Need help with high leak rate (30 L/m) please

[RickPC123]

I could really use some help with this issue, it is driving me nuts. I got a diagnosis and bought a Resmed Airsense 10 about a month ago. I have a beard so the store recommended Phillips dreamwear nasal pillows. It’s set to auto with max pressure 20.
I’ve been getting pretty consistently 30-35 L/min reports. I’ve been taping my mouth shut, but this doesn’t seem to help (although sometimes I wake up and the tape is off). The mask seems to have a good seal between the nostrils and pillows when I fall asleep, and I often wake up with it in place, but sometimes I wake up and it is off of my face. I sleep on my side and apparently move around a bit while I’m sleeping.
I’m pretty sure that for the majority of the night the mask is snugly on and my mouth is taped shut, so I am surprised and puzzled that the reading could mean that 95% of the time I am leaking in excess of 30 L/min.
There don’t seem to be leaks from the reservoir or machine. When the pillows are on before I fall asleep there is no leak.
I tried a different nasal pillow Nuance but it just made my nose sore and I had an even bigger leak.
I am determined to make this work and not suffocate during the night but I am not sure what to do. I have a bunch of questions:
1. What should I do to get rid of the leak ?
2. Is there a way to make sure the mask stays in place when you are sleeping?
3. Is there a more efficient mask that will work with a full beard?
4. Are there any experts that you could recommend to help me troubleshoot this?
5. Also the report is showing 2-3 events per hour. I don’t understand if that is events that occurred despite the cpap or that were prevented by it?
Thanks so much !!
Rick

[Pugsy]

I’ve been getting pretty consistently 30-35 L/min reports.

What number is this pertaining to? Is it what you see on the machine itself?
Or is it from an OSCAR report and if it is...is it the median average or the 95% number or the max number?

Are you sleeping soundly for the most part or are you waking frequently during the night for some reason or the other?
How are you feeling during the day?

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[Julie]

Going by others' experience, I'd say the beard is a major part of the blame - others have had to shave tho' they didn't want to.

[Pugsy]

A nasal pillow mask and a beard will work just fine together for most guys. Besides if it mask movement not having a beard isn't a guarantee that the mask won't still move. Wish it were that easy.

Or look at the mask I use....link down in my signature line.
It will work quite nicely with facial hair.

[Pugsy]

You might try a different nasal pillow mask.
I have tried both the Respironics nasal pillow masks and the Resmed.....I do think that the ResMed nasal pillow is a better mask and more stable.

Check out the ResMed AirFit P10 mask.
https://www.cpap.com/productpage/resmed ... k-headgear

or it's older sibling the ResMed Swift FX
https://www.cpap.com/productpage/resmed ... k-headgear

[RickPC123]

Thank you so much for the great ideas! I will try those masks!
The 30-35 L/m number is from my daily report in the Resmed MyAir app.
I am relieved to think the pillow type mask can work. Are there any other suggestions for me to try?- ie what if it is me wrestling the mask off while unconscious- any headgear to keep it on better or other solution?

[Pugsy]

Thank you so much for the great ideas! I will try those masks!
The 30-35 L/m number is from my daily report in the Resmed MyAir app.
I am relieved to think the pillow type mask can work. Are there any other suggestions for me to try?- ie what if it is me wrestling the mask off while unconscious- any headgear to keep it on better or other solution?

Okay...the MyAir app leak number is what we call the 95% number and all that means is you were AT OR BELOW that number in terms of leak for 95% of the night. The BELOW part is critical to understand because it can cause undue stress/worry about leaks when maybe they really aren't that bad.

Did you read the two links to threads I posted? If not, please read.

Answer the sleep quality and how you feel question please.

You can try taping the mask straps to your face so that when you try to remove the mask while asleep the slight discomfort may wake you up so you can stop that unwanted behavior. It's a common complaint. Your brain is still not used to having the alien plastered on your face and night and it wants that alien gone. With time your brain will get used to its new best friend.

Post an OSCAR detailed report if you can because we really need to see just how bad that leak might be but I don't think it is going to be nearly as ugly as you think it is.

[RickPC123]

Sorry I missed those questions:

Are you sleeping soundly for the most part or are you waking frequently during the night for some reason or the other?
I’m sleeping pretty soundly. I get up 2-3 times per night to urinate but that has been like that for a few years.

