major leaking issue

joeschmo0391 · Post by **joeschmo0391** » Wed Dec 14, 2011 9:34 am

hello, I am a 26 year old male with a bi-pap and i am having serious leaking issues that is disrupting my sleep and causing a great amount of stress for me. My Ahi has been fine, that isn't the issue it is just being constantly waking up and feeling so tired and exhausted from the disruptions. I have a bi pap auto from Phillips resperonics. 750p. my current pressure is e pap 13.0 cmh2o and i pap 17 ch h20. i have tired every full face mask avail at the sleep center. I just recently tried remzzz's and i find that they work for a bit but my mid night they are balled up and in my mask and the leakage continues around the bridge of my nose. I am hoping to find some sort of help with this to get this problem solved. Sleep for me has become an anxiety not knowing how i am going to feel in the morning. I look forward to all the help with this.

Joe

Pugsy · Post by **Pugsy** » Wed Dec 14, 2011 9:41 am

Anything that causes frequent awakenings... even minor leaks are unwanted. Major leaks can impact therapy and wake us so they are obviously unwanted also.

Please register and then add your equipment to your profile as I have done with mine. It is hard to give specific ideas about how to improve leaks without knowing exactly which mask you are using and even which masks you have tried and failed with. "Every full face mask at the center" doesn't really tell us a lot. We have no idea what is at the center.

Perrybucsdad · Post by **Perrybucsdad** » Wed Dec 14, 2011 9:45 am

Have you considered a nasal mask? I thought I couldn't use one as I described myself as a mouth breather, but after I tried a nasal pillow, I haven't gone back. One other thing I noticed is I was able to reduce my pressure, making my nights and morning much more enjoyable and I can achieve the same AHI or better. I know when I was at the higher pressures I was not very comfortable, and in the morning I always had to deal with the aerophagia as a result.

John

joeschmo0391 · Post by **joeschmo0391** » Wed Dec 14, 2011 10:08 am

I registered but don't see where i update my profile. i am currently using the full life full face mask. I have also tried the quatro, i can't remember the other ones i have tried i am sorry.
I know also that a nasal mask won't work for me.

Pugsy · Post by **Pugsy** » Wed Dec 14, 2011 10:44 am

This link explains how to add your equipment to your profile. Please use the text option because with the Icony we can't see the model names without clicking on the link and model name is important (and we are a bit lazy when it comes to clicking on links )
wiki/index.php/Registering_Equipment_in_User_Profile

I don't use a full face mask so I am unable to offer any hints on how to make them work better. Sorry about that but the other members who do use or have used the mask you use can offer ideas.

If you are lucky your machine will have data available so you can see at least if the leak is bad enough to impact therapy negatively...or if you just need to make some minor adjustments so it doesn't wake you so much.
Software is available for some machines (free) and this is why we need to know model of machine. Not all machine models collect the data to monitor leak.

Perrybucsdad · Post by **Perrybucsdad** » Wed Dec 14, 2011 10:48 am

joeschmo0391 wrote:
I know also that a nasal mask won't work for me.

Why do you say that?

joeschmo0391 · Post by **joeschmo0391** » Wed Dec 14, 2011 11:09 am

because i have a hard time breathing through my nose while awake. Even the sleep center feels the same way.

joeschmo0391 · Post by **joeschmo0391** » Wed Dec 14, 2011 11:20 am

Everything is updated that i know.. So i hope that a solution for this can be found and i will be able to sleep all night leak free and not have to wake up.

Pugsy · Post by **Pugsy** » Wed Dec 14, 2011 11:24 am

joeschmo0391 wrote:because i have a hard time breathing through my nose while awake. Even the sleep center feels the same way.

I am going to mention something and it may or may not relate to your not being able to breathe through your nose during the titration sleep study.

First of all..I normally breathe through my nose just fine during the day. I don't have any physical impediments in the nasal passageway nor do I have any particular nasal congestion from allergies.

I went to titration study and they put an over the nose mask on me first. Within about 3 minutes my nose became completely totally occluded. I am one of those people who the least amount of pressure on the sides of my nostrils, where my turbinates are, causes immediate congestion. Even the weight of glasses will do it somewhat.

I made the tech remove the over the nose mask....immediately I could breathe again. So I requested nasal pillow mask..no more pressure on the turbinates and no more congestion and I did just fine the rest of the sleep study. No need to even think about going with full face mask.

