Why are large leaks back again??!!

Dear forum friends,
I have been away from the forum because after months and months of trying different masks to solve my large leak issue, I thought I was okay. Weeks on end of 0 large leaks! And what a difference it made. I felt rested and alert the next day.
When they started to come back, I discovered that when I place the hose directly behind my head I did better. Then the hose fell off the mask at the top where it connects to my under the nose mask. So I started taping it on. I did okay for a while like that but over the past three weeks or so my leak rate started going up again. All this time I have continued to use the same Dreamwear under the nose mask.
My large leak rate varies from 5 to 12. And because I don't feel as well the next day I have concluded that even a large leak rate of 4 or 5 negatively impacts me.
So I'm back to square one.
I am attaching two recent OSCAR data reports, in case there is something I am missing. One has 0 large leaks. The other 5.4.
Today when I removed the tape from my hose connection (connection to mask not machine) the hose fell off. So maybe I need to buy a new hose? Could it be as simple as that?? Please, please!
Any advice would be much appreciated. My AHI readings are great - I just wish I could solve the leaking.
Thanks so much.


Res. Med. Airsense 10 Autoset for Her
Philips Res. Dreamwear Under the Nose Mask

I can’t help with reading the OSCAR graphs, I’ll leave that to others.

Regarding the reoccurrence of large leaks, I have similar issues pop up on occasion using a P10 or N30i mask. For me it is caused by one of:

1. The cervical collar I use to keep my mouth closed is not positioned correctly or needs to be replaced which allows my jaw to drop
2. My mask has face oils on it or needs to be replaced and does not stay in position so when I move during sleep it slides around
3. I unintentionally get the hose trapped under me and I pull the mask off when I move

All wake me up and my sleep is not as good those nights as a result. I have to reset everything and go back to sleep, sometimes without even realizing it

I know it is frustrating!

How old is the frame and headgear strap?
How old is the nasal cushion?

Pugsy,
I just replaced the nasal cushion. I am not sure of the age of the frame -- will check with supplier when they open tomorrow. It's been longer for the strap. It looks a little worn out. Basically I order replacements when I'm "due" (insurance).

Jlfinkels,
Thanks for sharing about your experiences with mask leaks. I can see how any one of those could be my problem. The thing that jumped out at me most was what you said about the cervical collar and your jaw dropping down. I use a chin strap, which kept me from mouth breathing, but it is getting worn out a bit after many washings. I have noticed recently that the dryness in my throat is very bad, so much so that last night I had a dream of choking! Could that be from mouth breathing?
Also, what you said about face lotions. I am not going to use any tonight to see if anything changes. Also, because the under the nose mask creates a pressure sore at the bottom of my nose, I have been using an ointment that nursing mothers use for tender breasts. I put a dab of that under my nose, then a small cotton ball. This has helped my nose sore but I wonder if these two things are causing my mask to slide around. A lot to think about.
Would love to hear your take on those ideas.

Are you sure you don't have acid reflux (GERD) that could be affecting your throat - very common with apnea for some reason and would need to be addressed separately by your MD.

I have tried the Dreamwear under the nose cushion mask. It was back when it was first released.
Your leaks look an awful lot like mine did early on when I was first experimenting and hadn't figured out proper tension of that strap plus I was trying the medium frame which was simply a bit too large for my small head.

So my first thought is mask movement leaking especially since you are also reporting the long hose wants to fall off.
Sounds like something is stretched out causing mask to simply move around a lot.
It also sounds like even small leaks can be disturbing sleep quality.

Do you have a spare new hose to try ?

As for the frame I don't know how much (if at all) it might have stretched.

I do know those back head straps will definitely stretch and need to be replaced. A lot of headgears use a similar back strap. Eventually they just lose all tension and you can't get it back. First thing to try ....wash that elastic in really hot water to see if you can shrink it any.

Peacenana wrote: ↑

Sun Aug 29, 2021 7:19 pm

Jlfinkels,
Thanks for sharing about your experiences with mask leaks. I can see how any one of those could be my problem. The thing that jumped out at me most was what you said about the cervical collar and your jaw dropping down. I use a chin strap, which kept me from mouth breathing, but it is getting worn out a bit after many washings. I have noticed recently that the dryness in my throat is very bad, so much so that last night I had a dream of choking! Could that be from mouth breathing?
Also, what you said about face lotions. I am not going to use any tonight to see if anything changes. Also, because the under the nose mask creates a pressure sore at the bottom of my nose, I have been using an ointment that nursing mothers use for tender breasts. I put a dab of that under my nose, then a small cotton ball. This has helped my nose sore but I wonder if these two things are causing my mask to slide around. A lot to think about.
Would love to hear your take on those ideas.

