New to CPAP need some reassurance and guidance

Hello, I’m writing because like many other’s I’m having a terrible time adjusting to my cpap. It’s been six weeks since I started and it’s taken two days to find a moment of energy to write this. I hope this post is not to long and rambling but I to tired to write coherently.

I’m 51, 6’2, 176lbs male. I’m in good shape. I run, hike and until recently generally have a lot of energy.

About two years ago I started snoring which kept my wife awake. I also started noticing that I was not feeling as rested after 7-8hrs of sleep as I use to feel and was wanting to sleep late more often. I mentioned this my doctor and she sent me in for a sleep test.

The result was sleep apnea 18 AHI and a cpap was recommended. I was surprised but after reading how bad sleep apnea can be for ones health I was grateful that there is solution.

I was handed a Resmed 11 and a P30i nasal mask with very little direction about what to expect or even on how to use it and sent home. I was not even told that I needed to keep my mouth shut with a nasal mask. I discovered that myself online some days later. I’ve quickly realized that I am going to have to manage this myself as my sleep clinic has not been very helpful.

Needless to say I’ve been having a hard time sleeping with the mask. I’ve had rainouts, leaks, sore nose, etc. Slowly I’m learning to to mitigate these things thanks to all CPAP boards and reddit.

I have used my cpap almost every night over that last six weeks from 4-7 hours. I’ve taken a few nights off. I do feel a bit more rested when I take a break, even half a night off. My AHI fluctuates from 5-11. Leaks are all over the place. One night the medium cushions work and the next night I can’t get a seal and have to us the large ones. I have the mask on loose that helps but I get leaks, especially when I sleep on my side. I just got some mouth tape hopefully that will help. having to fiddle with my mask to fix leaks throughout the night is really what keeps my up. The mask itself and the noise I can get use to. My cpap was set 5-9 and recently changed to 7-12 by my Dr.

I plan on getting Oscar in the coming days and using it and also plan on trying some different masks. I'm just to tired to mange it right now though I’m determined to master this thing.

The main thing I’m concerned about today in the crushing fatigue I’m experiencing since starting CPAP.

Prior to CPAP I had some trouble waking up and would usually crash at around 10am experiencing fatigue and difficulty focusing. I would not usually need to nap but it I did it would help. I also found myself wanting to go bed at around 8pm. A few years ago my wife had a hard time getting me to get to bed by 11pm.

Since starting cpap I have to nap 1-2 times a day. At first naps helped but now I only nap around 15-20mins but still feel exhausted and lay in bed to tired to move. More exhausted than sleepy.

In short, the exhaustion/sleepiness has gotten worst and worst. I actually have many of the symptoms that I read that people who suffer from severe sleep apnea have. Wanting to fall asleep driving, cognitive issues, feeling weak, headaches malaise etc. I have a 5 year old and I’m struggling managing her care. The other day I had a friend drive her to school for I felt unsafe driving.

Yesterday I was starting to think that maybe there is something else wrong with me. Fortunately I had a full physical a month ago with blood work and at that point everything was normal.

The main thing I’m concerned about today, right now, is the crushing fatigue I’m experiencing since starting CPAP. Is this sort of fatigue normal for someone who are just starting out with CPAP? Is it normal to feel SO much worst even six weeks into cpap treatment. My sleep doctor told me it often gets worst before it gets better. I don’t think it can get much worst and I’m thinking of taking 3-4 days off Cpap to catch up even it have sleep apneas.

Any input would be appreciated!

bmjnyc,

Welcome to the forum

bmjnyc wrote: ↑

Fri Mar 24, 2023 1:28 pm

Hello, I’m writing because like many other’s I’m having a terrible time adjusting to my cpap. It’s been six weeks since I started and it’s taken two days to find a moment of energy to write this. I hope this post is not to long and rambling but I to tired to write coherently.

For a first time poster, you've done a good job of giving us enough of the back story as well as a list of your problems. In other words, you're off to a good start.

I’m 51, 6’2, 176lbs male. I’m in good shape. I run, hike and until recently generally have a lot of energy.

