FACE MASK LEAKING/WAKING ME UP

[tammyem]

Hi all. I am having some problems with my full face mask (Amara Gel Face CPAP Mask and Headgear). I have an auto Dream Station cpap and I have been spending 90% of the time at 17-18 for pressure. The last few nights, I have been at 20 for pressure, which is the max that my machine is set for. What has been happening is now my face mask is having small leaks out the bottom and sides when the pressure reaches this max. It wakes me up every time - I can handle the pressure fine now with my breathing, but the leaks keep waking me up. I can feel the gel part of the mask move and then leak out - it makes noises too when it does this, so I am constantly waking up at night, fixing my mask and trying to go back to sleep. When I did my sleep study, they did not use pressure on me, so my ENT just set the max at 20. Any advice??

Tammye

[LSAT]

How do you know you are spending 90% of the time at 17-18...Are you sitting up watching?

[Okie bipap]

Sometimes a mask liner will help with the leaks, or make small leaks less noticeable so they don't wake you up. I made my liners from an ole, well-used tee shirt using the pattern I found at this site:
http://montfordhouse.com/cpap/diy-cotton-mask-liner.pdf

This size liner will work for a small or medium cushion. It can be enlarged for a large cushion. The hole in the center can be enlarged if desired. Just make sure you leave enough material to go under the mask cushion. When I used these, my wife crocheted a small bag with a draw string on it that we put the liners in to launder them. We would throw the bag in with the whites, then iron them dry to return them to their original size. If you do not want to make liners, you can purchase liners from your DME (REMZZZ), or from padacheek.com. Karen, the owner of padacheek is a cpap user and a member of this forum. My wife and I use several of her products which are very well designed and made.

[Jeff_Snore_No_More]

Have things changed? I have been on a machine for about 14 years. When I got my original sleep study, there were two parts. The first part was to determine if I did have sleep apnea, and how many per hour, how long per apnea, etc. The second part (titration) was to determine my pressures. Have they done away with the titration part?? You said they did not use pressure on you. I can't imagine this. And from what I know, for ANY doctor to just set your max at 20 arbitrarily is... how can I say this... DANGEROUS??? Someone correct me if I'm wrong.

[tammyem]

No LSAT, My machine tells me in the morning what my pressure was during the night, and it shows for 90% of the time I was at 20, my max for the last two days.

[OkyDoky]

The 90% reading measures the pressure that you were at or BELOW so you may have been at the higher numbers only a short time. You need to download Sleepyhead to see what your pressures are doing throughout the night. https://sleepyhead.jedimark.net/

[tammyem]

My doctor said that the Titration sleep study was going to be more expensive then the Auto CPap and that the Auto will give me what I need, so that is what he recommended. He had to give them a range for me to order the machine, so he set if for 5-20 for pressure, even though the machine should work with how much I need automatically. I am still thinking that I need a new mask, as it is still keeping me up at night with leakage. He is an ENT, but if things don't get better, I am going to see a sleep doctor.

Tammye

Have things changed? I have been on a machine for about 14 years. When I got my original sleep study, there were two parts. The first part was to determine if I did have sleep apnea, and how many per hour, how long per apnea, etc. The second part (titration) was to determine my pressures. Have they done away with the titration part?? You said they did not use pressure on you. I can't imagine this. And from what I know, for ANY doctor to just set your max at 20 arbitrarily is... how can I say this... DANGEROUS??? Someone correct me if I'm wrong.

[JDS74]

My doctor started me off in the same manner. It took a while, and getting reports from Encore Pro (and later SleepyHead) to find the minimum pressure needed to stop all of the obstructive events. Expecting the machine to chase the OAs fast enough is asking too much.

So, as suggested: get either Encore Pro or SleepyHead and start tracking your treatment. You'll find that some number other than the initial setting of 5 cm H2O will be needed to stop all of the OA events.

As another poster noted: the 90% number means that percent of the time your pressure was at or below the 90% number. It could have peaked to 20 cmH2O for a minute or two and then dropped back to a much lower number. Only data can tell what is happening exactly.

As a second issue, you are probably experiencing jaw drop that is contributing to the mask leaks at the bottom of the mask. Your description fits this exactly.
As your facial muscles relax when sleeping, your jaw has tendency to fall just a little bit and interfere with the mask seal.
The solution (most of the time) is to get a soft cervical collar (Walmart, Walgreens, CVS, etc.) and wear it at night.

[Okie bipap]

Once you start monitoring your own treatment with sleepyhead, you will see what is actually taking place. My wife's pressure often went over 20 before they got her pressure properly adjusted. Now, it very seldom goes much over 17. In fact, it almost looks like a cpap set to 17 instead of an auto adjusting machine. My treatment is the same way, but looks like it is set to 18. IO get very little variation in my pressure even though it can go as high as 25 if necessary.