Can't solve leaks, despair setting in, could use ideas

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
emmagoldman44
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Can't solve leaks, despair setting in, could use ideas

Post by emmagoldman44 » Sun Oct 01, 2017 3:58 pm

It's been over a year on Apap and I am still not sleeping well most of the time.

My current leakage problems is causing sleep deprivation problems that are causing me to be seriously depressed, barely functional and crying on & off most days. Eyes red & sore - I keep a water spray bottle at my bedside just so I can pry my eyes open in the morning. I have unfortunately a lot of other conditions which all make it harder to get Cpap success.
In case anyone can give me helpful feedback or even just some support, here goes...

**My lung functioning is compromised from a life of asthma, so I cant take too much resistance in exhaling, and if I try to exhale into the mask but the air starts backing up into my lungs due to too much resistance from mask or pressure, I get anxious and there goes the chance to fall asleep.
**I have insomnia - taking Ambien to fall asleep 7 years now. Normally start w P10 pillows, wake up 4 - 5 hours later and after 1 - 2 hours change to nasal mask & try to go back to sleep.
**I have head, neck and shoulder pain from car accidents, and I can get both muscle type headaches from straps pressing too tightly around my scalp, and also migraines from that. Ex: cannot sleep on my side w the P10, due to that rigid plastic end in the P10 headgear that ends above the ear, it digs in my skull and has caused bad migraines. So normally I sleep on my back the first part of the night with the P10 pillows. Then later I go to side sleeping with the Eson nasal mask.

So that first part of the night has fallen apart because for no apparent reason, the P10 has started leaking. I tried using a new headgear, but no improvement. The med size pillows fit better than the L but the opening is too small & gives too much resistance. So before I gave up on them, I tried enlarging the nostril openings with a scissor. I think I enlarged them more than necessary, I loved the feeling of unrestricted breathing, but it made the leaking worse.

I just got the Dreamwear gel pillows, 4th night of use. The small size fit my nostrils really well, I think it might solve the leaking problems, but made exhalation too difficult. I tried to go to sleep with the smalls, but even after a full dose of Ambien, the lack of free exhalation (this during the 4.2 cm ramp period, 1 EPR) caused me anxiety and I couldn't sleep for an hour afterwards.
The mediums solved the exhalation problem but are uncomfortably big for me, and did leak some.

Padacheek liner for the nasal mask does not work for me at any pressure - the air just slips between the fabric and my cheek.

My Eson nasal mask is over 6 months old so replacing it is the one idea I have to try, - but it always leaked some anyway. I know it supposed to not be overtightened, but it just lifts up & blows the air out if not tightened pretty good. However, I can't tighten it enough to solve the problem or else I will get a bad headache. I get it squeaky clean every day and clean my skin just before using it.

I got the Walgreens eyemask recommended elsewhere on this forum, but it leaves a gap (does not seal at all) between the mask and your skin. Good for creating darkness while you sleep though!

This is the survival strategy I am limping along with: I got a different sleep eyemask made of soft fabric, and sewed strips of plain cotton fabric bunched up from the bottom of the mask to serve as a 'baffle' again the airstream from the leaking mask. It works kind of okay with the nasal mask because I can tuck the fringes of the strips of fabric into the mask headgear, providing a sort of blockade again the leaks. The sound and feel of the escaping leaks do still wake me up at times, but at least my eyes are protected. Also I have reduced my pressures from 8 - 12 down to 7 - 9. To hell with getting the best AHI. Actually last night was still only .5 AHI compared to .1 - .3 before so that's not bad.

Well, I don't want this to become more of a manifesto that it has to be, so I will just say thanks in advance to any constructive feedback.

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LSAT
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Re: Can't solve leaks, despair setting in, could use ideas

Post by LSAT » Sun Oct 01, 2017 4:18 pm

Raise the EPR to 3 for easier exhaling

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Julie
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Re: Can't solve leaks, despair setting in, could use ideas

Post by Julie » Sun Oct 01, 2017 4:20 pm

Check out Onyx sleep masks - made for Cpap.

A MESS

Re: Can't solve leaks, despair setting in, could use ideas

Post by A MESS » Sun Oct 01, 2017 5:21 pm

Dont think there is a leak proof mask around. MY doctor (board certified Pulmonologist) says not to worry about leaks if your AHIs are good--5 or under. Mine are good so I try to ignore them, and finally got two nights in a row of decent sleep . Do you get any feed back from your machine? I have allergies--and would not attempt cpap lone. Many here on this board do self treat.

When I learned I could have sleep apena I went to a sleep Dr/pulmonologist. I have only been on Cptap for 5 weeks and have had my share of troubles, so I am no expert. That said, your AHIs are in control. Yay! You have asthma=--could you also have some allergies ? What about some medical intervention here to help you out?

emmagoldman44
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Re: Can't solve leaks, despair setting in, could use ideas

Post by emmagoldman44 » Sun Oct 01, 2017 5:29 pm

Wow, LSAT, thanks for mentioning the EPR. I was confused! It used to be on 2, then somehow I thought I was reducing pressure to change it to a 1. I am going to put it back on 2. However, I don't think it comes into play with my problem with the Dreamwear pillows small size, since I felt the exhale resistance too much at a 4.2 starting (ramp) pressure, where there would be no difference experienced 1 EPR vs 3EPR, correct?