About two years ago I started snoring which kept my wife awake. I also started noticing that I was not feeling as rested after 7-8hrs of sleep as I use to feel and was wanting to sleep late more often. I mentioned this my doctor and she sent me in for a sleep test.

The result was sleep apnea 18 AHI and a cpap was recommended. I was surprised but after reading how bad sleep apnea can be for ones health I was grateful that there is solution.

Sounds like your doc did a good job of listening when she sent you for the sleep test. I was 52 when I was diagnosed. I was (still am) a petite-sized woman: I weigh around 110 lbs and I'm 5'1" tall (on a good day). It's important to remember not everybody with OSA fits the stereotype of overweight, inactive middled-aged man.

I was handed a Resmed 11 and a P30i nasal mask with very little direction about what to expect or even on how to use it and sent home. I was not even told that I needed to keep my mouth shut with a nasal mask. I discovered that myself online some days later. I’ve quickly realized that I am going to have to manage this myself as my sleep clinic has not been very helpful.

Pretty much par for the course. Glad you found us.

Needless to say I’ve been having a hard time sleeping with the mask. I’ve had rainouts, leaks, sore nose, etc. Slowly I’m learning to to mitigate these things thanks to all CPAP boards and reddit.

The learning curve is steeper for some folks than it is for others. Glad you think you are making progress on these issues.

I have used my cpap almost every night over that last six weeks from 4-7 hours. I’ve taken a few nights off. I do feel a bit more rested when I take a break, even half a night off. My AHI fluctuates from 5-11.

That treated AHI combined with usage of (only) 4-7 hours may be part of why you are still tired. Of course, you're also having trouble sleeping with the mask, and so when you do keep the mask on all night, you probably still feel like you were wrestling with an octopus on your nose all night long and that you kept waking up to fight the octopus and that it was tough to then get back to sleep with that octopus on your face. Been there, done that, and have the scars to prove it.

But unfortunately taking breaks, even a half night off, allows the part of your brain that is still having trouble grappling with the idea of sleeping with an octopus on your face for the rest of your life to win out. In other words, as nice as it is to take that break, it's not helping you learn to sleep with the mask. And that's a real problem because the sad fact is you probably won't feel better until you learn to sleep well with the mask, all night every single night. We can help you with that problem.

Leaks are all over the place. One night the medium cushions work and the next night I can’t get a seal and have to us the large ones. I have the mask on loose that helps but I get leaks, especially when I sleep on my side.

So what's the problem with using the large nasal pillows every night? If you can get the large ones to consistently seal and the medium ones only seal on some nights and not others, that's a pretty good indication that your nose needs the large nasal pillows. Don't fight that, just use the large pillows.

It's good you realize the mask needs to be loose. I don't use the P30i, but I have used (and still sometimes use) the similar P10 and my usual goto mask is the Swift FX. In all these masks, you need to remember that the pillows need to rest on the outside rim of the nostrils: only the very tippy-tips of the cones go into your nose.

I'm predominately a side sleeper. I have found that I need an asymmetric adjustment to the back strap on my masks. You might try tightening the strap on the side closer to the bed more than the side that's closer to the ceiling. Or you may find that what works for you is the other way round: tighten the strap that's closer to the ceiling more than the one that's closer to the bed. Try it both ways and be sure you are lying down in bed while you are fiddling with the straps. I'd also suggest spending some time fitting the mask far away from bedtime so that you can really pay attention to what you are doing with each adjustment. When you find something that seems work, start moving around to see whether you get a lot of leaks and whether you can fix the leaks by just pulling the mask away from your nose just a bit and then letting it go. (More on this in a bit.)

If you haven't tried the Lanisoh trick, that's also worth doing. Lanisoh is a lanolin cream sold to breast feeding mothers to soothe their sore nipples, so you find it in the baby aisle of most grocery stores and drug stores. Dabbing a bit of Lanisoh around the nostrils not only will soothe sore noses, but it also is just a bit tacky to the touch, and that tackiness can help with getting a nasal pillows mask to seal well.

