How to Troubleshoot & Improve Leak Performance?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
MikeekiM
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Re: How to Troubleshoot & Improve Leak Performance?

Post by MikeekiM » Thu Feb 22, 2024 5:45 pm

This article scares me a little (only a little, I am still going to continue experimenting with taping my mouth shut to prevent leaks).

https://www.verywellhealth.com/taping-l ... ed%20mouth.

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vandownbytheriver
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Re: How to Troubleshoot & Improve Leak Performance?

Post by vandownbytheriver » Thu Feb 22, 2024 11:31 pm

MikeekiM wrote:
Thu Feb 22, 2024 2:17 pm
I hadn't looked at my OSCAR data until now. And now that I have had a chance to look at it, it is clear that the mouth taping did work for most of the night.
(snip)
Again, for those that are long time mouth tapers, how do you deal with things that cause discomfort or inconvenience when your mouth is taped shut? I am talking about things like a stuffy nose, a tickle in your throat that makes you want to cough, or an actual cough that you cannot suppress?

Will keep reporting updates moving forward! Thanks everyone!
Your graph actually looks more like mask leaking than mouth leaking IMO... very chaotic spiky graph, constant leaking. EDIT: Just noticed that's leaking *over months of use*... sorry... it will look spiky. When I had mouth leak problems it happened during REM... lost muscle tone, jaw dropped, tongue lolled, air starts coming out... my graphs show minimal leaks, then ramping up to full-on constant leak... then arousal. I don't notice until I wake with bad dry mouth. Are you having dry mouth? I did not have mouth leaks/dry mouth until I got to be about 63yo... loss of muscle tone during REM became noticeable then. Used to keep a glass of water by the bed... no longer!

Here's my leak graph from my first night trying CRST (I'd tried band-aids before, no good). As you can see from my journal I had to re-tape... note the dramatic improvement during the final session. Mask used was Zest Q nasal, pressure got up to 13cm with no issues. The earlier session you can see the leaking fade in... that's the tape failing.
first night tape.PNG
first night tape.PNG (50.2 KiB) Viewed 5340 times
I use the Cover Roll Stretch tape... both Nick and Jason recommend it. When I was using nasal mask I would put two vertical strips on each mouth corner then one across the middle... it took this much to hold 14cm. Now I'm on FF mask and I still tape... it helps with jaw drop and drooling... one small horizontal strip is fine, even leaving the corners open. Tuck your lips in (opposite of purse), then tape... it's not fun to remove from the sensitive lip skin.

The thing about CRST is that water is its enemy... if you need to get out of it in a hurry you can lick it from the inside... I was able to actually answer the phone this morning without ripping skin off. When I normally remove it I take a handful of water and bathe the tape... then let it soak for a minute or two... comes right off.

Stuffy nose? Me and generic Afrin have thing going on... I get the pump mist bottle, then refill it from the squeeze bottle. Yes, rebound and all that... *decades* of use have not killed me yet... it *just frickin' works*. Do not swallow the mucous, blow it out when it loosens up. You may try neti salt rinse etc... whatever works for you. You can still cough, it's just not very productive. CRST is so cheap that you don't worry about wasting it... bought two rolls in late November and just barely into the second roll now.

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MikeekiM
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Re: How to Troubleshoot & Improve Leak Performance?

Post by MikeekiM » Fri Feb 23, 2024 1:07 am

Thanks for your response @vandownbytheriver.

No, I am not finding my mouth getting dry. And yes, I posted my monthly charts, not my dailies. My daily shows that my leakages seem to be under control using the tape, but I was not able to keep the tape on all night long. I am hopeful that I will be able to keep it on this evening. I will report back.

Thanks for sharing your tips, tricks and suggestions!

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ozij
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Re: How to Troubleshoot & Improve Leak Performance?

Post by ozij » Fri Feb 23, 2024 6:57 am

MikeekiM wrote:
Thu Feb 22, 2024 2:17 pm

Again, for those that are long time mouth tapers, how do you deal with things that cause discomfort or inconvenience when your mouth is taped shut? I am talking about things like a stuffy nose, a tickle in your throat that makes you want to cough, or an actual cough that you cannot suppress?

