Is this normal?

[tvmangum]

Okay, I'm now 3 days into my CPAP therapy and things are slowly getting better . . . except for leaks. The first night I was able to go 2 hours before the leaks drove me crazy and I took the mask off. The past 2 nights I have been able to go almost 5 hours before the leaks got the best of me. I'm handling the pressure of 14cm just fine. The problem seems to come when I try to switch sleeping positions.

When I go to bed I lay on my back to make sure that everything is working correctly. I am using the ramp feature to go from 5cm to 14cm over 30 minutes but am usually awake when I reach full pressure and do not notice any leaks. Once I am sure there are no leaks I turn to one side to sleep. Everything is fine. Sometime during this time I usually wake up and find a leak which I correct. A little later there will be a leak in a different place which I fix. I may turn to my back to sleep and have a entirely different leak which I correct, etc. I guess my real questions/concern is if there is such a thing as a "positional leak?" By that I mean, depending upon my position the mask leaks at different places and to fix the leaks say on the left side of my body creates new leak for me trying to sleep on the right side of my body which creates leaks if I try to sleep on my back.

I am using the same make from my titration study and didn't have any leak problems then so I am wondering if I'm doing something wrong.

Suggestions???

[2girlsmom]

When you say you lay down to be sure it fits, do you roll side to side before going to sleep to check for leaks in all directions? That may help. And remember you can dial the top part up or down to get the best fit.

Where are the leaks coming from? Maybe if we know if it's mainly eye or mainly around the bottom we could offer even more help. I use the same mask and really, really like it. I find that if my headgear is not tight enough I get leaks. I dial down the top and tighten the headgear so that I can still fit a finger in under the straps and that works for me.

[tvmangum]

I do roll from side to side to check for leaks and can find none either by feeling or listening. It seems that the leaks are coming from the sides of my mouth. I don't usually have problems with leaks around my eyes which is where the RT told me that I would probably have leaks. I think the dial on the top of the mask is down as far as it will go but I would have to look to be sure.

[echo]

I have to wear a chin-strap (or preferrably pap-cap) even with a full face mask, otherwise my jaw drops when I'm sleeping, and causes all sorts of leaks around the mouth.. Just food for thought....

Edit: just realized you said it has to do with switching sides. Do you have a good hose management system that keeps the hose from pulling on your mask when you turn from side to side?

[Paul56]

Yes, there can be positional leaks because your face will change shape depending on what position you are in.

If the leaks are around your mouth you could try adjusting the lower straps on your Quattro. That is what I usually do if I notice leaks on the lower side during the night... I will adjust the lower straps while laying down.

[congahands]

Where is your hose running? With my Quattro I run it up over my head. It seems like a combination of adding tension on the straps, and rocking the mask up and down with the knob on the forehead piece helps.

The other thing that seems to help me is washing my face until it's squeaky clean right before I go to bed. I also use the Citrus II CPAP mask wipes on my mask every morning.

Hope this helps!!!

[Paul56]

Where is your hose running? With my Quattro I run it up over my head. It seems like a combination of adding tension on the straps, and rocking the mask up and down with the knob on the forehead piece helps.

The other thing that seems to help me is washing my face until it's squeaky clean right before I go to bed. I also use the Citrus II CPAP mask wipes on my mask every morning.

Hope this helps!!!

Yep, I'm with that... the only thing I do different is that I wash the face & forehead cushion every day.

I find when first installing the mask in the evening that it feels tight... even after laying down... but that feeling gradually goes away. By the time I get up in the morning the mask does not feel tight at all.

[2girlsmom]

I wipe my mask cushion and forehead piece down with a baby wipe... an unscented one... as we have a diapered toddler in the house and always have baby wipes I do notice a lot more leaking when my mask cushion doesn't get either washed or wiped down with a wipe.

As for the side and mouth leaks, do you possibly have the mask up too high on your face? I can open my mouth without leaks when wearing my quattro but if it was up too high I wouldn't be able to. Are the lower headgear straps below your ears? Tightning those may help as well. Keep posting, we'll help you through this, and if you can't get the Quattro to work you may need to try another ffm. I tried the Ultra Mirage first and did not do well with it as it leaked around my eyes, but the Quattro works prefectly.

[2girlsmom]

Thought of something else You may find the dial being down far on the top will cause the mask to fit funny at the bottom. Play with that dial some too. Sorry to throw out so many ideas.

[bbong73]

I'll throw this out there since nobody has asked, are you sure you have the right size mask? this can make a big difference
GC

[mellabella]

I have the Quattro, a thin, bony (I prefer the term "sculpted" ) face, and I find that, now that I've "broken it in" and know how to adjust it, the Quattro is the most leak free mask in my extensive stable. If you're leaking at the sides of the mouth, a few ideas:

--Ditto the suggestion that you clean it every day...it really does make a difference
--Do your nightly adjustment with the pressure full-on, and your jaw relaxed (slightly parted, if that's what happens naturally when you doze off)
--...and most counter-intuitively: make sure the mask isn't on too TIGHT. Especially at the sides, you'll get a better seal if the mask feels slightly "loose" so that air can puff up the cushion and seal to your facial irregularities

[tvmangum]

Things are getting better. Thanks to everyone for their suggestions. Many of them I was already trying but one or two I tried last night for the first time. I was able to sleep until almost 5:00 this morning with my FFM on at 14cm. Only had 1 leak all night that I am aware of and everything was fine except I turned the dial on the mask the wrong way and my nose is sore and I have an outline of the mask on my face.

I checked my # this morning and this is what I found:
AHI: 12.3 (down from 24.10 in September)
AI: 4.6
HI: 7.7

I know that the AHI coming down is good but I my sleep study reports don't break down to the AI and HI level so I guess I'm doing okay.