The P30i you are using also has the hose attachment at the top of your head, and the air flows through the hollow tubes on the sides of the mask. Since you are a side sleeper, it's worth considering if how you are sleeping is forcing much more (all?) the air to go through just the tube that is on the ceiling side of your head, and if it is whether this might be contributing to additional leaks when you are rolling around in bed from side to side. So you might want to consider trying a mask with the hose that attaches at the front (like the P10). I run my hose under the covers and essentially "hug" it all night long. So that makes turning over pretty easy.

I just got some mouth tape hopefully that will help. having to fiddle with my mask to fix leaks throughout the night is really what keeps my up. The mask itself and the noise I can get use to.

First a question: When you wake up to a leak, how much fiddling do you have to do to try to fix the leak? And how long would you say you have to fiddle with the mask during a typical wake?

Second a suggestion: I have found that most of the time I can fix a small, but annoying leak without the need to rouse all the way to wake. Here's how I do it: When I wake up feeling like there's a leak, I just pull the pillows off my nose by a fraction of an inch. I have to be prepared for a blast of air, however. When I feel that blast of air, I just let go of the pillows and they naturally settle back down against my nostrils and better than 90% of the time, there's no more leak. And I just go back to sleep.

So try that approach. Before starting to play with the straps, first just pull the pillows away from your nose by just a fraction of an inch and be prepared to feel a blast of air. Then let go of the pillows, allow them to settle back against your nose all by themselves, and allow yourself to go back to sleep. Once you've mastered it, the whole technique can be done in less than 30 seconds, and you can be back asleep within a minute.

My cpap was set 5-9 and recently changed to 7-12 by my Dr.

Sounds like the doctor is a bit worried about your AHI still being 5-11 with the machine. And that's a good thing---it means the doc is on top of looking at AHI data and not just the usage data.

I plan on getting Oscar in the coming days and using it and also plan on trying some different masks. I'm just to tired to mange it right now though I’m determined to master this thing.

Installing Oscar is not difficult. And loading the SD card data into Oscar is not difficult. Understanding what the Oscar data says does take some time, but post screen shots and we can help.


Now we come to the meat of your current issue:

The main thing I’m concerned about today in the crushing fatigue I’m experiencing since starting CPAP.

Been there, done that, have the scars to prove it. AND I did get through it with a lot of help from cpaptalk.com. It does get better, but it can take a while. But it still sucks to be in that small group of PAPers who seem to feel worse after start using the machine. In my case it took a good 6 months before I was honestly able to say I was beginning to sometimes feel better with CPAP than without it.

Prior to CPAP I had some trouble waking up and would usually crash at around 10am experiencing fatigue and difficulty focusing. I would not usually need to nap but it I did it would help. I also found myself wanting to go bed at around 8pm. A few years ago my wife had a hard time getting me to get to bed by 11pm.

So you were symptomatic and your symptoms of untreated OSA were getting worse. Focus on that for a minute and write a note to yourself about just how bad you felt before CPAP.

Since starting cpap I have to nap 1-2 times a day. At first naps helped but now I only nap around 15-20mins but still feel exhausted and lay in bed to tired to move. More exhausted than sleepy.

I'm glad you understand there is a difference between being exhausted and sleepy. CPAP treats sleep disrupted breathing and the problems it typically causes with daytime sleepyiness, which in turn can lead to a feeling of exhaustion. But it only treats these problems if the user is sleeping well with the CPAP. And right now, you're still having a lot of problems with CPAP-disrupted sleep since you are waking up and fighting leaks for much of the night. Fix the biggest leaks and learn how to quickly manage the smaller ones without needing to wake all the way up, and in time you will be sleeping well with the CPAP.

But you're not there yet. And in the meantime, you're dealing with this:

In short, the exhaustion/sleepiness has gotten worst and worst. I actually have many of the symptoms that I read that people who suffer from severe sleep apnea have. Wanting to fall asleep driving, cognitive issues, feeling weak, headaches malaise etc. I have a 5 year old and I’m struggling managing her care. The other day I had a friend drive her to school for I felt unsafe driving.

