new "large leak"

[tiggy]

I used a DreamStation (or its predecessor) for about 15-17 years, until the recall. I was able to purchase a ResMed AirSense 10 Autoset to replace it almost exactly two months ago. My pressure settings are 7-12 and most nights the pressure is around 9.5. My AHI score is around 4.8 (down, oddly, from the DreamStation which had me, last year, at around 8.6 averaged over the whole year. I believe the difference is likely caused by two things: the fact that the machines probably measure AHIs different and also to the fact that the AirSense pressure is higher than the DreamStation pressure was).

The first month or so on the new machine, my "large leak" figure was around 17L but in the past few weeks it has ballooned to over 40L every night. Pressure (and AHI both) have stayed largely the same.

I use the old, no longer made, Puritan Breeze nasal pillows--a mask I am so fond of I have managed to keep it in working order for many years. But I am quite concerned about the fairly sudden increase in the leak figure. Any thoughts or recommendations? (FWIW, I checked the air hoses to make certain there were no leaks of any kinds in the hoses themselves.) Thanks.

[ChicagoGranny]

But I am quite concerned about the fairly sudden increase in the leak figure. Any thoughts or recommendations?

You didn't give us any clues, but here are some general recommendations from an old thread.

To reduce unintentional mask leak -

- Make sure the mask is fitted properly. (See mask manufacturer's video.)

- Make sure the headgear is adjusted properly (See mask manufacturer's video.)

- If you use a low ramp pressure or a low minimum pressure, you should fit and adjust your mask at the higher pressures it is operating at for most of the night. You would temporarily change the machine pressure settings while you do the fitting and adjusting. It's best to do this well before bedtime before you are tired and ready for sleep. Don't forget to change your settings back to the ones you prefer.

- Make sure to use good hose management - the hose should not pull on the mask. Notice how your hose is positioned between machine and mask. It should be positioned to minimize any pull on the mask. Hose management is an individual practice. How it is done depends on the mask, the position of the machine, your sleeping position and other factors specific to the individual.

- If you still have problems, learn from the forum what mask liners are available.

- Start a thread in cpaptalk asking for help. Subject: Need Help with Mask xxxxxx

- If your mask still has excessive leak, try other masks. Many people report trying several masks before they find one that works well for them.

Note: Links to just some of the mask manufacturers' instructional videos can be found on the forum host's website - https://www.cpap.com/cpap-masks.php and https://www.youtube.com/

- CG

[tiggy]

Thanks for the quick reply. It is certainly possible that any one (or more) of the items in the list you provided are wrong and I have my homework cut out for me. What puzzles me is that for the first month or so, everything was stable. To the best of my knowledge, I am doing nothing differently now: the mask fits as well (or poorly) this month as it did last month. I arrange the hose as carefully now--and exactly the same way as before. It seems peculiar that the change would be so sudden and so significant. So I guess two things are really of concern to me: 1) how the change is likely to have happened so quickly (which I admit I may never know) which is ultimately less important than 2) how concerned I should be?

I would strongly prefer not to consult my sleep doc; I have long been unhappy with her and the recall was the last straw. I have an appointment with a new guy in January. And frankly, I have serious doubts that my "current" doc would be much help anyway.

A new mask is undoubtedly a wise idea, no matter what. I have been procrastinating because I have been happy with my old mask and I would prefer not to have to get used to something new. However, the old mask is old and not in as good a shape (or, presumably, fit) as it was once upon a time. Still, the "fact" remains that the leak number was fine (or at least acceptable) for the first 4-6 weeks and has lately gone bonkers.

[ChicagoGranny]

However, the old mask is old and not in as good a shape (or, presumably, fit) as it was once upon a time. Still, the "fact" remains that the leak number was fine (or at least acceptable) for the first 4-6 weeks and has lately gone bonkers.

I've been using the same mask for a year and getting zero leak. A couple of weeks ago, I started getting large leaks. It seemed like time to get out the new spare. But I procrastinated and fiddled with the headgear a bit. Voila! Leaks gone!

I would strongly prefer not to consult my sleep doc; I have long been unhappy with her and the recall was the last straw. I have an appointment with a new guy in January. And frankly, I have serious doubts that my "current" doc would be much help anyway.

In my experience, it is very rare that a doc can help with mask fitting and adjusting. A respiratory tech who can help is slightly less rare. DIY

[tiggy]

And, following the advice to fiddle with the mask, I did and am pleased to report that there was a screw loose. Literally. There is a little thingamajig that loosens to adjust the angle of the nasal pillow holder. I had apparently loosened it and never re-tightened it. Did so last night. And we're back down to "normal" leaks. Thanks, ChicagoGranny!