Julie, thanks for the Onyx mask suggestion, I will look into it.

However, also re: A mess -- the leaks do wake me up with the sensations and noise of the leaking. About my asthma, it is not really an issue of current asthma symptoms creating problems, it is that the lungs are damaged from a lifetime of bronchitis & inflammation. Am taking Flonase lately to clear out nasal congestion just to maximize my chances of getting a better nights sleep.
Glad to hear you got 2 nights of decent sleep. Someday, I hope for the same.

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RogerSC
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Re: Can't solve leaks, despair setting in, could use ideas

Post by RogerSC » Sun Oct 01, 2017 6:34 pm

emmagoldman44 wrote:Wow, LSAT, thanks for mentioning the EPR. I was confused! It used to be on 2, then somehow I thought I was reducing pressure to change it to a 1. I am going to put it back on 2. However, I don't think it comes into play with my problem with the Dreamwear pillows small size, since I felt the exhale resistance too much at a 4.2 starting (ramp) pressure, where there would be no difference experienced 1 EPR vs 3EPR, correct?

Julie, thanks for the Onyx mask suggestion, I will look into it.

However, also re: A mess -- the leaks do wake me up with the sensations and noise of the leaking. About my asthma, it is not really an issue of current asthma symptoms creating problems, it is that the lungs are damaged from a lifetime of bronchitis & inflammation. Am taking Flonase lately to clear out nasal congestion just to maximize my chances of getting a better nights sleep.
Glad to hear you got 2 nights of decent sleep. Someday, I hope for the same.
Yes, each increment in EPR (expiratory/exhalation pressure relief) decreases the pressure that you are exhaling against by 1cm pressure. So I would try EPR at 3, which puts you at (normal pressure - 3cm) as suggested by previous poster. Don't know if this helps, hopefully it's helpful to restate this is a slightly different way *smile*.

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Pugsy
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Re: Can't solve leaks, despair setting in, could use ideas

Post by Pugsy » Sun Oct 01, 2017 6:39 pm

emmagoldman44 wrote:I felt the exhale resistance too much at a 4.2 starting (ramp) pressure, where there would be no difference experienced 1 EPR vs 3EPR, correct?
For EPR to work and offer the comfort there has to be some room to reduce the pressure during exhale.
There's not much room to drop the pressure if the starting pressure is 4.2...it can only drop to 4 no matter what the EPR setting might be.

I know this is going to sound crazy but a person needs to be using 6 or 7 inhale to really feel the benefit from using EPR at 3.
It is the difference that makes it easier.

If you can't handle exhaling against 4 cm...there is the DeVilbiss that will go down to 3 cm but it doesn't really offer the exhale relief in the same way that ResMed does with EPR and the same thing applies to whatever it does use...there has to be some room for the pressure to drop during exhale for any exhale relief to work.

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TedVPAP
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Re: Can't solve leaks, despair setting in, could use ideas

Post by TedVPAP » Sun Oct 01, 2017 7:24 pm

emmagoldman44 wrote:It's been over a year on Apap and I am still not sleeping well most of the time.

My current leakage problems is causing sleep deprivation problems that are causing me to be seriously depressed, barely functional and crying on & off most days. Eyes red & sore - I keep a water spray bottle at my bedside just so I can pry my eyes open in the morning. I have unfortunately a lot of other conditions which all make it harder to get Cpap success.
In case anyone can give me helpful feedback or even just some support, here goes...

**My lung functioning is compromised from a life of asthma, so I cant take too much resistance in exhaling, and if I try to exhale into the mask but the air starts backing up into my lungs due to too much resistance from mask or pressure, I get anxious and there goes the chance to fall asleep.
**I have insomnia - taking Ambien to fall asleep 7 years now. Normally start w P10 pillows, wake up 4 - 5 hours later and after 1 - 2 hours change to nasal mask & try to go back to sleep.
**I have head, neck and shoulder pain from car accidents, and I can get both muscle type headaches from straps pressing too tightly around my scalp, and also migraines from that. Ex: cannot sleep on my side w the P10, due to that rigid plastic end in the P10 headgear that ends above the ear, it digs in my skull and has caused bad migraines. So normally I sleep on my back the first part of the night with the P10 pillows. Then later I go to side sleeping with the Eson nasal mask.

So that first part of the night has fallen apart because for no apparent reason, the P10 has started leaking. I tried using a new headgear, but no improvement. The med size pillows fit better than the L but the opening is too small & gives too much resistance. So before I gave up on them, I tried enlarging the nostril openings with a scissor. I think I enlarged them more than necessary, I loved the feeling of unrestricted breathing, but it made the leaking worse.

I just got the Dreamwear gel pillows, 4th night of use. The small size fit my nostrils really well, I think it might solve the leaking problems, but made exhalation too difficult. I tried to go to sleep with the smalls, but even after a full dose of Ambien, the lack of free exhalation (this during the 4.2 cm ramp period, 1 EPR) caused me anxiety and I couldn't sleep for an hour afterwards.
The mediums solved the exhalation problem but are uncomfortably big for me, and did leak some.

