Need help with high leak rate (30 L/m) please

Are those leaks causing you to wake up during the night fairly often?

I’m waking up around 3 times per night. There seems to be a correlation with the leak times.

Are you experiencing any nasal congestion?
Slight but not bad at all.

Ok I raised the minimum pressure to 8.8

Also I don’t have an “AutoStart” setting in the Resmed 10 however it does have a “SmartStart” which I am assuming is the equivalent.
I checked and that is off.

So what do you think is causing these leaks and what permutations can I try to get rid of them?

Thanks!

RickPC123 wrote: ↑

Mon Nov 13, 2023 10:32 am

So what do you think is causing these leaks

Either mask movement or mouth opening or combination of both are responsible for the leaks.

RickPC123 wrote: ↑

Mon Nov 13, 2023 10:32 am

what permutations can I try to get rid of them?

You first have to determine what is causing them and then try to fix it.

If the tape is coming loose then you know that you need to do a better job of taping and keeping the mouth shut.

If the tape hasn't come loose... then you know that your mask fitting is needing improvement. Either cushion size or maybe strap tension or maybe even a different mask.

Great! I will try both.

Question- From looking at the numbers, does it seem that the leak rate is significantly impairing the efficacy of the therapy ?
Or does it seem like it only has a small effect?

Thanks!

RickPC123 wrote: ↑

Mon Nov 13, 2023 8:39 pm

Great! I will try both.

Question- From looking at the numbers, does it seem that the leak rate is significantly impairing the efficacy of the therapy ?
Or does it seem like it only has a small effect?

Thanks!

While it isn't a real pretty leak line it isn't a horrible leak line either.
If the leaks didn't wake you up I would say just ignore them.
The machine doesn't really get into much trouble doing its job until you start seeing a lot of leak above 30 to 35 L/min mark and then only affects things while you are deep into large leak territory.
10 minutes or really, really bad leak is only going to affect those 10 minutes in terms of therapy effectiveness.
Certainly not the end of the world.

For myself...unless the leaks (big or little) wake me up or I spend half the night deep into large leak territory...I just don't worry about them. I learned a long time ago that sometimes the cure is worse than the disease when it came to fixing leaks. The things I tried so that I could get a "real pretty leak line" seemed to cause more sleep disruptions than the leak was causing a problem. Gotta get the sleep first before any of the numbers or pretty graphs mean much.

It's rare that I don't have some sort of leak because I know I open my mouth at times. Not often and when I do it's rare that I go deep into large leak territory and when I do it's normally very brief....I usually sleep through it all so I just shrug my shoulders and move on.

BUT if leaks (big or little) are causing wake ups....they are disturbing our sleep and that is of course unwanted and need to be dealt with.

For me I don't even bat an eyelash until I see time above the 35 L/min line and then when I look closely if it is 5 minutes I shrug my shoulders...now if it is 50 minutes and I see this happen quite often then I decide if I need to do anything.

I have yet to see a need to do anything.
It's very rare though.

Excellent!
Thank you for your wise insights!
The CPAP life can be very complicated and you are really helping people who would be stumbling around in the dark.
Thank you so much!!

Your flow limits are pretty high. You can lower these by using EPR full-time set at 3. That should help you feel better.

Deborah K. wrote: ↑

Wed Nov 15, 2023 11:49 pm

Your flow limits are pretty high. You can lower these by using EPR full-time set at 3. That should help you feel better.

About the EPR: yes, and no.
It works for some, doesn't work for others -- has to be tried personally.

Progress Update:

1. Mask Seal Issue: Solved. Got the Bleep Eclipse and it is great. Complete seal. The skin around my nose is a little sore but it is an excellent mask! Thanks for the great recommendation.

2. Mouth Breathing Issue: Got a Mouth Shield (silicone shield inside mouth) and Hostage Tape to stop mouth breathing. I realized that even with these, the air pressure is building up in my mouth to the point that my checks puff out and eventually the air finds a way out. Blows through a weak spot in the shield or the tape. I’m still getting the high leak rate.

