OA or Large leak?

I have been experimenting with my cpap machine tuning for almost a month now. Thanks to all the tips found in this forum, I have made a lot of progress. I started with 8 AHI and I am now able to keep it around 2 without interrupting my sleep.

Here is what I have done so far. I first got the my AHI down to 4 by changing my mask type to nasal. Then got it down to 3 by increasing min pressure. I noticed no matter how I increase the pressure, my OA would not go below 2. So the decided to try disabling EPR, that helped me get OA below 0.5 and as a result AHI to 1.

However, I am now stuck in a state where if I disable EPR, I can get OA to close zero, but will get multiple large leaks (>10%) and woke up multiple times at night due to dry mouth. If I enable EPR, I can get large leak down to 0.03%, sleep through the whole night without dry mouth, but OA will get above 1, which results in double AHI.

I have also tried taping my mouth with EPR on, it helps a little bit with the dry mouth, but large leaks are still there. And I obviously would prefer not having to do this every night. Setting EPR to 1 seems to have the same effect as disabling EPR, i.e. multiple large leaks.

Any tips on what I can do to keep both OA and large leak low? Thanks in advance

Unless you totally tape your mouth shut, that still leaves some amount of leaking through the mouth, and it appears that's what's happening from what you're saying.

Others have used a cervical collar to try to manage chin-drop, and also using a chin strap may help. I've used a chin strap successfully at the highest pressure my current machine can do (the machine I'll be using will change next week...) but keep in mind, that's using a FFM. The question is, is the leak coming right out of your mouth, or your mask solution, or a combination of the two? If you're lucky, you'll be awakened with a leak in progress and be able to identify which of those it is.

Welcome to the forum.

This is what wins hands down for me....

dave2008 wrote: ↑

Sun Dec 02, 2018 2:49 am

If I enable EPR, I can get large leak down to 0.03%, sleep through the whole night without dry mouth, but OA will get above 1, which results in double AHI.

Good solid sleep always wins in my book because how I sleep and how I feel trumps everything.

That double AHI...is it composed of OAs and hyponeas primarily or how many central apneas are mixed in?
More pressure won't fix centrals anyway.
More pressure will of course reduce OAs and hyponeas but if the more pressure needed to get a near perfect AHI creates more problems than it fixes...then it's not worth it.
More pressure is accomplished by either reducing or eliminating EPR or increasing the overall pressure when using EPR.

Doubling a very low 1.0ish AHI to 2 ish....insignificant difference as long as a person is sleeping well and feeling decent.
I wouldn't go chasing numbers....I always chase good sleep first.

But if you just HAVE to chase near perfect numbers.....I need to see some detailed reports to get an idea what to maybe offer.
And we need to know if those events flagged are real or not. If they aren't real and are maybe related to normal arousals that we have during the night...more pressure won't fix those. Going to extra ordinary measures could end up causing more sleep issues.
See this page...read and watch the videos so you can learn to distinguish real vs not real flagged events.
http://freecpapadvice.com/sleepyhead-free-software

welcome to the zoo!

a couple of things, if i may-

an alternative to taping or chin strap-

viewtopic/p1089718/viewtopic.php?f=1&t= ... s#p1086296

also, may i recommend xylimelts? it's a lozenge that helps promote saliva. it's a small bit that fits between teeth and cheek, though some say gum and cheek. helps me fight that dry mouth feeling. it's otc and should be found in either your local grocery or drugstore in the oral health section.

i use both of the above plus a foam cervical collar and it helps me out tremendously.

lastly, if i may, when you have a moment could you go to your profile and enter you equipment? that way it shows up at the bottom of your posts, as it does on mine.

thanks!