Weight Loss Causing Large Leaks?

[Sleepystever]

Hi All,
New here.
I have been using a CPAP for 2 1/2 years. Everything has always worked flawless. I sleep great and feel great. I get two green smiley faces each morning for humidifier and mask fit.

However for the last 2 months I have been getting the dreaded red frowny face for leaks. Since that started I also have been waking up with super dry mouth. So I suspect for some reason I now have a mouth leak problem.

Anyway I have been trying to troubleshoot what the problem might be. I need some expert help here.

My machine is in good working order. I do not hear or feel any leaks. I just replaced both the tubing and the nasal pillows this week and that still did not fix the issue.

My sinuses are clear and no issued there.

The only thing that has changed is that I started a Keto diet plan on May 1st. By the middle of May my CPAP was having issues. I have been on the Keto diet now for almost 12 weeks and have lost 60 lbs.

Is it possible that my weight loss is somehow affecting my CPAP effectiveness? I feel like I am still sleeping pretty well but am a little more tired during the day.

I have wondered if the weight loss has decreased the severity of my sleep obstruction and now the pressure I am set at is over inflating me and causing me to have a mouth leak. But I don't know if that is even a thing.....?????? To try and prove or disprove my theory I decreased my pressure last night from 15 to 10. I woke up this morning to 2 nice green smiley faces. So something worked better. I felt like I slept just fine too.

After doing some reading today, I downloaded Sleepyhead and pulled up all my sleep data. I will try to post a screen shot from the last 2 nights. One at pressure 15 and one at 10. I would love to know what you all think about this issue and what I can do about it. I have read about chin straps, and taping lips, and mouth guards etc. But I want to try and understand what changed to make things go from working perfectly to really crappy.

Thanks in advance for any help!

[Sleepystever]

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[Sleepystever]

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[Mogy]

If you lose or gain significant weight your optimum settings could very well change.
The flat topped large leaks are usually considered mouth breathing if you are using a nasal only mask. The setting at 10 looks like it is much better than 15.

I found the same thing as you with regards to weight loss. When I first started with pillows I didn't have a problem with leaks. I lost about 30 lbs and during that time my leakage increased. If I use my machine now, I need to tape my mouth shut or my mouth gets very dry.

[Julie]

Not only can even a very small loss cause changes, but your face changes quickly with loss (or gain) and your mask will fit quite differently, possibly (often) causing leaks.

[LSAT]

If you lose weight, parts of your body shrink...your face is one of them. You might need a smaller mask.

[beepsilver]

Being in or transitioning to ketosis can have a significant impact on hormones which in turn can affect how well you sleep. While weight loss could be a contributing factor to your mask leaks, fitful sleep can also compromise your mask seal. Looking at your timeline...the two could be related. You could experiment with adding more carbs for a couple of days (exiting ketosis) and see if your leaks improve.

[Sleepystever]

Thank you for your replies.
I have an appointment with my sleep doc this week to discuss it with him.
The last 2 nights I have increased my pressure by 1. (Thursday night 10, Friday 11, Saturday 12). I plan on running at 13 and 14 the next 2 nights before I see my doc. That way he will have some data to look at at pressures ranging incrementally from 10-15.

I am almost positive this is a result of mouth leak and not mask leak. The nasal pillows seem to stay in place all night without issue. It is just puzzling to me why all of a sudden my mouth is coming open during sleep when it has never been a problem for the past 2 years....

All that being said..... My numbers at 10, especially my AHI look pretty good (but I am not sure I am looking at the data with very educated eyes). There is still some leaking but it seems to be much less. It felt like I got good sleep. I did wake up with a dry mouth but not as bad a usual.

Is there anything I am missing on the data from the pressure at 10 night that I should be concerned with?

Thanks for your experienced advice.

[chunkyfrog]

Weight loss is unpredictable.
My face lost it first--the rest took a lot longer.

[DalePickle]

I'm having the exact same problem! I've been using a cpap machine for 12 years now and have never had a problem with leaks. Have always used a nasal mask. But over the course of 5 months I've lost about 35 lbs and am now experiencing mouth leaks every night for the very first time. Not mask leaks but mouth leaks. So just like you I know it's caused by the huge weight loss but how? Keep us posted on what your doctor says cause I'm experiencing the same thing.