Hello from a new member and help with these damn leaks

[daveinar]

Hello,
I was diagnosed with OSA in 2008 but was resistant and very non compliant after one or two nights of waking up with that nasty hose and my mouth like a desert. Fast forward to 2013 and my cardiologist told me use the machine or we could talk about a pacemaker for my arrhythmia. My cardiac doc did my first sleep study in his clinic and I I just saw his wife who is a pulmonologist (one stop shopping)

OK, I'm stubborn but apparently i gained some wisdom in the past 5 years. I used the machine that night and every night since. I've been compliant every night since. I have already noticed a decrease in my palpitations but haven't been back for an office visit yet, but subjectively I think it's already better.

I told my doc I wanted a fully data capable machine and I now have a PR system one 660 bipap. I am about 45 days in this time and really have no issues using the machine. I only sleep 5-6 hours a night but I think I was staying up late to avoid going to bed because my apneas were stressful, waking up paralyzed or dreaming that I was drowning and waking up out of breath and pulse racing. Anyway, I am sleeping better and starting to sleep longer each night(over 8 hours last night).

My AHI is low, around 2 and the high nights are all flagged during high leak conditions so I don't know if they are real or not. Nights I manage to not have bad leaks I run around 1.

My main problem is the damn leaks!!!
. My pressures are high, 23,19 and I use a Fisher Pakel 432 and i can cinch it down tight enough but the straps are stretched out after two days and i am developing an ulcer on the bridge of my nose. My DME sold me a blue gel FFM and it leaks into my eyes or farts all night long, i can't tighten it down enough to not leak and only used it one night.

So, any help or suggestions would be greatly appreciated. I've been lurking here and I am very grateful for sharing and information, if I had to rely on my DME I wouldn't know anything... My doctors are good and take time in their visits but I don't always know what to ask so reading here is very beneficial.
Dave

[Bill44133]

My main problem is the damn leaks!!!
. My pressures are high, 23,19 and I use a Fisher Pakel 432 and i can cinch it down tight enough but the straps are stretched out after two days and i am developing an ulcer on the bridge of my nose. My DME sold me a blue gel FFM and it leaks into my eyes or farts all night long, i can't tighten it down enough to not leak and only used it one night.

So, any help or suggestions would be greatly appreciated. I've been lurking here and I am very grateful for sharing and information, if I had to rely on my DME I wouldn't know anything... My doctors are good and take time in their visits but I don't always know what to ask so reading here is very beneficial.
Dave

Hello Dave!

Welcome to the forum. You have my exact settings of 23 and 19. It is a battle every night for leaks.
I have had the best nights with 0 mins leaks and less adjusting through the night using the PMI Probasics Zzz-Mask Full Face.
It does not have the support on the forehead and straps in right by the nose. It is relatively inexpensive and would recommend it.
Here is the link from the boards sponsor for the mask I am talking about: https://www.cpap.com/productpage/zzz-ma ... asics.html
It is really light weight but does a good job controlling leaks with my high pressures. Also, make sure you are washing your face good before bed time.

Good Luck

[Pugsy]

You might add a mask liner to see if it helps with leaks and comfort.
Many forum members who have to use pressures like yours just swear by them.
Padacheek makes some really nice liners that will last a long, long time
http://www.padacheek.com/PAC_Maskliners.html

There are other mask liners designed for single night use
https://www.cpap.com/productpage/remzzz ... iners.html

If you will send forum member Becky a Private message..she will send you a free sample of the Remzzz liners since she works for them.
memberlist.php?mode=viewprofile&u=62662

You can also try making a homemade mask liner out of an old T Shirt to see if it helps.

[Denial Dave]

+1 for pad-a-cheek..... I've got higher pressures too.... 19 IPAP & 14.4 EPAP

I bought 2 pad-a-cheek mask liners about 14 months ago. Last month, I had to replace them due to wear.

Karen's pad-a-cheek products are amazing.

Rem ZZ's never worked for me and they are not re-usable.