Will keep reporting updates moving forward! Thanks everyone!
If your nose is stuffy enough to bother your when you tape your mouth, you need a full face mask. I use a ResMed F30 for when my nose is stuffed, or I need a break from taping

I can handle tickles, when I have to cough or sneeze, I take the tape off (that's what the folded in tab(s) is (are) there for. I then I simply tape again.

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MikeekiM
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Re: How to Troubleshoot & Improve Leak Performance?

Post by MikeekiM » Fri Feb 23, 2024 9:44 am

Well, I guess I am a mouth breather. I got my first perfect 100 score in Resmed's MyAir app. Prior to this perfect score I always lost my points for leaks.

I was able to wear the mouth tape all night long. Here is my leak chart in OSCAR.

Image

Now I am wondering if keeping my mouth closed is a learned behavior or not. That is, will I ever be able to ditch the tape?

Thanks to everyone for helping me troubleshoot my leak issue. Issue fixed!

Now I need to figure out if I want to live with mouth tape, or move to my spare AirFit F20 full face mask.

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Pugsy
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Re: How to Troubleshoot & Improve Leak Performance?

Post by Pugsy » Fri Feb 23, 2024 10:03 am

MikeekiM wrote:
Fri Feb 23, 2024 9:44 am
will I ever be able to ditch the tape?
Maybe....that's about the best I can say.

When I first started cpap therapy I was a mouth breather but more out of habit than from the need to mouth breathe from a congested nose.
Probably just a habit from gasping for breaths prior to starting cpap therapy when I wasn't breathing.
Took me about 3 months to "unlearn" that habit....well sort of unlearn it anyway.
After about 3 months I started getting lazy and "forgetting" to tape up and just being too lazy to go get the tape.
I started watching my leak rate line and discovered that the times with LOTS of leaking seemed to be much less frequent and they didn't wake me up and when it happened it didn't last very long so I abandoned the mouth taping and just live with the occasion mouth opening stuff.
My choice.....but then I don't think I ever had the mouth opening problem that you seem to have.

FWIW though....I never really had a problem with the taping thing or not a big problem anyway.
plus I never had a congestion problem either so there was never a physical need to mouth breathe to move enough air for me to be comfortable.

I also learned that when I am on my back the mouth is more likely to fall open and let me mouth breathe more.
I don't do well on my back anyway because it causes more back/pelvic pain so I don't spend all that much time on my back.
The pain wakes me up and I have to change position.

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MikeekiM
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Re: How to Troubleshoot & Improve Leak Performance?

Post by MikeekiM » Fri Feb 23, 2024 11:26 am

My next step is going to be to try using a smaller piece of tape over the center of my lips to see if I can get away with a more minimal "non-hostage" taping format.

:)

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vandownbytheriver
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Re: How to Troubleshoot & Improve Leak Performance?

Post by vandownbytheriver » Fri Feb 23, 2024 10:12 pm

MikeekiM wrote:
Fri Feb 23, 2024 11:26 am
My next step is going to be to try using a smaller piece of tape over the center of my lips to see if I can get away with a more minimal "non-hostage" taping format.

:)
See that rising leak thing at 05:20? That's mouth leaking, your tape job failed I believe. You were having some nice REM and got too relaxed. See if you can get the leaks to stay below the red line all night... pay no attention to the smiley faces, they lead you astray... Oscar will flag these leaks. In the morning, test your tape job by puffing out your cheeks... give it a second or two... you'll feel the air start to come out if it's leaky, normally at one corner. My method: two vertical strips covering the corners, then one horizontal strip across connecting them.

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Machine: AirCurve 10 Vauto USA C2C CO
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Additional Comments: I use O2Ring, Oscar, SleepHQ, and Cover Roll Stretch mouth tape.

MikeekiM
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Re: How to Troubleshoot & Improve Leak Performance?

Post by MikeekiM » Sun Feb 25, 2024 11:44 am

Image

So I guess now that I am completely sealing my mouth shut and the tape is still in place when I wake up, that these leaks are caused by my mask becoming unseated from my face (for the most part). Like laying on the side of my face and having the pillow push the mask gasket away from my cheek.