If you can normally breathe through your nose just fine during the day....try this...press your fingers against the sides of your nose up above the nostril part. Does it create congestion? If so it is possible that the inability to breathe is related to the pressure on the turbinates like with me.

If you have other physical reasons why you cannot normally breathe through your nose even during the day then obviously a nose only mask will not work and you do indeed need a full face mask and unfortunately they are simply harder to get a good seal sometimes simply because more surface area to create a problem.

I mention this turbinate pressure thing because it is actually quite common and easily remedied if that is the only issue.

Pugsy · Post by **Pugsy** » Wed Dec 14, 2011 11:30 am

You have the PR S1 BiPap Auto and Encore Viewer 2.0? Have you used the software to evaluate the magnitude of the leak? Is it large enough to impact therapy? Or is it just enough to be annoying and wake you up?

Have you tried one of the Hybrid masks? There are 2 brands. Innomed Hybrid and the ResMed Liberty?
They are full face masks since they cover the mouth but use nasal pillows to cover the nasal interface. Less surface area to have to try to seal.

What pressure settings are you using on your machine? Is it possible that in auto pressure increases that the pressure is creating the leak? How do you adjust the fit of the mask? At full pressure or at ramp pressure or no pressure?

Perrybucsdad · Post by **Perrybucsdad** » Wed Dec 14, 2011 11:33 am

Joe, if possible, could you upload an image of a typical night of sleep for you. I'd be interested to see the various waves to see if anything jumps out at us.

John

joeschmo0391 · Post by **joeschmo0391** » Wed Dec 14, 2011 11:37 am

i have tried the hybrid list, my leak and ahi had gotten much worse. Within the current leak problem my ahi isn't being affected its just affecting my sleep. I haven't downloaded this program yet, but I am going to the sleep center at least once a week and every time i go in they down load list.

They hybrid mask i used was the liberty.

epap 13 cm h20
ipap 17 cm h20
this is the only info i was able to find in regards to pressure so i hope that helps

joeschmo0391 · Post by **joeschmo0391** » Wed Dec 14, 2011 11:40 am

I forgot to ad that I adj my mask before doing the ramp so the pressure is at its highest. And when i do adjust it i have to have it so tight that i wake up with marks and sores all over my face.. and if i don't have it tight it will leak a lot worse then what it does now.

Pugsy · Post by **Pugsy** » Wed Dec 14, 2011 11:49 am

You have software choices available right now to see your reports.
I have examples here. viewtopic.php?f=1&t=64906&st=0&sk=t&sd= ... re+options

Personally, I would suggest giving SleepyHead a try. It is free and not nearly the PITA that Encore is (I use them all).

http://sourceforge.net/projects/sleepyhead/

User Guide
http://sourceforge.net/apps/mediawiki/s ... sers_Guide

I will bow out of mask fit discussion since I already gave my one and only idea.
There is an anti leak strap that has helped several members.. Enables mask to be secure but not have to be so tight because too tight doesn't let the mask float like it should.
http://www.padacheek.com/PAC_AntiLeak_Strap.html

Again pressures used can make a difference when using auto mode, especially at higher pressures. Just the variations in auto mode can make keeping a good seal difficult at any pressure. Too much variation.

Perrybucsdad · Post by **Perrybucsdad** » Wed Dec 14, 2011 11:52 am

Let me ask this then... how do you know you are leaking?

I'm not that familiar with your mask, but most masks work on the same principal in that a cushion of air is what helps seal the mask. I know when I used my Mirage quattro FX, if I crunched down the straps too tight, it would leak worse. It seems intuitive to since it down real tight, but in actuality it makes things worse.

I'm not saying to make it so loose that wind blows all over the place, but loosen it maybe just a little. Janknitz has an excellent article that she wrote (http://tinyurl.com/2ft3lh8) that will help you tame the mask. It is written for a different FFM, but the concept is the same.

Also, without seeing data, it's really hard to help. If you could try and get the software and upload an image, we could help you a lot more. Without seeing this, I think most of us will be unable to help.

John

major leaking issue

major leaking issue

Re: major leaking issue

Re: major leaking issue

Re: major leaking issue

Re: major leaking issue

Re: major leaking issue

Re: major leaking issue

Re: major leaking issue

Re: major leaking issue

Re: major leaking issue

Re: major leaking issue

Re: major leaking issue

Re: major leaking issue

Re: major leaking issue

Re: major leaking issue