Long time user with increased leakage

I've been using Cpap for over a dozen years. Sufficiently comfortable and apnea well treated with an average of one event per night. For years the leak rate was 0 to 3% over red line.
A year ago I started taking Zepbound. Not because of sleep apnea, but because of a heart issue exacerbated by too much weight. The year went along and I lost 60 pounds. Now over the last few month the leak rate is 16-25%.
The two masks I've used are P10 and P30i with medium nasal pillows. The pillows seem like they fit well. Masks have always slid around on the back of my hair (a chin length bob) which is less than idea but I don't think it is causing the current leaking problem.
I know there is a possibility that my apnea status has changed. I'm not interested in stopping cpap. I have a deviated septum and having air blow in when I'm horizontal is great for me.
Has anyone had a problem where a mask suddenly starts leaking? Are there other masks I should be considering?
Thanks for any ideas. This group is the best.
Claire

Have you checked the hose to make sure it hasn't developed a small hole in it?
I had that happen to a hose that I had used for years. Small tiny hole and I couldn't feel a leak anywhere but when I filled the hose with water dripped out in one little tiny spot.

How old is the hose? Do you have a spare hose you could swap out and try?

Are you sure you mouth is staying closed? Might try taping it shut for one night to make sure the leaking is from mouth opening.

How far over the 24 L/min line are you going? How long is it above 24 L/min?

Oh Pugsy, Thank you for that good idea. I will check that today. I've never had a system for replacing the hose, so honestly I have no idea how long it's been in use. But I do know I have several extras, which might be a clue that it's been a while.
I use a mask with pillows because the full face felt too claustrophobic. But I do open my mouth so I started taping years ago. Numerous iterations of what to use for taping but my current and most favorite is a roll of silicone tape from Amazon that I cut pieces off and just use a piece vertically, at the center. Works great.
Thank you Pugsy for all your hard work here and all your experience and cleverness. You are a godsend to all of us.
Claire

Pugsy, I loved your idea that it might be the hose, but it wasn't that. After putting new hose on the % of time over red leak line was still high.
So the next night I used mouth tape and completely covered my mouth rather than a N/S strip in the middle. No change.
I use Medium sized pillows on the P30I and I have a test Large and Small coming in next shipment from DME to experiment. With the weight loss it is true that my face is less pudgy than it used to be. Now I'm wondering if the nasal pillow gets dislodged when I turn (fairly often) from side to side as I sleep (arthritis in hips).
Back to some more experiments.
Claire

elizabeth25 wrote: ↑

Thu Aug 06, 2026 6:53 pm

I've been using Cpap for over a dozen years.

are you using the same machine you started with?

Do an experiment while awake.
Use the machine for at least 30 minutes while awake and absolutely not asleep.
Use your usual mask and set up so you know with absolute certainty nothing is leaking.
Then pull the SD card and use OSCAR software to look at the leak line.
You are using a SD card and OSCAR aren’t you?

Since I last wrote I've been in and out of town. Not the best time to experiment, but I did anyway.
Zonker, this is a machine I've had for about 3 years.
In the interim I tried Pugsy's idea of mask on while awake. No leak at all.
On my P30i mask I tried both the large pillows and small pillows but went back to medium. Small was almost good but it hurt intermittently, which woke me up.
I was actually experimenting on two machine because I have a second machine that I keep at a weekend place. Both are air sense 10. One is regular and one is "For Her". For the For Her machine I had it set to the For Her setting. For the other I had it on the regular setting. On both machines I have the range at 6 to 16. I don't remember how I came to settle on that. Long ago.
What I got to wondering about was what would happen if I played with that. So I changed the For Her to APAP and changed the regular one to "soft". Bingo. It is the only variable I've changed that had any impact on leaks. On both machines leaking was substantially lowered.
I'd never played with those settings because I didn't know what they were for. But somehow, 60 pounds later, this is working better.
Thanks for your help Pugsy. It kept me looking.
Claire

i'm happy it worked out for you!

I’ve been on a CPAP for around 15 years and have had leakage around the mask. I’ve tried sewing the straps to a small degree of success but it looks unsightly.
What I finally have found is that if I punch a hole in the straps with a leather punch or something similar-after fitting and adjusting, I use Chicago screws and they look good and the leakage has ceased. The Velcro just doesn’t hold up even with a new mask.