Padacheek liner for the nasal mask does not work for me at any pressure - the air just slips between the fabric and my cheek.

My Eson nasal mask is over 6 months old so replacing it is the one idea I have to try, - but it always leaked some anyway. I know it supposed to not be overtightened, but it just lifts up & blows the air out if not tightened pretty good. However, I can't tighten it enough to solve the problem or else I will get a bad headache. I get it squeaky clean every day and clean my skin just before using it.

I got the Walgreens eyemask recommended elsewhere on this forum, but it leaves a gap (does not seal at all) between the mask and your skin. Good for creating darkness while you sleep though!

This is the survival strategy I am limping along with: I got a different sleep eyemask made of soft fabric, and sewed strips of plain cotton fabric bunched up from the bottom of the mask to serve as a 'baffle' again the airstream from the leaking mask. It works kind of okay with the nasal mask because I can tuck the fringes of the strips of fabric into the mask headgear, providing a sort of blockade again the leaks. The sound and feel of the escaping leaks do still wake me up at times, but at least my eyes are protected. Also I have reduced my pressures from 8 - 12 down to 7 - 9. To hell with getting the best AHI. Actually last night was still only .5 AHI compared to .1 - .3 before so that's not bad.

Well, I don't want this to become more of a manifesto that it has to be, so I will just say thanks in advance to any constructive feedback.
Much of what you say may have more to do with your anxiety than with physical reasons. I suggest you spend awake time watching TV with your equipment - hopefully you will become more comfortable and confident.

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HannaJ
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Re: Can't solve leaks, despair setting in, could use ideas

Post by HannaJ » Sun Oct 01, 2017 9:44 pm

I don't have suggestions for your exhalation problem, but I just got a new mask, the ResMed AirTouch F20, which does not leak near as much as former masks. It is edged with memory foam, which not only makes the mask much softer on the face, but also helps with leak problems, because the foam is flexible and fill in where leaky gaps might arise. It is not completely leakproof, but leaks the least of the five masks I've tried.

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bernardc
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Re: Can't solve leaks, despair setting in, could use ideas

Post by bernardc » Sun Oct 01, 2017 10:30 pm

I agree with TedVPAP. You should find a physician (usually a psychiatrist) who will give you something potent enough to let you sleep. You need to break the viscous cycle with prescription drugs--they're not the enemy. What's worse: Taking prescription drugs or not sleeping? I'll take the drugs any day.

Another stop-gap solution is to apply gaffer's tape to help hold down trouble spots. Gaffer's tape is like duct tape but it pulls up clean and it's just a much better behaved product. I've used it and have no skin trouble at all the next day. I understand that women use it when wearing certain glamour garments to control nip slips and the like.

I have a limited base of experience, but I found that the Respironics Amara Full View Minimal Contact solved my leakage troubles. I use high pressures (up to 20), so I know leakage. One thing to keep in mind is that the smaller the size of the mask, the lower the force on it from the air pressure pushing it away from your face.

The Respironics Auto-BiPAP allows a difference in pressure up to 8 between inhale and exhale.

nicholasjh1
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Re: Can't solve leaks, despair setting in, could use ideas

Post by nicholasjh1 » Mon Oct 02, 2017 11:54 am

I struggled with leaks a lot do to my indented and thin nose bridge. Constant leaks right into my tear ducts! after many different masks and some trial and error the one thing that worked for me was nasal pillows, with moleskin attached to the pillows. The moleskin ends up stopping 90% of the leakage, and makes the pillows feel more comfortable since I don't have to strap them down very hard! Long story short. Keep trying (maybe my method, maybe something else). Persevere!
Instead of Sleep apnea it should be called "Sleep deprivation, starving of oxygen, being poisoned by high CO2 levels, damaging the body and brain while it's supposed to be healing so that you constantly get worse and can never get healthy Apnea"

Luthie2006
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Re: Can't solve leaks, despair setting in, could use ideas

Post by Luthie2006 » Wed Oct 04, 2017 7:22 am

Emmagoldman44: Is your mask a fresh new one which I think I read you do have a new mask. Instead of cutting the holes, can you try a Large P10 mask?
I have little nostrils (child-like) but yet I find with the Large pillows, it is more comfortable and sits still under my nose I start getting leaks when the AirFit P10 pillows are 4 weeks used.

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Re: Can't solve leaks, despair setting in, could use ideas

Post by ajack » Wed Oct 04, 2017 7:48 am

What is your tidal volume like? It would help of you put up a sleepyhead chart.
you may need to see your doctor for another sleep study. With crook lungs, you may do better on a bipap/bilevel. depending on your out of pocket, you could just hire or buy a second hand one. to see if it's better for you.

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Re: Can't solve leaks, despair setting in, could use ideas

Post by A MESS » Thu Oct 05, 2017 8:12 am

Leaks_-I was told by my pulmonologist that as long as your AHIs are under 5--dont worry about small leaks.