sure my mask wasn't leaking, and get into bed with the machine still running in the fit check mode. After two to three minutes, the machine would start running normally.

I was under the impression the machine would only go to your average pressure. Do they all go to maximum pressure?

THe machine does not know your average pressure until after you use it. It does not use the previous day's data for anything. So yes it uses the max pressure setting for the fit check. Do you have the clinicians manual? There is a link to get it over on the sleep apnea board. It's got a lot of very detailed information for you.

TASmart wrote:THe machine does not know your average pressure until after you use it. It does not use the previous day's data for anything. So yes it uses the max pressure setting for the fit check. Do you have the clinicians manual? There is a link to get it over on the sleep apnea board. It's got a lot of very detailed information for you.

I couldn't find where it says what pressure it uses - from the manual:

"Mask Fit is designed to help patients fit the mask properly.
The Mask Fit feature delivers CPAP pressure for a three-minute period,
prior to starting treatment. During this time, the mask can be adjusted to
minimize leaks."

IS that your ASV? I forgot you were using that, I have no clue what that does. but I would bet it's just the max pressure. ASV also does not keep track of your previous data, each day is a new start.

My machine was set by Drs office to ramp up from the pressure from 5 to 20. Its pretty stable at about 13-14. Still, no matter what I do still have leaks. AHIs running at about 3.5 down from 68 per hr. If the mask did not leak at all would I get a perfect score of no leaks?

jchilds582 wrote: jchilds582

To reduce unintentional mask leak -

- Make sure the mask is fitted properly. (See mask manufacturer's video.)

- Make sure the headgear is adjusted properly (See mask manufacturer's video.)

- If you use a low ramp pressure or a low minimum pressure, you should fit and adjust your mask at the higher pressures it is operating at for most of the night. You would temporarily change the machine pressure settings while you do the fitting and adjusting. It's best to do this well before bedtime before you are tired and ready for sleep. Don't forget to change your settings back to the ones you prefer.

- Make sure to use good hose management - the hose should not pull on the mask. Notice how your hose is positioned between machine and mask. It should be positioned to minimize any pull on the mask. Hose management is an individual practice. How it is done depends on the mask, the position of the machine, your sleeping position and other factors specific to the individual.

- If you still have problems, learn from the forum what mask liners are available.

- Start a thread in cpaptalk asking for help. Subject: Need Help with Mask xxxxxx

- If your mask still has excessive leak, try other masks. Many people report trying several masks before they find one that works well for them.

Note: Links to just some of the mask manufacturers' instructional videos can be found on the forum host's website - https://www.cpap.com/cpap-masks.php and https://www.youtube.com/

- CG

a mess wrote:If the mask did not leak at all would I get a perfect score of no leaks?

It is doubtful if you could get a night without having some leak. When my machine starts, I get air blowing out of the holes in the elbow until the pressure gets high enough to close the flapper valves. This gets reported as a leak. If the mask moves a little during the night, it leaks a little bit. I have never had a night where I did not have some leakage show up.

xxyzx wrote:

TASmart wrote:The way I understand what you have said is that you are using an APAP of 4.5 to 13. That is a very wide range of pressures and that makes leaks more likely. A ramp is something totally different, a ramp is where the machine starts at a low pressure when you turn it on then slowly increases to a base pressure over time to make it easier to get to sleep. IF you are indeed using an APAP you would need to download sleepyhead for free and install it and get some nightly information posted for people to look at. If you so a search for sleepyhead thee are a number of posters who have given detailed instruction on how to get it and use it.

Fundamentally I would narrow that range, it's not very likely you need that much variation in your therapeutic pressure. Personally, I find anything more than 2 cm h2o causes disruptions to my sleep quality so I generally do best just sticking with CPAP. You will probably differ

it is not the difference that causes leaks
it is the maximum pressure that can cause them

many people need a wide range for treatment

Not the difference but the cycling of pressures seems to increasethe leakage.

xxyzx wrote:the mask is designed to leak some
so you dont have co2 buildup in it and keep breathing that air
has to be someplace for the exhale to go so leaks are built in

That's not leak. It's vent.

Learn the terminology.

Dubbayoo wrote:I would look into the various mask liners. I had a lot of leakage issues till I found those.

+1
Liners are great solution to plug up the leaks. Plus it helps to have a material on your face and NOT the mask directly on your skin.

https://www.cpap.com/productpage/remzzz ... iners.html

http://www.padacheek.com/

I wish you well