Chin strap with ResMed AirFit N20 mask (Gary Aikin)

I've been on CPAP since December 8th and my daily reports at ResMed.com/myAir indicate I perhaps have fairly high mask leakage levels. My mask (a ResMed AirFit N20 nasal mask) works fine. As far as I know there is no leakage from my mask cushion. Although for the most part I am not a mouth breather at night, I have noticed that a few times most nights I do find myself breathing through my mouth a bit. I'm guessing this is why high leakage levels are being reported for me. Since starting CPAP my levels have ranged from a high of 37 L/min to a low of 11 L/min. I've not experienced dry mouth from this.

Should I be concerned about these levels?

Can anyone recommend a good chin strap to use with the AirFit N20? Last night for the first time I used a chin strap, one I bought at my DME company. I had difficulty using the chin strap with my N20, but was finally able to get it on my face and used it all night. My reported leakage level for last night was 12 L/min -- maybe the chin strap helped a bit? (My levels for the previous four nights, without a chin strap, were 31, 20, 25 and 19.) The combination of the chin strap and mask left me with more marks on my face than without the chin strap, although not severe.

Also, when using a chin strap, is it best to have the chin strap over the mask or under the mask? The technician/co-owner at my DME company indicated I should have the chin strap over my mask, but this didn't work out well -- With the chin strap over my mask, the chin strap caused the straps of my mask to twist and warp. I thought this would cause leaks from my mask cushion, so I chose to wear the chin strap under my mask. From photos on the web, it appears that my chin strap is a Philips Respironics Premium Chinstrap. My chin strap is a wide chin strap with an adjustable back strap to help keep the chin strap in place.

GaryAikin wrote: ↑

Tue Jan 08, 2019 7:56 am

Since starting CPAP my levels have ranged from a high of 37 L/min to a low of 11 L/min.

Which number is the 37? Is it the median average...the 90/95% number or the maximum?
Do you ever wake up from any leaks...big or small?
Do you ever see any events flagged during times in large leak?...even if it's just a UA?

Chin straps are supposed to be "gentle" reminders to keep the mouth shut when it's jaw drop that is the primary problem. They aren't supposed to be vise grip tight.
Clench your teeth together...now breathe through your mouth...chin strap won't/can't stop that kind of mouth breathing and your jaw didn't even drop.

I was told by my DME to wear the chin strap under the mask strap. Makes sense. You don't want to have to take the chinstrap off if you need to remove your mask for some reason.