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Pugsy
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Re: How to Troubleshoot & Improve Leak Performance?

Post by Pugsy » Sun Feb 25, 2024 12:32 pm

Yep....mask movement leaking. Doesn't surprise me.

How's the sleep quality? Sleeping soundly for the most part or waking often because of leaks or whatever???

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vandownbytheriver
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Re: How to Troubleshoot & Improve Leak Performance?

Post by vandownbytheriver » Sun Feb 25, 2024 5:18 pm

In my opinion it's tape job failure... big mask leaks like that tend to wake you up. Also, the profile of tapering up to leak plateau is a tape job fail IMO. The tape is still in place... it just leaked from a corner. Test your tape job in the morning by puffing against it. All IMO.

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Machine: AirCurve 10 Vauto USA C2C CO
Mask: Fisher & Paykel Vitera Full Face Mask with Headgear (S, M, or L Cushion)
Additional Comments: I use O2Ring, Oscar, SleepHQ, and Cover Roll Stretch mouth tape.

MikeekiM
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Re: How to Troubleshoot & Improve Leak Performance?

Post by MikeekiM » Mon Feb 26, 2024 9:26 am

Pugsy wrote:
Sun Feb 25, 2024 12:32 pm
Yep....mask movement leaking. Doesn't surprise me.

How's the sleep quality? Sleeping soundly for the most part or waking often because of leaks or whatever???
Sleep quality seems good. And yes, I sleep soundly and don't wake often due to leaks. Today I had a similar chart to the one above.

MikeekiM
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Re: How to Troubleshoot & Improve Leak Performance?

Post by MikeekiM » Mon Feb 26, 2024 9:27 am

vandownbytheriver wrote:
Sun Feb 25, 2024 5:18 pm
In my opinion it's tape job failure... big mask leaks like that tend to wake you up. Also, the profile of tapering up to leak plateau is a tape job fail IMO. The tape is still in place... it just leaked from a corner. Test your tape job in the morning by puffing against it. All IMO.
I took your comment to heart and tried a longer piece of tape to make sure I got the corners really well. But today's chart looks identical to my previous chart.

Tonight, maybe I'll put one horizontal over my lips, and two verticals at the ends to secure it even better to see if that makes any difference at all.

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Pugsy
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Re: How to Troubleshoot & Improve Leak Performance?

Post by Pugsy » Mon Feb 26, 2024 10:14 am

So......perhaps 2 problems
mouth breathing which the taping has helped reduce AND some mask movement as well.
There's no law that says people can't have more than one problem.

At some point you might want to go without taping again just to see how much the mouth breathing might be really that much of the 2 problems.

At some point you might want to think about trying a different mask if you still worry about mask movement leaks but to be honest....if those leaks aren't disturbing your sleep and you feel like you are sleeping good and even better you feel decent during the day....I don't know that I would worry too awfully much about the leaks at this point.

You can most certainly sleep through mask movement leaks of the size you are seeing. I have slept through much worse myself and with my mouth taped because I wanted to make sure I was addressing the correct problem when I was seeing some bigger than usual leaks when I was trying a new mask and having trouble with leaks.

If the tape isn't loose....and you still see leaks...then the only culprit is mask movement.
Then you get to decide if you want to continue working on improving the leak line or just accept it and move on because you are sleeping good and feeling good.

Your choice. Sometimes the cure is worse than the disease though. :lol:

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MikeekiM
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Re: How to Troubleshoot & Improve Leak Performance?

Post by MikeekiM » Mon Feb 26, 2024 12:35 pm

Yeah, at this point, I am pretty happy with where I am at. Any improvements at this point I consider opportunistic refinement and adjustments.

And I have only been taping for a few days, so I think there is still more that I can learn from the data over the next few weeks.

The thing I really hate about the N20 is that I often need to scratch my nose in the middle of the night, and I can't do it without wiggling my hand beneath the silicone gasket (which, of course, causes a leak albeit very brief).

I have a bunch of mask options that I can experiment with, but the N20 has been the one that has worked for me the best. But a lot has changed since I tried to use the other mask options (including the sleep tape), so I may go back and try some of the other mask options that I have, including the F20, P10 and N30i.