Is my pressure considered a 'high pressure', plus mask woes

[wannasmile]

My APAP avg pressure is 18. Would that be considered a relatively 'high' pressure?
At this pressure is it common to have problems finding masks that work?
Are leaks common?
What about discomfort/pain due to the pressure distorting the face?

Some of you may remember all of the mask problems I've had due to the shape of my nose / face / etc which has made it impossible to find a full face mask that fits. The only mask I can wear is the airfit nasal pillow but it doesn't fully treat me because my mouth opens up, and nothing I've tried has fixed that either. And I have problems with breathing through my nose (it stuffs up a lot and when I lay down especially). I have occasionally found some full face masks that were "close" to working, but then when the pressure on the machine creeps up it starts to leak too much and then I have to tighten it and then it hurts. Latest mask I'm trying is the Resmed Mirage Liberty hybrid thingy with the mouth piece and the nasal pillows. Same problems as all the other masks.

Aside from the nose and face shape issue, with full face masks, I also find it extremely uncomfortable how the air blows into my mouth and makes my cheeks puff out. It kind of hurts after a while, not to mention the in/out pufferfish effect keeping me awake and being annoying.

Long story short, I'm wondering if the pressure I'm dealing with is commonly associated with inability to get a good mask fit and inability to be comfortable.
Any ideas what to do about the leaking, discomfort, pufferfish effect?

I'm essentially ready to give up for good and never try anything again and just use the nasal pillow for the rest of my life despite my sleep apnea not being fully treated.

p.s. I apologize for the negativity but I'm feeling very sad and defeated and tired of all of this, not to mention having the sleep apnea symptoms still of anxiety/fatigue etc

[Pugsy]

18 cm or anything in the high teens is considered high but did you know there are people who use over 20 cm pressure all night?
Some machines will go to 30 cm.
It does present extra challenges for sure though especially when we can't keep the mouth shut.

[chunkyfrog]

I see you have been a forum member since 2017.
Has this always been the case, or are you returning to cpap after a "hiatus"?

[ChicagoGranny]

My APAP avg pressure is 18.

I was prescribed a bilevel machine with pressure 24/18. This high pressure was difficult. I started using a foam cervical collar. Now, with a pressure of 10.0 minimum and average around 11.0, I have few problems.

[Miss Emerita]

Are you doing some things to unstuff your nose? I just read a post from Chicago Granny with a link to some good information about nose vs. mouth breathing:

https://www.cnn.com/2020/08/20/health/h ... index.html

Here are some things to try, if you haven't already:

* See an allergist and start treatment any allergies you may have. Allergy shots would treat the allergies themselves; the allergist might also prescribe symptom-relieving medications.

* See an ENT doctor to see whether you have structural problems in your nose or lower down in your airway.

* Use a rinse like NeilMed regularly. It's available in most drugstores. Don't use it in the couple of hours before your bedtime; you want to be sure all the liquid has a chance to drain out.

* Use over-the-counter Flonase, which will reduce any swelling you may have in your nasal passages. Use it in the evening, maybe an hour or two before bedtime, to give you maximum help at night. It takes a couple of weeks to kick in, so be patient with it.

* Some people report that their nose will clear out with a pillows mask if they give it 20 minutes or so to do its work.

But maybe what I should have written first: do you breath through your nose or your mouth during the day?

[wannasmile]

I see you have been a forum member since 2017.
Has this always been the case, or are you returning to cpap after a "hiatus"?

Always been a problem since the very first time I started treatment.

[wannasmile]

My APAP avg pressure is 18.

I was prescribed a bilevel machine with pressure 24/18. This high pressure was difficult. I started using a foam cervical collar. Now, with a pressure of 10.0 minimum and average around 11.0, I have few problems.

Could you please share more info about this foam collar? How is it used? What is the purpose in the context of sleep apnea? Thanks

[wannasmile]

Are you doing some things to unstuff your nose? I just read a post from Chicago Granny with a link to some good information about nose vs. mouth breathing:

https://www.cnn.com/2020/08/20/health/h ... index.html

Here are some things to try, if you haven't already:

* See an allergist and start treatment any allergies you may have. Allergy shots would treat the allergies themselves; the allergist might also prescribe symptom-relieving medications.

* See an ENT doctor to see whether you have structural problems in your nose or lower down in your airway.

* Use a rinse like NeilMed regularly. It's available in most drugstores. Don't use it in the couple of hours before your bedtime; you want to be sure all the liquid has a chance to drain out.

