Another Newbie Needing Help

[screamineagle]

Good Day All,

I've been lurking since late July when I was diagnosed with moderate to severe OSA. I was titrated at 10 on 7/23. We had gotten a late start in the lab and 10 was as high as they were able to go due to time constraints. Anyway, my question pertains primarily to leak issues. I feel myself becoming compulsive to lower my leakage but am having no luck whatsoever. I have increased my settings on an M Series auto with A Flex to 11 and 16 and don't know whether that is enough, too much or what. I have tried several different masks (listed below) and found that the only ones I can use are Full Face due to mouthbreathing. If you have any suggestions, they would be greatly appreciated. I have been 100% compliant and monitor my progress daily. The one thing that is constant is that my leak line looks like a chainsaw blade and my numbers seem high. I have had a full beard for 35 years but have cut it back almost to stubble. Anyhow here they are from 8/31 to 10/4:

Average 90% CPAP 12.3
Average CPAP Pressure 11.0
Average NR A/H Index 0.1
Average Obstructive Apnea Index 2.1
Average Hypopnea Index 1.6
Average AHI 3.7
Average Flow Limitation Index 0.8
Average Vibratory Snore Index 6.1
Average Max Leak 113.7
Average 90% Leak 72.4
Average Leak 57.1
Average Large Leak 1 hr 9 min 14 sec

Again, any help would be greatly appreciated.

Thanks
Dale

[rested gal]

You really are struggling with a leak problem, Dale. The Quattro FF mask you're using now, and the Ultra Mirage FF that you've tried before, are both good FF masks for many people. Sorry to hear you've not been able to get them to not leak for you. Because mask leak is what's happening. Obviously not "mouth leak" since you're wearing a FF mask and it's ok to mouth breathe with a FF mask covering mouth and nose together.

Perhaps someone else has a suggestion to make one or more of your FF masks seal better for you. Me...well, I'd pick out a non-FF I liked and tape my mouth AND wear a chin strap to keep my jaw from dropping and possibly loosening the tape. Easy for me to say "tape", though... I don't have a beard to deal with.

Hope you find a solution to the leak problem.

[Wulfman]

Have you done the "Teflon tape fix" to the mask yet?
If not, and you aren't aware of it......go to the Search function and search on "Teflon".
Lots of threads about it.

Other than that........."shave"?

If I don't shave for a few days, my leak rate goes up several points.

Den

[ww]

I guess the real test is how are you feeling? Your leak numbers should be running around 40-44, NOT 70!!!!! The AHI numbers mean little and are probably much higher than you think! Unfortunately, I have to shave every night to get decent leak data, although I would prefer to shave far less often. You have the worst combination of beard and mouth breathing and I can't see how that is compatible with any mask available. It is doubtful that you are getting much actual therapy at all. Why not shave and see how you feel getting good therapy as I guarantee you that you can always grow back the beard.

I tend to agree with Rested Gal if you cannot shave it all off daily, then try a chin strap (which seldom work) or tape (which I refuse to do) and a NA II (Nasal Aire) or other nasal pillow or prong systems.

[Paul56]

I have the Quattro and can report good success with it.

I don't have the beard but on occasion do sport a coupla days growth.

The upper strap... have this one fairly loose such that it wraps around your head lightly. You make all your upper mask adjustments through the forehead adjustment. Make this upper strap too tight and you may end up with headaches. There is really no reason to have it tight.

The lower strap... this is the only lower adjustment so you will need to adjust it accordingly.

The adjustments I find always seems to be some trade-off between leak control and comfort.

I wash the face cushion and forehead pad every day. I always wash my face before putting the mask on. Install the mask then I go lay down, pull the mask away from my face and snuggle it back down. This allows the mask to conform to my face in the horizontal position rather than the vertical position it was installed as a few minutes earlier.

You may need to make adjustments during the night. I found it took me several nights before I got used to the mask and got the adjustments right. I seem to have won the leak battle but I am still tweaking the adjustments.

[ozij]

Mack's silcone earplugs, rolled into snakes and put on you mask seal?

O.

[rested gal]

LINKS to Lab Rat Trophy awards
viewtopic.php?t=15104

On that page you might find some mods to other masks (even non FF masks) that will work with your Quattro...or with one of your other FF masks if you still have them around.

[screamineagle]

I thank you all so much for the info. Yes, I have done the teflon tape thing, at least on the inside elbow where it attaches to the mask. Just for my information, if the expiratory flush is app 40 lpm at a pressure of 12cm h20, what then would be an acceptable leak number. Do I subtract the 40 lpm from the average leak of 57.1? I haven't had more than a couple of minutes of the "Large Leak" when using the Quattro. "Large Leaks" are something I have for the whole night when using any kind of nasal pillow mask.

I might be grabbing at straws here, but even I haven't seen my face in a long time and to be quite honest, I'm not sure I want to. It was bad enough shaving off the last six inches of beard.

Again, thank you all. I'm sure I'll learn but it may take a while.

[Wulfman]

I thank you all so much for the info. Yes, I have done the teflon tape thing, at least on the inside elbow where it attaches to the mask. Just for my information, if the expiratory flush is app 40 lpm at a pressure of 12cm h20, what then would be an acceptable leak number. Do I subtract the 40 lpm from the average leak of 57.1? I haven't had more than a couple of minutes of the "Large Leak" when using the Quattro. "Large Leaks" are something I have for the whole night when using any kind of nasal pillow mask.

I might be grabbing at straws here, but even I haven't seen my face in a long time and to be quite honest, I'm not sure I want to. It was bad enough shaving off the last six inches of beard.

Again, thank you all. I'm sure I'll learn but it may take a while.

Basically......"yes".
You have your KNOWN "Vent Flow Rate" (about 40 lpm @ 12cm.) and anything over that would be considered "leak".
That's also the pressure I use, so I'm pretty familiar with my leak numbers with the UMFF and Quattro. On a "good" night with the UMFF, I get around 40 and on some "leaky" nights, it's in the mid 40's. After doing the Teflon fix on my Quattro, my leak rate went from the upper 30's to the lower 30's.

Den