I've been there and done that. I had a total crash and burn that set in by the third day of PAPing. Six weeks in, I was miserable, had people at work asking me what was wrong, and already had multiple "emergency" meetings with the PA in the sleep doc's office and was being told the PA thought I needed to do another in-lab sleep test for a bi-level titration because she was out of ideas on why I so miserable from the aerophagia and the increased night time wakes and the excessive daytime sleepiness (complete with micronaps while teaching my classes).

The main thing I’m concerned about today, right now, is the crushing fatigue I’m experiencing since starting CPAP. Is this sort of fatigue normal for someone who are just starting out with CPAP? Is it normal to feel SO much worst even six weeks into cpap treatment.

It's not unheard of, but it is a bit unusual. It is tied, of course, to how quickly one gets to the point of being able to sleep through the night with a reasonably normal number of wakes/arousals rather than repeatedly waking up all night long with problems that have to be fiddled with in order to fix them. Some of that is a person's own sensitivity to certain kinds of problems---most of us are capable of sleeping through a minor leak, but some folks wake up with every single tiny leak. Most people can sleep through a bit of rainout, but some people are faced with dealing with waking up with a soaking wet nose, and that's going to bother anybody. Some people have major problems with aerophagia (that was my big issue), and others never wake up with a bloated belly.

So you are a bit of an outlier in terms of how long it's been since you started CPAP and how bad you are feeling right now, but the problems you are dealing with are not unheard of and there are folks who have had transitions that have been as bad as yours is (or worse) and still wound up becoming happy PAPers. So don't give up.

My sleep doctor told me it often gets worst before it gets better.

At least your doctor didn't lie. My first sleep doc told me I'd feel better within a week. And he passed me off to a PA rather than dealing with me himself once it was clear I was getting worse, not better. And eventually he had that PA fire me as a patient because I was not getting better fast enough for him to make money off of me as a patient.

I don’t think it can get much worst and I’m thinking of taking 3-4 days off Cpap to catch up even it have sleep apneas.

I would advise against taking 3-4 days off CPAP right now: That's enough time that you will basically be going right back to Square 1 in terms of training your body to sleep with this octopus on your face.

I would suggest the following things:

1) Keep a simple log on how good/bad you are feeling each day, along with how good/bad you slept during the night. Sometimes the initial improvement in how your are feeling can be so subtle you might miss it unless you are keeping a log. I had super bad insomnia at the same time I was trying to learn to CPAP, and the first sign that PAPing was doing something positive was when the note, "Woke up without hand/foot pain this morning" started appearing 2 or 3 times a week in my sleep log. I would suggest a Keep It Simple kind of log. Record the following things on paper or in a spreadsheet on the computer:

• When you went to bed and when you got out of bed
• Estimated it took you to get to sleep---if you think your spending a lot of time tossing and turning at the beginning of the night.
• Estimated number of wakes---guess about this, don't keep records. But if you remember waking up 4 or 5 times to fiddle with the mask and once to go pee, then saying 4-6 times is fine.
• Rate how you felt on waking: 0 = Lousy, 5 = Great. The goal is to move from lots of 0's and 1's to mostly 3, 4, and 5's. But seeing more 3's that 0's is progress.
• Rate how you felt during the day: 0 = Lousy, excessively sleepy/exhausted, 5 = Plenty of energy. The goal is to move from lots of 0's and 1's to mostly 3's, 4's and 5's. Seeing more 2's and 3's than 0's and 1's is progress.
• Any notes that you think are important

2) Use the log to prepare for calling the sleep doc's office and to prepare for your next appointment with the sleep doc if you have one. The log will let you document just how bad you are feeling right now and whether anything is getting better.

3) Try using just the large nasal pillows for a while. If they don't leak, but the mediums do, then using the large will fix one problem.

4) Get Oscar and download your data. Then post a few screen shots of some daily data and we'll talk you through what it means. Let us see the leak graph and we'll tell you whether the leaks are so bad that they're affecting the efficacy of your therapy or whether the main problem with your leaks is that they're waking you up even though they're not bad enough to worry about in terms of the efficacy of your data.