* Use over-the-counter Flonase, which will reduce any swelling you may have in your nasal passages. Use it in the evening, maybe an hour or two before bedtime, to give you maximum help at night. It takes a couple of weeks to kick in, so be patient with it.

* Some people report that their nose will clear out with a pillows mask if they give it 20 minutes or so to do its work.

But maybe what I should have written first: do you breath through your nose or your mouth during the day?

Thanks
My nasal stuffiness is not as big of an issue as the problems of 1. pressure being too high and 2. the masks not fitting my face due to my nose shape and such.
Regarding nasal stuffiness, the airfit nasal mask forces the air really good so usually I can breathe through my nose at the higher pressure.
I have multiple issues causing the nose stuffiness and other problems. I have a narrow palate and deviated septum, among other things.
The other stuff like sinus rinses and sprays and meds don't do anything for me, probably because the issue is primarily structural. That said there may be other medical issues which make it worse at times.
I just went through the link you posted and ended up on an interesting video about taping the mouth shut. I've always been scared to try it because I was afraid if my nose got stuffed up then I'd suffocate. Some people are saying you don't have to tape the entire mouth shut, just the middle of the lips. I might be willing to try this but I doubt it will work due to the high pressure on my machine (it will just blow the air out any open spaces).
During the day I breath through both my nose and my mouth depending on various factors. I am a shallow breather in general probably due to high stress and tension

[ChicagoGranny]

Could you please share more info about this foam collar? How is it used? What is the purpose in the context of sleep apnea? Thanks

Foam cervical collars will hold the neck and head in the best position for airway patency. They also will prevent jaw drop.

There are several brands. Here is one that I like. My advice is to start with a 3-inch firm collar. You may need to go to 3.5 or 4.0 inches after some experience. It's a cheap trial. Collars are also available in most drug stores, but they are usually medium and not firm. Medium is probably OK for a trial, but for me, firm works best and lasts longer.

https://www.amazon.com/Coreline-Cervica ... ef=sr_1_14

[Miss Emerita]

If you can keep the air from going into your mouth in the first place, it won't blow out through your lips. You might want to start practicing this method:

Try putting the tip of your tongue behind your upper front teeth. Then position the main part of your tongue up against your upper palate. Finally, give a little suck or swallow to create a bit of suction. You should now be able to open your mouth while breathing entirely through your nose. Practice this during the day, and see if you can get it grooved in deeply enough to help while you are asleep at night. For some people, this is really all it takes to avoid mouth leaks.

Chicago Granny's suggestion will help make sure your jaw won't drop and break the seal your tongue is making.

Taping can be helpful in some circumstances, but if you have a lot of air going into your mouth, and your lips are taped closed, you will wind up with "chipmunk cheeks."

[wannasmile]

Could you please share more info about this foam collar? How is it used? What is the purpose in the context of sleep apnea? Thanks

Foam cervical collars will hold the neck and head in the best position for airway patency. They also will prevent jaw drop.

There are several brands. Here is one that I like. My advice is to start with a 3-inch firm collar. You may need to go to 3.5 or 4.0 inches after some experience. It's a cheap trial. Collars are also available in most drug stores, but they are usually medium and not firm. Medium is probably OK for a trial, but for me, firm works best and lasts longer.

https://www.amazon.com/Coreline-Cervica ... ef=sr_1_14

Thank you so much! I will look into this!

[wannasmile]

If you can keep the air from going into your mouth in the first place, it won't blow out through your lips. You might want to start practicing this method:

Try putting the tip of your tongue behind your upper front teeth. Then position the main part of your tongue up against your upper palate. Finally, give a little suck or swallow to create a bit of suction. You should now be able to open your mouth while breathing entirely through your nose. Practice this during the day, and see if you can get it grooved in deeply enough to help while you are asleep at night. For some people, this is really all it takes to avoid mouth leaks.

Chicago Granny's suggestion will help make sure your jaw won't drop and break the seal your tongue is making.

Taping can be helpful in some circumstances, but if you have a lot of air going into your mouth, and your lips are taped closed, you will wind up with "chipmunk cheeks."

Thank you! This is excellent information!

[ChicagoGranny]

if you have a lot of air going into your mouth, and your lips are taped closed, you will wind up with "chipmunk cheeks."

I'm wondering if Somnifix strips avoid that problem? They do have a small vent.

[Miss Emerita]

You'd think they would, but my own experience is that no air ever goes out the little vent, even if I try. I think it has something to do with the pursing of the lips before application of the strip.