Gurus please help, Issue with Resmed S10 autoset and P30i

Hello all, I have come across a real issue in the past week and have no idea which way to turn.

I will start off saying my max pressure is set to 16

I am using the Resmed S10 with a Resmed Airfit P30i nasal pillow mask and chin strap. I was booked in for surgery last Thursday and was told that I would have to use my CPAP while in hospital for the 5 days.
After surgery, I used the machine and found with the hospital beds all the adjustments you can make to them I adjusted the bed in such a way I did not need my chin strap as I did not breathe through my mouth at all by the look on it, that's the only thing I could put it down to.

The first 3 nights were not an issues I was getting AHI readings of below 1 (Normally below 3.5) and leak rates of 0 (Normally below 3), I was in heaven, on the 4th day I was moved to a different room, the hospital staff unplugged the CPAP and moved it for me (along with the bed I was sleeping in)

I will preface with during the early days of getting CPAP if using a nasal mask if I slept with my mouth open the sound of the escaping air would wake me and the wife every time, but I do wake sometimes for no reason at all.
Here is where the trouble starts.

That night for some reason I could not get comfortable and when woken during the night by the nurse for an OB’s check I had a very dry mouth and slight leak from one of the nasal pillows, I had a little trouble resealing the mask but it ended up ok.

At that stage, I thought the honeymoon was over and I need my chin strap again, the next morning checking my stats I had a very high leak rate of 31L and an AHI reading of 1.1

I left hospital on Sunday and finally got home.

That night the chin strap was back on and in my own bed I headed off to noddy land, again during the night I woke with a very dry mouth and a really small leak from one of the nasal pillows which resealed easily. Checking the stats showed a high leak again, AHI was 1.1 and leak 25L

The next 4 nights were the same with AHI’s below 2 and leaks above 25L(with this mask I have not had this issue before)
I have tried retightening the mask and the chin strap but has not made a difference

What could have changed to cause this issue?

Here is an update

I have had the data from the machine analyzed by my sleep tech, what she has said is the leak rate is not constant and the way its charted is consistent with mouth breathing.

I decided to do away with the chin strap and try mouth tape, I tried it out and it seals very well. I woke three times during the night with severe dry mouth, the mouth tape was completely sealed, I tried blowing through my mouth and could not, I woke this morning and it was still sealed and though I was going to rip my lips when removing it.

I am completely lost, I have eliminated mouth breathing as an issue, I am sure the mask is not leaking but I am getting dry mouth

Dry mouth can happen for any number of reasons and be unrelated to cpap use or mouth breathing.
Medication side effects is probably the most common cause.
Other health issues another cause.
Maybe hydration issues....maybe something related to your recent procedure...maybe related to medications you were given when in the hospital that aren't totally out of your system.

Frustrating and annoying for sure.
You might try some extra hydration at night...review your medications to see if any of them could possibly be a factor and maybe change dosage times...might even do what a lot of cpap users do who battle dry mouth..they add one of those oral hydrating products like Biotene.

Sounds like the air is coming from your nose into your mouth maybe. It's problem a lot of people have. Maybe someone smarter than me can tell you how to fix it. I've heard holding your tongue to the roof of your mouth helps but I'm not sure how to keep that up when you're asleep. I just use a full face mask because I can't stop it.

glenncol wrote: ↑

Fri May 10, 2019 5:55 pm

Hello all, I have come across a real issue in the past week and have no idea which way to turn.

I will start off saying my max pressure is set to 16

I am using the Resmed S10

There's no such thing as a "Resmed S10", there are however, a whole bunch of different Resmed AirSense, AirCurve, and even AirStart 10 machines.

Which exact one do you have?

palerider wrote: ↑

Fri May 10, 2019 7:16 pm

glenncol wrote: ↑

Fri May 10, 2019 5:55 pm

Hello all, I have come across a real issue in the past week and have no idea which way to turn.

I will start off saying my max pressure is set to 16

I am using the Resmed S10

There's no such thing as a "Resmed S10", there are however, a whole bunch of different Resmed AirSense, AirCurve, and even AirStart 10 machines.

Which exact one do you have?

Resmed S10 Autoset

Pugsy wrote: ↑

Fri May 10, 2019 6:24 pm

Dry mouth can happen for any number of reasons and be unrelated to cpap use or mouth breathing.
Medication side effects is probably the most common cause.
Other health issues another cause.
Maybe hydration issues....maybe something related to your recent procedure...maybe related to medications you were given when in the hospital that aren't totally out of your system.

Frustrating and annoying for sure.
You might try some extra hydration at night...review your medications to see if any of them could possibly be a factor and maybe change dosage times...might even do what a lot of cpap users do who battle dry mouth..they add one of those oral hydrating products like Biotene.

Hi, yeah hydration is no issue for me i drink approx 4 liters of water per day and prior to going to bed i drink a 600ml bottle of water.

This issue has only start in the last week, as mentioned i used tape to seal my mouth to eliminate mouth breathing causing the dry mouth but i still had a high leak rate of 30L and dry mouth

tyrone747 wrote: ↑

Fri May 10, 2019 6:44 pm

Sounds like the air is coming from your nose into your mouth maybe. It's problem a lot of people have. Maybe someone smarter than me can tell you how to fix it. I've heard holding your tongue to the roof of your mouth helps but I'm not sure how to keep that up when you're asleep. I just use a full face mask because I can't stop it.

Hi, yeah o have never had this issue until last week

If you are getting your leak numbers off the machine's LCD screen then you need to realize that it might not be as nearly bad as the numbers initially appear.
On the LCD screen the machine reports what is called a 95% number. The definition of a 95 % number is where we are at OR BELOW for 95% of the night. That "or below" part of the definition is very important and often people don't understand it or they forget about it.
That 95% number is NOT where we spent 95% of the night and it isn't an overall average either. It's really just a number that is easily skewed to the high side by relatively short periods of time in large leak.

I have a good example here in this thread...95% number was a whopping 48 L/min but if you look at the actual graphs...I really didn't spend all that much time in large leak territory.
viewtopic.php?f=1&t=108724&p=1036669&hi ... t#p1036669

Your worry about leaks might be unwarranted.

Pugsy wrote: ↑

Fri May 10, 2019 8:15 pm

If you are getting your leak numbers off the machine's LCD screen then you need to realize that it might not be as nearly bad as the numbers initially appear.
On the LCD screen the machine reports what is called a 95% number. The definition of a 95 % number is where we are at OR BELOW for 95% of the night. That "or below" part of the definition is very important and often people don't understand it or they forget about it.
That 95% number is NOT where we spent 95% of the night and it isn't an overall average either. It's really just a number that is easily skewed to the high side by relatively short periods of time in large leak.

I have a good example here in this thread...95% number was a whopping 48 L/min but if you look at the actual graphs...I really didn't spend all that much time in large leak territory.
viewtopic.php?f=1&t=108724&p=1036669&hi ... t#p1036669

Your worry about leaks might be unwarranted.

Hi mate, yeah i hear you

What concerns me is that up until last Saturday my leak rates were under 3L and no dry mouth ever using CPAP, then over night it has been above 25L and dry mouth every night , something must have happened

My unit is still using water so humidity is being generated , you can feel the tube being heated so that is working