Pressure leaks and overall chart review

[breathingenthusiast]

I've been using CPAP for "mild" sleep apnea for a couple of months and it has been life-changing. However, my OSCAR graphs show significant pressure leaks. I've attached the reports from the past couple of days. I have it set to a fixed pressure of 8.0 because it was chasing leaks in APAP mode. I don't have insurance so I bought a used machine on Craigslist and self-titrated.

I also don't sleep soundly through the night. I tolerate the CPAP itself quite well, but I tend to wake up and just sort of lie there about halfway through the night, going in and out of sleep. I still feel much more rested than pre-CPAP, and never need to take the multi-hour daytime naps that I used to. I've been sleeping (or not sleeping) like this for years though, and it's not as bad as it was pre-CPAP.

I do get nasal congestion during sleep, but when I tried turning the humidity down, my sleep wasn't any better (probably worse) and I would get bad dry mouth. I've even taken Afrin to see if eliminating the nasal congestion would fix the leaks and it did not. I also tend to get reflux (but not heartburn) when I sleep.

I would be very grateful for any insight you can provide on the leak issue or if you notice anything else.

[Dog Slobber]

I bought a used machine on Craigslist and self-titrated

Good job, proud of you!

graphs show significant pressure leaks

The graphs show significant leaks, your the one who's cocluded they are pressure leaks. 8cm is fairly low pressure and not generating a lot of pressure to blow through unless the mask is loose.

Consider:

• tightening your straps
• changing cushions size
• mouth tape
• trying the p30i, they are compatible with the n30i mask and many believe they have a better seal.

[breathingenthusiast]

Oh, I guess I thought all leaks were inherently pressure leaks, but now I see the distinction. Thank you very much for your help. I will try your suggestions and report back. Is there a way of discerning whether the leak is a mask leak or a mouth leak by looking at the graphs?

[Pugsy]

Is there a way of discerning whether the leak is a mask leak or a mouth leak by looking at the graphs?

Unfortunately there's no real way for the machine to differentiate between mouth breathing leak or mask movement leak .

A leak is a leak to the machine no matter where it is from.

BUT unless you are waking up from whatever leak you have you can't tell. If you are doing a LOT of mouth breathing it might cause a lot of dry mouth sensation so that might give you a hint as to what is going on.

While your leak line on the graph reports is ugly looking it really never reaches large leak territory and if you are sleeping soundly it isn't enough to make a negative impact on the therapy itself. ResMed has a conservative line in the sand for leak report of 24 L/min and as long as you stay below 24 L/min leak line your therapy (and leaks aren't waking you up) then I wouldn't worry about it. It's an ugly leak line for sure but not big enough to be a negative impact on the therapy itself. My leak lines are always ugly but rarely cross into large leak territory (exceeds 24 L/Min) so I don't worry about what is causing the leaks.

If you were wanting a nice 0.0 leak line....unnecessary worry. I have had them on occasion which makes me assume mine are mask movement leaks because if I can get a nice low leak line I figure it is most likely mask movement because I don't use a full face mask and I don't tape my mouth shut or do anything to keep the mouth shut.

Now if you want to experiment to see if you are for sure mouth breathing or not you could tape your mouth shut for one night and make sure the tape doesn't come loose and then see what the leak line looks like. That's what I did years ago just to answer the "is it mouth breathing or mask movement question".....and with mouth taped and still in place the next morning so no chance of any mouth breathing and I still had some fairly ugly leak lines....so my leaks were mask movement leaks.
Answered that question so I just shrug my shoulders and move on.

[breathingenthusiast]

Yeah, that makes sense. I wondered if there was some kind of signature in the graph that could help distinguish the type of leak. But regardless, I'm glad to know that the 24 L/min threshold is fairly conservative and an ugly leak line doesn't mean the therapy is compromised.

I tried mouth taping for a few nights and the graphs do look a lot better. But it's not particularly comfortable, so knowing I don't need to worry about it is reassuring. Thank you so much for your help!