Large Leaks Resmed ASV machine

I seem to be having numerous mask large leaks, mostly (not always) starting when the pressure goes up over 20. I get similar results when wearing a chinstrap or taping my mouth shut so pretty sure most leaks are actually "mask leaks". So, I would like to reduce the IPAP maximum somewhat to see if I can avoid some of the leaks. I have recently tried 4 or 5 different masks with similar results. My AHI's are almost always below 2.0 so I don't want to mess that up. Current settings on my Resmed ASV are are follows: EPAP 6.0 min, 15.0 max, PS 4.0 min, 15.0 max. Would a good starting point be to just reduce the maximums on EPAP AND PS to 10.0???? OR, is there a better way to do it??? Should I leave the minimum settings alone? I saw my sleep physician a few days ago and he is good with me experimenting with some adjustments.

How much leak?
Number, please.

Last night was pretty typical of many nights. 95% leak rate was 39.6 and time was 20.23%. Total AHI was 0.72 (4 events in 5.35 hours). Longest leak was about 27 minutes between 1:00-1:30AM and I was not aware of it.

It would probably help to see some Oscar screenshots or or SleepHQ share links so we can see exactly how the pressures are interacting over time. As you know, ASV machines undertake quite a dance of EPAP and IPAP going up and down in response to events.

The Resmed manual recommends that PSmax should not be lower than 15, which is your current setting. Depending on whether you're getting many apneas (which we can assume are obstructive) then lowering EPAPmax to limit your top pressure could help. You could also try ASV mode in lieu of ASVAuto to peg the EPAP and perhaps make it more comfortable.

As a general rule, you shouldn't adjust pressures to control leaks, but it seems you've exhausted your reasonable options in terms of masks.

Not sure what information you want to see, so here is most of it.

Just to see if I understand this correctly. If I left machine on ASV Auto and left PS at 4-15 and changed EPAP to 5 min and 5 max OR switched machine to ASV mode and set EPAP to 5 and PS at 4-15 they would both be the same. Either one would max out my pressure at 20. Not sure what you meant by "peg the EPAP".

bernieb wrote: ↑

Sun Sep 10, 2023 12:58 pm

I get similar results when wearing a chinstrap or taping my mouth shut so pretty sure most leaks are actually "mask leaks".

That mask is usually easy to get and keep a seal, even at high pressures. You might want to find it on YouTube and watch some videos on fitting and adjusting.

I'll let others continue the discussion on machine settings.

Do the leaks disturb your sleep at all? Wake you up much?

ChicagoGranny wrote: ↑

Mon Sep 11, 2023 4:32 pm

bernieb wrote: ↑

Sun Sep 10, 2023 12:58 pm

I get similar results when wearing a chinstrap or taping my mouth shut so pretty sure most leaks are actually "mask leaks".

That mask is usually easy to get and keep a seal, even at high pressures. You might want to find it on YouTube and watch some videos on fitting and adjusting.

I'll let others continue the discussion on machine settings.

I with around with Dreamwear cushion, N30i, N30 and about a week ago started using N20. I think the N20 may be the best for me but not sure yet.

Pugsy wrote: ↑

Mon Sep 11, 2023 5:54 pm

Do the leaks disturb your sleep at all? Wake you up much?

Leaks sometimes wake me up but am usually able to fall back asleep soon after, however, my wife complains about the leak noise more than I do. On occasion, I do sleep through most of the leaks.

bernieb wrote: ↑

Mon Sep 11, 2023 7:48 pm

Pugsy wrote: ↑

Mon Sep 11, 2023 5:54 pm

Do the leaks disturb your sleep at all? Wake you up much?

Leaks sometimes wake me up but am usually able to fall back asleep soon after, however, my wife complains about the leak noise more than I do. On occasion, I do sleep through most of the leaks.

Ahhh...disturbs the wife's sleep more than yours. That's a problem as well.

I will let you carry on. If it wasn't a problem for the wife or you I don't know that I would put a lot of effort on reducing that leak if it were me as long as I was sleeping good and feeling good.

But a problem for the wife makes it as important as if it were a problem for you. Her sleep is important too.

Pugsy wrote: ↑

Mon Sep 11, 2023 8:22 pm

But a problem for the wife makes it as important as if it were a problem for you. Her sleep is important too.

happy wife, happy life.

Interesting results. Sunday night only slept for about 3.5 hours. Last night thought I should take some sleep medicine (Dr. prescribed). Slept 8.55 hours. AHI's were 0.0. Only about 4% large leaks with longest at 4 minutes (95% at 24.0 or below). Seriously....the best night's sleep I have had in at least two years.
Don't like taking drugs (I am a pharmacist). Perhaps I don't need to be messing around with lowering mask pressure. Maybe the best solution for me would be to purchase a pair of diamond studded ear plugs for my wife.
Bernie

zonker wrote: ↑

Mon Sep 11, 2023 8:24 pm

Pugsy wrote: ↑

Mon Sep 11, 2023 8:22 pm

But a problem for the wife makes it as important as if it were a problem for you. Her sleep is important too.

happy wife, happy life.

Pffft now *I don’t snore but my partner does. Pretty obnoxious!

bernieb wrote: ↑

Tue Sep 12, 2023 4:50 pm

Last night thought I should take some sleep medicine (Dr. prescribed).

Which one?