weight loss, mouth breathing, and pressure changes

[Chairman Meow]

I have actually had to tighten my headgear using the adjuster clip thingy that came with my last order, but I've been doing that as I lost weight. I actually got new headgear not too long ago, I noticed a better fit, but no change in the mouth breathing.

Here is my data from last night. I zoomed in on the 3am-10am section because that was when I was sleeping - though I was awake and talking to my husband from about 9:30am. I did test the new pressure for a little while (from 6-7pm) when I changed to autoset, but I wasn't sleeping then. I've noticed that most of my obstructive events seem to happen when I'm not asleep... like when I first put on my mask or after I'm awake in the morning. I think that I'm usually talking or still adjusting during these times... is it possible that these aren't actually events?

It looks to me like I still spent a pretty good amount of time with leakage (not as much as the previous night, but still more than I'd like) and I didn't wake up with dry mouth... but do these leaks still look like open mouth leaks?

[Pugsy]

Unfortunately it's impossible to know for sure if the leak is mask movement leak or mouth breathing leak unless you actually tape your mouth and have the tape be intact in the morning and you either still see the leak or you don't.

Last summer when I was trying the DreamWear gel pillows I was having some really big leaks and since I know that I sometimes mouth breathe I couldn't be 100% sure what the leaks were. I didn't think I was mouth breathing all that much (wasn't waking me up and no dry mouth) but the leaks were pretty bad so I opted to tape my mouth for one night just so I could know for sure where the leaks were coming from.
I fully expected the leaks to pretty much disappear but to my amazement they were still there in full force even with the tape in place so that means mask movement.
It wasn't a total surprise because I had an inkling that the small size gel pillows might be a bit too big for me and the DreamWear doesn't come in an XSmall size.
The mask movement leaks showed the same kind of plateau and peaks that we normally think of and want to blame on mouth breathing....so there's no way to know for sure unless a person tapes their mouth and the tape stays intact all night.

Visually from just looking at the graphs we can made some educated guesses as to the cause of the leaks seen but until you can actually for sure remove the mouth breathing potential with tape there is no way to know for sure.

[Pugsy]

Oh....it's not uncommon at all for awake breathing irregularities to get flagged as some sort of apnea event.
So yes,...you can get OAs, hyponeas or centrals while awake and while they show up on the AHI totals they aren't real and thus don't count in the overall evaluation process. The machine doesn't know sleep status or awake status. All it measures is air flow and sometimes our awake breathing is simply irregular and the machine thinks something is going on when it really isn't. We call it SWJ or Sleep/Wake/Junk and it has to be mentally removed/ignored from the evaluation process.

Did the leaking last night disturb your sleep...wake you up?

[Chairman Meow]

I actually slept really well, the leaks did not affect my sleep... but I still wanted to see if it was mouth breathing, so I taped my mouth last night... and this was my new graph.



So I'm thinking that it was probably mouth breathing. However, since it didn't negatively affect my sleep... I will be laying off the tape tonight. While the previous nights leaks did not negatively affect my sleep, it took me forever to fall asleep with the tape on my mouth.

I'm very interested to see how continued weightloss will affect my pressure needs in the future, since just losing 40lbs reduced my pressure needs from 12 to a max of 8 last night with a 0 AHI. I'm hoping to be one of the lucky few who can reverse the OSA with weightloss, but I will be fine if that's not the case. Thank you for all of your advice and guidance.