What do I do with that? Does everyone get that intense build up of pressure in the mouth? What are possible solutions to that I could try? Settings on the machine? Other solutions? Is the pressure issue worse because the Bleep Eclipse has such a great seal?

3. I’ve been waking up less frequently and I am realizing that the waking up is related to the apnea and being woken up with the mouth pressure issue and not so much just having to go.

Feel like I am getting close to a great night’s sleep if I can just fix this mouth breathing issue.

Thank you for your advice!!

RickPC123 wrote: ↑

Fri Nov 17, 2023 7:06 am

air pressure is building up in my mouth to the point that my checks puff out and eventually the air finds a way out. Blows through a weak spot in the shield or the tape. I’m still getting the high leak rate.

What do I do with that? Does everyone get that intense build up of pressure in the mouth?

Search the forum for "chipmunk cheeks"...you aren't alone and it really isn't caused by "high pressure" at all.
It's caused by air entering the mouth and with lips shut that air causes the cheeks to inflate. It can happen with as little as 5 cm pressure.

You have to learn how to keep that air going up the nose and down the airway from ever entering the mouth...and that is much easier said than done. I know you probably won't believe me but I can (with mask and machine on) open my mouth and talk normally or stick out my tongue and blow raspberries or do a big yawn and no air enters my mouth at all to try to escape.
None..zero..zip. There's a reflex action that cuts off the air flow from the airway into the mouth and I make use of that reflex action. In fact it is difficult for me to do the chipmunk cheek thing...
Unfortunately since it is a reflex I can't tell you how I do it. Wish I could...I could sell it and make tons of money.
I am not the only one who can do it. We have lots of forum members who can do what I do.
If you blow up a balloon you don't have air shooting out your nose do you? That's that reflex action I am talking about.

RickPC123 wrote: ↑

Fri Nov 17, 2023 7:06 am

Is the pressure issue worse because the Bleep Eclipse has such a great seal?

Again it is NOT a pressure issue and not related to whatever mask you are using.

It took me about 3 months of cpap use to master that reflex action. It can be done by some people...not all unfortunately.

RickPC123 wrote: ↑

Fri Nov 17, 2023 7:06 am

Progress Update:

1. Mask Seal Issue: Solved. Got the Bleep Eclipse and it is great. Complete seal. The skin around my nose is a little sore but it is an excellent mask! Thanks for the great recommendation.

i'm not a bleep user, but i used to get a sore nose from my nasal pillows. i used Lannsinoh which is a lanolin product used by nursing mothers. it's at amazon or your local drugstore in the infant care section.

BLEEP USERS? would the use of lanolin be contraindicated for the bleep?

(yes, i said contraindicated, b*tches!)

zonker wrote: ↑

Fri Nov 17, 2023 1:22 pm

BLEEP USERS? would the use of lanolin be contraindicated for the bleep?

If someone uses any sort of moisturizing product at night....it's going to cause the adhesive to come right off...won't stick at all.
Especially something so oily as the lanolin product.

Definitely a no - no....and definitely contraindicated for night time use. Sorry.

Now it could be used during the day but it has to be washed off completely prior to placement of the adhesive.

The least little bit of sweat, oils, dirt, make up, moisturizing cream, etc...that is on the area where the adhesive has to stick...is going to cause the adhesive to fail.
Been there and done that and have the Tshirt to prove it..

I can still use night time moisturizing stuff....just not where the adhesive needs to go.
But if someone has a boo boo where the adhesive needs to stick then they need to let it heal up or suck it up.

Pugsy wrote: ↑

Fri Nov 17, 2023 2:01 pm

zonker wrote: ↑

Fri Nov 17, 2023 1:22 pm

BLEEP USERS? would the use of lanolin be contraindicated for the bleep?

If someone uses any sort of moisturizing product at night....it's going to cause the adhesive to come right off...won't stick at all.
Especially something so oily as the lanolin product.

okay, good to know!