5) Consider what you are doing in terms of bed pillow arrangement and bed covers: Sometimes leaks are the result of a mask getting shoved out of place by the bed pillow. A CPAP pillow with cutouts can help with that. Sometimes exhaust venting from a mask can bounce off the bedcovers and feel like a leak when there's not actually a leak.

5) Try some other masks. You might want to try a mask that doesn't have the hose attach at the top of the head. You might want to try a nasal mask or a nasal cradle mask. You might want to try a full face mask. Mask comfort is in the nose of the PAPer.

6) When you need to whine about how bad you are feeling and you need some support, post here.

Thank you so much for such a thorough and thoughtful response to my post! Very encouraging. I only had time to glance at it this evening but will respond and answer some the questions you asked in the coming day or so. Many thanks!

Terrific advice from robysue1, as always! One quick question: during your recent medical work-up, were you tested for such conditions as anemia, thyroid problems, low testosterone, and autoimmune disease? I ask because you describe yourself as being exhausted and weak, along with experiencing daytime sleepiness.

Hello, I managed to figure out OSCAR yesterday. I used the mask fitting suggestions last night and had the best night I've had yet. I slept through the night and was able to quickly fix any small leaks. I woke up around 5am and my cpap reported that my mask had a good seal through the night. However I went back to sleep for an hour or so and when I woke up the cpap reported that I had a bad seal.

I've also started a sleep journal as was recommended. Here is a link to my Oscar data. Hopefully I did everything correctly!


https://imgur.com/a/q4169Pu

It's great you've started using Oscar!

I'm not sure why you got an OK on leaks when you woke up around 5 a.m. You have large leaks off and on throughout the night.

It sounds as though you're sleeping through the leaks, which is good, but they're often high enough that the machine isn't able to compensate for the lost pressure. So they do need work, and you might review robysue1's message to get some ideas about this.

One question: do you wake up with a very dry mouth? I'm trying to figure out whether some of your leaks might be mouth leaks.

Your AHI isn't great, but I wouldn't worry so much about that right now. The central apneas are pauses in your breathing of 10 seconds or more when there's no obstruction in your airway. CAs often follow arousal breathing; when that happens, the real problem is the arousal and not the CA itself. As you start sleeping better, the CAs may well subside on their own. You had a cluster of OAs that apparently woke you up. The clustering may indicate that you rolled onto your back or tucked your chin down toward your chest. Do either of those possibilities sound likely to you?

Thanks so much for your input and interpretation of my of my Oscar data!

I did not realize that I had leaks all night. I did and will continue to try robysue1's suggestions for leaks. I'm starting to think nasal pillow masks are not for me which is a shame. I find myself not wanting to move or shift position in bed to avoid leaks which is not great. I do wake up with a dry mouth, usually its the back of my mouth or throat. Feels like a sore throat. I was thinking of getting some mouth tape. I may try with a band aid tonight.

As far as the cluster OAs I do move around a lot in my sleep. More than most I think and have been told.

I guess the good news is that slept though the nigh which is a first thus I feel more rested today than I have since I started CPAP.

Thank you again for your time, I really do appreciate it!

Yes, before you give up on nasal pillows, do try taping your mouth. You might want to invest in a box of Somnifix strips. They're pricey, but they're gentle on the skin and hold well (unless there's a lot of saliva). If the taping idea seems to work, you can buy cheaper tape in rolls.

You might also try a couple of other things:

1. Tongue position. 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.

2. Collar. If your jaw tends to drop down during the night, pulling your mouth open, then a soft cervical collar, or a firmer snore collar, can be a big boon. More here:
http://www.apneaboard.com/wiki/index.php...cal_Collar
A collar might also help you with positional apnea clusters, if you find one that's comfortable for you.

3. Although chin straps tend to pull the jaw back, which is not helpful, the Knightsbridge Dual Band strap has a design that pulls the jaw straight up, which makes it a possible alternative to a cervical collar.

bmjnyc wrote: ↑

Sun Mar 26, 2023 6:54 am

I've also started a sleep journal as was recommended. Here is a link to my Oscar data. Hopefully I did everything correctly!


https://imgur.com/a/q4169Pu

bmjnyc,

Here's what that data looks like:


You've got a significant leak problem. You are in Large Leak territory for about 50% of the night. That's a lot of large leaks that just can't be ignored.