[avi123]

Hello,

My main problem is the damn leaks!!!
. My pressures are high, 23,19 and I use a Fisher Pakel 432 and i can cinch it down tight enough but the straps are stretched out after two days and i am developing an ulcer on the bridge of my nose. My DME sold me a blue gel FFM and it leaks into my eyes or farts all night long, i can't tighten it down enough to not leak and only used it one night.

So, any help or suggestions would be greatly appreciated. I've been lurking here and I am very grateful for sharing and information, if I had to rely on my DME I wouldn't know anything... My doctors are good and take time in their visits but I don't always know what to ask so reading here is very beneficial.
Dave

Reply,

I myself wasted almost a year of therapy by using Fisher & Paykel #431 and # 432 full face masks. It was b/c of the hi leaks from those masks. As I understand it, the cushions of these mask don't use the advanced technology of the double silicone flaps technology for sealing as do Resmed and Respironics. Another issue was the fixed frame of the masks that did not comply with my face contour. Would you like me to post here my log showing the leak rates from that time while using those masks? In this log I used pressures up to 10 cm. Your hi pressures would make it much, much, worse.

As to your arrhythmia, IMO, a CPAP would not remedy it b/c arrhythmias are caused by the electrical malfunction of the heart chambers and CPAPs have nothing to do with it. A CPAP would help you get the oxygen at nights but what about daytimes?

As you see in the sketch below, the two yellow nodes are the natural pacemaker of the heart. They are located in the wall of your right atrium and contain pacemaker cells which create electrical impulses that control your heart rate. The electricity is spread throughout your heart muscles thru those yellow lines. In your case something is wrong with this intrinsic conduction system and therefore a mechanical device called an artificial pacemaker (or simply "pacemaker") is used instead.

[Sheffey]

As to your arrhythmia, IMO, a CPAP would not remedy it b/c arrhythmias are caused by the electrical malfunction of the heart chambers and CPAPs have nothing to do with it.

Any type of stress can make an arrhythmia worse. I have had a benign arrhythmia for many years. Now that I use CPAP it is seldom noticeable. The stress of apnea was removed.

[daveinar]

Many thanks for all the responses and information.
I've actually tried not cinching the mask quite so tight and I have managed to get a pretty good seal, most of the leaks at the bottom of the mask which aren't too bad and aren't in my eyes!! The air on my eyes keeps me up. Last night was a horrible night, not sure why, started with a clean mask, i shaved and had a good seal early then it went south, leaks weren't over the top but enough that i was awake what felt like all night, finally had to take it off about 6:00 and slept another hour with out it.

I will definitely try the zzz mask. I cant get the blue gel one to work at all though. It has to go back. And now, to make it even better, my 432 head gear has shredded so I tried the respironics head gear wit it and the geometry is way wrong. probably why i had so many leaks last night. So I am off to a semi local DME to pick up a new headgear today ( I've actually become addicted to my mask and hose, who woulda thought?

As to the arrhythmia, the cardiologist said they would get better and he has been pretty good so far.. I can definitely tell a difference already.
thanks again for all the responses, you guys do make it a bit easier to trudge along with treatment.
Dave

[ReadyforRest]

daveinar, have you tried a nasal pillows mask? You might consider it. Less mask on your face, so there are fewer leaks.

[NateS]

As you see in the sketch below, the two yellow nodes are the natural pacemaker of the heart. They are located in the wall of your right atrium and contain pacemaker cells which create electrical impulses that control your heart rate. The electricity is spread throughout your heart muscles thru those yellow lines. In your case something is wrong with this intrinsic conduction system and therefore a mechanical device called an artificial pacemaker (or simply "pacemaker") is used instead.

I've had a pacemaker for more than ten years, and that's the best explanation and diagram I've yet seen to simply explain the situation requiring correction.

Just wanted to say: Thanks, avi!

Best wishes, Nate

[SleepyToo2]

Avi, do you have a reference for the image? If it is actually stored on another web site, I apologize. I am using my Kindle Fire at the
moment and can't see any links.