How are you feeling during the day?
I’m feeling better than I used to with nothing, but I don’t feel like I am getting the full most life-changing impact that I hear from others.
(This could be a reverse placebo effect though because I check the report every morning and it says “Adjust Mask” and shows the high leakage rate. )

I liked the post on that # being deceiving because of the “or below” definition. The lcd readout every morning has a smiley face do that means that the high leak rate impacted less than 30% of the night which is great news!

I will get my Oscar data and post it once I find an SD reader and get the data.

I really like that Bleep mask you use. I’m going to try that.

I also like the taping the mask to the face idea. Although I guess I need to undo/redo that for my bathroom trips.

[RogerSC]

Thank you so much for the great ideas! I will try those masks!
The 30-35 L/m number is from my daily report in the Resmed MyAir app.
I am relieved to think the pillow type mask can work. Are there any other suggestions for me to try?- ie what if it is me wrestling the mask off while unconscious- any headgear to keep it on better or other solution?

Also have a beard here. In addition to a nasal pillow mask, the nasal cradle masks also work well with a beard. As you can see from my equipment at the bottom of this posting, I'm currently using a ResMed AirFit N30 nasal cradle mask, which is a nice, lightweight, quiet one. It has taken me a while to get the leak level down on the N30, but it's fine now.

The Dreamware nasal mask is also a nasal cradle mask and worked well for me...it was more stable than the N30, but louder, with a jet stream of vent air coming out the front. And heavier as well.

The mask that I used for the longest time was the ResMed Swift FX mask, another nasal pillow mask. The Swift FX worked better for me since it has more structure than the AirFit P10 did, but these things are all very individual and personal.

The main thing is to keep trying until you find something that works for you. I'm sure that you'll get there, persistence furthers.

[Pugsy]

I also like the taping the mask to the face idea. Although I guess I need to undo/redo that for my bathroom trips.

Nope. You just unhook it from the long hose from the humidifier and wear the mask to the bathroom.
Just be careful if you sit down on the toilet and that little hose that is part of the mask might fall in the toilet.

How old are you? Of the age that your frequent bathroom trips are related to the prostate maybe????

If you are going to purchase the Eclipse out of pocket...send me a PM as I can try to get you a promo code to use to save some money on your purchase.

[RickPC123]

I’m 56 and I’m sure that’s why I make so many trips.

That’s good to know it unhooks so easily. I’ll try that tonight.

Thanks for all the great advice!

[ozij]

I’m 56 and I’m sure that’s why I make so many trips.

That’s good to know it unhooks so easily. I’ll try that tonight.

Thanks for all the great advice!

Are you aware that untreated or improperly treated sleep apnea can also cause many nighttime bathroom trips?
When the machine has a wide open range of pressures the minimum can be too low, as a result your breathing is obstructed, the machine responds, your breathing stabilizes, the pressure goes down, you breathing obstructs - and so on. Your minimum should be near the 90th or 95th percentile reported. That means the pressure at which you spend 90% or 95% of the night. Setting the higher minimum will keep the pressure from dropping low enough to permit repeated obstructions.

[RickPC123]

https://imgur.com/a/p9Kg9h3

Here is my SD card information read by OSCAR.

Any insights or advice based on this would be greatly appreciated!

Thanks so much!!

[Pugsy]

Are those leaks causing you to wake up during the night fairly often?

Are you experiencing any nasal congestion?

[ozij]

It looks like the high leak co-incides with reduced air flow - please check that on other nights.
And, while i can't say for sure which is the cause and which the result, I think you may do better all in all if you raise your minimum to 8.8 or so. Your median pressure - is 8.66 on this night. That means you're spending half the night at this pressure or even higher.
Your machine's present settings - min 4 max 20 - are good for getting a sense of which pressures you need, not for long term therapy. Presently, it keeps going back down to where the pressure is too low for comfort, and then going "Uh oh, that's too low, lets raise it".
Given the leaks, flow limitations, and the number of times you have to get up, I'm wondering if that lower pressure is simply too low to give you restful sleep. By raising the minimum you can prevent some of the flow limitations and that could give you more restful sleep, and keep some of the leaks at bay.

Are you using Auto Start on the machine? If you are, turn it off - Auto Start goes with automatic stopping - auto stop happens in response to large leaks, and you don't want the machine to do that when you're actually trying to sleep with it.