Which set of nasal pillows did you use on this night? The medium one or the large one? You had said that the large seemed to leak less, and I'm wondering if you used the medium ones on this night.

Mouth breathing might be part of the culprit, and mouth taping if you are willing to could help.

But some of those large leaks are really constant large leaks. In other words, mask fit also needs to be considered. Did you roll over in bed and somehow push the pillows partway off the tip of your nose and trigger a leak? And if the pillows are too small for your nose, they can get pushed partway into the nostril and this too can trigger a leak.

bmjnyc wrote: ↑

Sun Mar 26, 2023 6:54 am

Hello, I managed to figure out OSCAR yesterday. I used the mask fitting suggestions last night and had the best night I've had yet. I slept through the night and was able to quickly fix any small leaks. I woke up around 5am and my cpap reported that my mask had a good seal through the night. However I went back to sleep for an hour or so and when I woke up the cpap reported that I had a bad seal.

Mr. Red Frowny Face shows up when you are leaking at a rate of 24 L/min or more for 30% of the night. My guess is that when you first woke up, your large leaks were just under 30%, and the leaking for the last hour pushed the rate up into the territory where Mr. Red Frowny Face appears.

Miss Emerita wrote: ↑

Sun Mar 26, 2023 8:07 pm

2. Collar. If your jaw tends to drop down during the night, pulling your mouth open, then a soft cervical collar, or a firmer snore collar, can be a big boon. More here:
http://www.apneaboard.com/wiki/index.php...cal_Collar
A collar might also help you with positional apnea clusters, if you find one that's comfortable for you.

I tried a cervical collar to keep my mouth closed, on a suggestion from a forum member, and it did the trick. I wear a full fade mask, but my mouth was opening and causing a very dry mouth. The collar had an unexpected effect as well. I like sleeping on my back, but that would cause my AHI to go way up, so I avoided it. With the cervical collar, I can sleep on my back for most of the night and still keep my AHI below 1.0, often quite a bit below it. (Last night, 9+ hours with AHI of 0.)

Earlvillestu, thanks for sharing your experience. I find it fascinating that you got help both with the dry mouth and with the AHI during back-sleeping. I'm going to tuck that nugget away!

Basic Facts: 51, 6'2, 175lbs, 18AHI

please excuse this rambling post but I'm so tired I'm struggling putting my thoughts together.

So I'm back after a few days, still exhausted and frustrated with CPAP. I've only skipped 4 days in 8 weeks. I even use it for naps. I'm still feeling much worst than I did prior to starting CPAP. I've been on CPAP 8 weeks and it's only getting worst. Just 8 weeks ago I was running four miles 4x a week. I was functioning a pretty high level, though over the last few years I noticed some extreme morning tiredness and cognitive stuff that was affecting work day. I always had to go to bed very early. Since staring CPAP I've been utterly exhausted and sleepy all the time. Luckily I'm not working in my field as if I was I would have to take leave. I feeling all the extreme effects of lack of sleep and sleep apnea that I read about. The other day I had to nap in my car after dropping my daughter off at school. Once I got home I spent the whole day on the sofa until pick up time. Sometimes I get worried that something else is wrong with me but having recently had my physical with blood work I think tis is all a result of lack of sleep or bad sleep.

I will say that at this point I'm use to my P30I mask and the CPAP noise does not bother me anymore. I've also figured out the nasal pillows and don't get many audible leaks and when I do I can easily reseal the pillow even when half asleep. After seven weeks of CPAP my DR noticed lots of leaks. About a week ago he told me to try taping my mouth. I did that for a few nights reflected in the the OSCAR charts I posted. Even with tape my leaks are very hight 45-50 L/M. I don't understand how that's possible. I am not waking up with my mask of my face. Sometimes I wake and I can hear small nasal leak and fix it. My mouth is totally tapped shut. However even with these hight leak rates I'm getting the lowest AHI yet.

