Trilogy help

My mom has been put on the Trilogy unit at night. She has secondary pulmonary hypertension and sleep apnea. We almost lost her a month ago, but seems to be on the upswing. However, she is having so many issues at night with her Trilogy machine/mask leaking. Once she falls asleep, she opens her mouth and the seal breaks, causing a loud annoying sound! It wakes her up and she tries to readjust the mask, however, once she falls back to sleep, same scenario again. My dad is not able to fall back asleep at night once he is woken up therefore he is not getting any sleep. My dad says that my mom is snoring and that's making noise also. When I slept with her one night so he could rest, I didn't hear snoring. But I didn't sleep either.... way too noisy! Any suggestions on how to keep the seal from leaking? She has 10 different mask at her house from her cpap and bipap machines. This has been a long exhausting struggle. She called me today crying and said that she dreads night time, knowing that no one will be able to sleep.


HELP!!!

There's a couple of us that have a Trilogy here. Madalot I know is experienced with it too..

If she's opening her mouth you can try two things: Full face mask and / or a chin strap. The chin strap solution is common among those who only use nasal masks. IF she's already using a FFM and still opening her mouth, then the addition of the chin strap could aid in preventing this.

There are couple FFM models that extend over / below the chin as well. These are the Fisher & Paykel models (Flexifit 431 /432 and Forma) and the Hans Rudoloph 7700 V2 (has a chin cup).

If she's still snoring with the machine on and working normally then her EPAP may need to be raised, so bring this up with the doctor. Madalot has been experimenting with the AVAPS-AE setting which claims to aid in automatically maintaining the integrity of the airway in a similar way to auto adjusting xPAP's.

It would be helpful to know what the settings are on your mom's Trilogy. Knowing what type of pressures she's dealing with could be helpful in getting a solution to this problem. Also, what mask is she using? I know that I had a horrible problem with leaks until I found my mask.

Like your mom, my mouth falls open the moment I fall asleep. I'm using the F&P 431. It might be helpful to try to keep your mom on her side instead of her back.

As aytikvjo mentioned, I am currently experimenting with AVAPS-AE, a setting that automatically adjusts EPAP pressure. I'm doing this for back sleeping & snoring. It DOES seem to help.

If your mom is using a FFM, then a cervical collar would help with the jaw drop and avoid the pressure that moves the jaw back slightly. Pulling back on the jaw has a tendency to increase obstructive events and is normally not a problem with nasal masks.