My response is strictly based on my experiences. I tried a variety of chin straps but have to tighten them so much that I got marks on my head. The cervical collar, which took about a week to get used to wearing, functions by filling the gap from chin to chest which makes it difficult to drop my jaw. As a result I rarely get any leaks, but when I do they are minor. The collar also helps keep my neck in good alignment so I don't get many events from a collapsed airway as a result of dropping my head. On my Resmed Airsense 10 autoset I use climate control and humidity on auto, which typically sets it to 81 degrees Fahrenheit and humidity on 4. That along with keeping my mouth closed has stopped dry mouth syndrome. I also sometimes use Biotene mouthwash and toothpaste when my allergies are really bad to help with dry mouth.

Consider trying a Resmed N30i or P30i mask as it gives a different fit than a Dreamwear (which I have no experience with as I only use Resmed masks). I have not tried Lanisoh type products as I just switch to a different mask when I get a sore nose (P10 to N30i).

Listen to the advice from the folks on this board. They have been using CPAP a long time in many cases and have a wealth of experience that was a big help to me.

Thank you, everyone. This is such valuable information and a great comfort to know I'm not alone.
I am happy to report that over the past two nights I have had a large leak rate of less than 1% and less leaking in general. I changed out the hose (tubing), mask frame and found a behind the head strap that was less worn (thank you, Pugsy!). I also ordered new supplies including mask frame, head strap, nasal cushions and tubing.
Jlfinkels, I took your advice and stopped putting on face lotions at night. Also tightened up my chin strap. I have tried many masks but the Dreamwear under the nose seems best for me. I will check but I think my climate control and humidity settings are on auto. I use the Biotene every night but still suffer from dry mouth although it has been better over the past two nights.
The sore nose persists but I use Aquaphor on it and that seems to soothe it.
So far so good. . .

Peacenana wrote: ↑

Tue Aug 31, 2021 6:39 am

Thank you, everyone. This is such valuable information and a great comfort to know I'm not alone.
I am happy to report that over the past two nights I have had a large leak rate of less than 1% and less leaking in general. I changed out the hose (tubing), mask frame and found a behind the head strap that was less worn (thank you, Pugsy!). I also ordered new supplies including mask frame, head strap, nasal cushions and tubing.
Jlfinkels, I took your advice and stopped putting on face lotions at night. Also tightened up my chin strap. I have tried many masks but the Dreamwear under the nose seems best for me. I will check but I think my climate control and humidity settings are on auto. I use the Biotene every night but still suffer from dry mouth although it has been better over the past two nights.
The sore nose persists but I use Aquaphor on it and that seems to soothe it.
So far so good. . .

Good news. It is a learning process as we try different things to find what works for each of us.

I am no expert, but understand from another forum that large leaks are only a problem if they occur during 20% or more of any given -- versus 5% in the first OSCAR chart posted above. So maybe this isn't a problem unless it is waking you up.

clownbell wrote: ↑

Tue Aug 31, 2021 4:02 pm

I am no expert, but understand from another forum that large leaks are only a problem if they occur during 20% or more of any given -- versus 5% in the first OSCAR chart posted above. So maybe this isn't a problem unless it is waking you up.

Well...any leak no matter or big or small that someone feels is messing with their sleep it unwanted and thus can't be ignored.

Did you miss this comment from the OP?

Peacenana wrote: ↑

Sun Aug 29, 2021 2:58 pm

My large leak rate varies from 5 to 12. And because I don't feel as well the next day I have concluded that even a large leak rate of 4 or 5 negatively impacts me.

Friends,
Update on my leaking problem: it is back!! Ugh!! It started slowly after I made the adjustments that Pugsy and others suggested. A few great nights and I felt rested. Then the large leaks started to creep in again, low at first, leading up to last night's over 16% and I feel exhausted. I am posting last night's OSCAR data. Is there anything else you can recommend for me?
Thank you so much.

It seals well for about half the night then things go to hell. If you can't figure out what is happening when it goes to hell then maybe it's time to explore other mask options.

To fix a problem one must first identify the problem.