Still talking about leaks..............

[Country4ever]

I was going to check out masks at the local DME (Lincare) this past week, but had a number of unfortunate things arise (Daughter in car crash).

I know I sound like a broken record, but please be patient with me. My mind is deteriorating and my memory is pretty bad and I think I repeat myself.
Plus, my numbers took a nose-dive around January and my mind has gotten even worse.

I haven't involved my sleep doctor in my problems because I just don't think he knows much. I'm tired of him looking at me with this very confused look when I talk about some of my problems and I don't want to change docs because I refuse to have another sleep study, and my present sleep doc doesn't push me for that.
Just to recap: I use original Swift nasal pillow. For 2 years my numbers were great at a straight pressure of 7.2. I gained about 5# at Christmas, which I'm slowly losing. I also had a very bad cold in January, which I never seemed to fully recover from (no sinus congestion, but gunk in my naso-pharynx).
I also around the same time started wearing a mouth splint for TMJ. I tried sleeping without it for 4 days and my numbers were occasionally better, but not consistently.
I tape my mouth closed and it stays closed all night. No mouth dryness.

Last night, my leak rate was 1.24 l/s!!!!
My daughter, who is staying with us while she is recuperating from her car crash, sleeps in my room and is very aware of things at night. She said she never hears any snoring.
Can a nasal pillow actually lose 1.24 l/s of air???
I honestly am thinking the machine is off. I've checked all my stuff in my settings, and everything is what it should be as far as type of mask, length of tubing, etc.
Even when I first started wearing cpap and had ridiculous amounts of mouth-breathing, the leak rate never got anywhere near what it was last night.

I have noticed that my soft palate is weaker than usual. Is it possible that the pressure of 7.6 isn't enough to open the soft-palate obstruction and all the air comes back out my nose (as opposed to just a leak caused by movement or bending of the nasal prongs??)

I still feel like I'm getting some benefit during the day, but I'm waking up with headaches, which tells me I might not be getting ventilated enough.
But still..........what's with a leak rate of 1.24???
I think I'll turn on my leak alarm. It won't be a fun night, but maybe it will let me know what's going on (without software data).
I know I'm being anal about this..........but I'm a pretty good trouble-shooter, and this just isn't making any sense to me.
Just to remind you.........all new tubing, head gear, pillows, etc., etc., etc.
Mouth is taped shut....no leaks there.
I feel comfortable all night and maybe wake up once a night and go right back to sleep.

I still suspect that this mouth splint is causing problems, not by its presence, but by the change it has made in my jaw alignment. It should actually be helping, by moving my jaw downward and forward.........but wearing this splint is one of the possible culprits of my bad numbers.
And I just can't believe its that 5# weight gain. I was about 8# heavier 2 years ago and got good numbers. Something just isn't right.

So again, please be gentle with my repeating myself. My mind is slipping and I'm peddling as fast as I can.
Thanks.

[ozij]

I honestly am thinking the machine is off. I've checked all my stuff in my settings, and everything is what it should be as far as type of mask, length of tubing, etc.

I was thinking the same -- get your DME to give you a loaner for a week, because at this point, something broken and leaking inside the machine makes more sense at this point than anything else.

Don't take "no" for an answer, make it clear how bad you feel and that you've changed all your other equipment.


O.

[JStaggie]

Someone else reported on the forum that they found a small leak in their hose when cleaning it (water was streaming out of the hole). Since you've already been troubleshooting you may have checked that already, but just thought I'd mention it.

[Country4ever]

Thanks ozij and JStaggie,
Even though I changed absolutely everything about 10 days ago, I'm going to change my pillow again tonight. If I make the slightest movement, air rushes around the prongs. Maybe it was just made too soft.?? I took my TMJ oral device out last night and got my leak down to the .20's, which is still too high, but better than 1.24!
I will visit the DME this week. I think I'll get a Hybrid mask. Maybe if I am having a problem with my weak naso-pharynx/soft palate area, I can bypass it with the mouth mask part.
The only inkling that I'm getting that its me and not the machine is how crappy I've been feeling lately. Plus, I'm having tons of irregular heartbeats, which I had before using cpap. We'll see. I need to get some good sleep! I'm going a little crazy here.

[ozij]

The only inkling that I'm getting that its me and not the machine is how crappy I've been feeling lately. Plus, I'm having tons of irregular heartbeats, which I had before using cpap. We'll see. I need to get some good sleep! I'm going a little crazy here.

That could just as well be proof your machine is malfunctioning, and giving bad therapy, or none at all. SnoreNoMore2005 had a similar problem:

viewtopic.php?p=431639#p431639

I've been using CPAP for 5 years and all of a sudden I'm getting really dry lips and dry mouth. My first thought was mouth breathing causing this but it seems strange because I haven't done it before and I'm a 5 year user. I already use a heated humidifier.

Could there be another problem at work here? Sometimes I'm lying in bed and an air bubble escapes between my lips. Does that mean something?

I've tried chin straps, tape, and full face masks but to no avail.

Could I have a machine malfunction?
Does anyone have any other suggestions as to the cause or cure?
Could my machine settings now be too high?
It's really messing with my sleep.

Thanks for your help.
SnoreNoMore2005

I found out what my problem was and I wanted to report it here in case anyone else experiences the same situation:

My 5½ year old Respironics M Series Autopap was malfunctioning and blowing a much higher pressure than my setting required. This was causing me to open my mouth when it would normally be closed. It was as if I set the pressure too high on my machine. I found this out by using my spare machine and immediately noticed the difference in air pressure even though the settings were the same.

I never even considered that I might have an equipment malfunction since it was such a gradual change I am sure. So I guess the take home lesson is people should probably get their machines calibrated every so often if they start having problems after using the machine successfully for a long period of time.
Good luck to all. I hope this helps someone else.

SnoreNoMore2005

My emphasis. Please insist on having your machine checked, and trying a loaner.

[Country4ever]

Thanks ozij,

I took my machine into Lincare about 2 weeks ago to have them check the pressure. It didn't seem real reliable what she did........she put a manometer-type thing on the end of my tubing and it had a t-tube on it, and she would cover her hand over the end of the tube momentarily and take it off. She did this several times. Then she said "looks like your pressure is somewhere between 7 and 10."
Shouldn't she be able to be more precise than that in checking the pressure?
Makes me think they wouldn't do much better in checking anything else in the machine.
Anyhow.........I will keep in mind that it very well could be the machine.
Thanks ozij!