I wonder if something is wrong with my machine/hose/mask. I often wake about 3-4 hours after falling asleep and check my leak numbers. Last night they were at 45L/m and in morning it was the same number. However when I look at my leaks on Oscar it shows that I was having leaks well after I checked my leaks on machine but the number is the same?

Any input would be greatly appreciated!

PS- my doctor has prescribed a sleeping aid to "help me get over the hump" hope it helps!

https://imgur.com/a/q4169Pu

bmjnyc wrote: ↑

Thu Apr 06, 2023 9:40 am

Even with tape my leaks are very high 45-50 L/M. I don't understand how that's possible.

Because there are other places for masks to leak besides out the mouth.

bmjnyc wrote: ↑

Thu Apr 06, 2023 9:40 am

However even with these high leak rates I'm getting the lowest AHI yet.

So....during the times when you see the leak being above 30-35 or above it is possible that the lack of flagged events simply means the leak was so bad for so long that the machine couldn't sense, record or respond to any events that might have happened. It is possible that you had apnea events go unflagged because the machine was clueless as to what was going on because of the leak. Is the AHI low because nothing happened or is it low because some stuff didn't flagged????

If you are taping your lips and the tape isn't coming loose then the cause of your leaks isn't mouth leaking...it's from something else. Mask movement (a fitting problem) would be my primary suspect if we know for sure the tape didn't come loose.
Not to mention that amount of large leak so often and so prolonged can sure impact overall sleep quality.
I bet you are waking often and that alone trashes sleep quality and will sure impact how you feel during the day.
You aren't getting enough good solid sleep for the restorative powers of sleep to work their magic.
If we could evaluate sleep stages that you are having...I bet a significant reduction in the deeper stages of sleep and/or REM is a factor in how you feel.

You need to continue to work on getting the leak situation under better control. If the leaks were more constant I might suspect a hole in the hose or a connection not being sealed but the leak is intermittent and when I see that I always think mask movement issue first. If you can't snug the mask up better because of comfort....maybe a different mask is needed.
Not all masks work well for all people.

As others have mentioned, finding the right mask for your face and your sleep habits can call for persistence in the quest.

Two masks for you to consider:

First, the Aloha mask, which has a bit more structure than your current mask. The hose is traditional, but you can route it up to the top of your head by using a little loop on the top strap. The mask can be fiddly to take apart and reassemble, but if it solved your leak problems, that might be worth it.

The other mask is the Bleep. You use ports that stick to your nose and then an interface that either snaps onto the ports (original Bleep) or fastens via magnets (Bleep Eclipse). There are many fans of the Eclipse here; for me and some others, the original Bleep works better. The original Bleep takes practice to use -- the snapping in bit can be fiddly -- and the Eclipse solves that problem. For some, like me, the downside to the Eclipse is too much noise and some discomfort. (But some people don't experience an increase in noise.)

Miss Emerita wrote: ↑

Thu Apr 06, 2023 11:17 am

For some, like me, the downside to the Eclipse is too much noise and some discomfort. (But some people don't experience an increase in noise.)

I wish I could figure out why the Eclipse is noisy for some and not others because then we might be able to do something about it. My Eclipse is totally silent. I can't even manipulate anything to make it noisy with the exception of maybe some little bit of extra breathing noise if I get my arm or the bed covers too close to the vent holes....even then the little bit of noise I might get is far from being a deal breaker like it is for other people.

I don't know what is going on. Might just be one of those individual things. I couldn't stand any of the F30i, N30i or P30i masks because of that annoying darth vadar breathing noise. For me it was so loud there was no way I could/would sleep with it yet there are other people who either can't hear that noise or it just isn't a problem for them and they sleep through all of it. I didn't like the "i" series masks enough to bother with trying to figure out a solution either. So I am not going to bother trying to fix a problem that just presents with those masks because I won't use them anyway. They just aren't up near the top of my mask preferences list. There's one thing on my preferences list that is a deal breaker and that is the "stuff" on my face and head that I personally find annoying to me. The fact that others don't have the same annoyance factors is just part of cpap life....everybody is different in multiple ways.