Six months and still struggling

Here's my SleepHQ link for last night: https://sleephq.com/public/teams/share_ ... /dashboard

Below are notes from last night. I'd appreciate any feedback on what I should do tonight. I'm between trying to tape + headband again vs new x30i mask.

Pressure: 14/10
Setup: humidity 3, temp 74, cover roll stretch tape cheek to cheek, scunci headband over mouth, trigger: high, ti range: 0.8-3
Quality (1-10): 2
Aerophagia (0-3): 2
Wake: 3
Day:
Night:
mouth-air wakeups: no

raising my pressure to 14/10 felt fine and not getting the feeling of being overwhelmed with air rushing in to my throat
leaks were really bad with only using the cover roll stretch tape. at 7am i switched to putting scunci headband over the tape and that seemed to keep the leaks down
i think cervical collar would probably help me since it seemed to help in the past but i find it very uncomfortable and would like to avoid using it if i can find another solution. it feels very hot
just raising humidity to 3 and temp to 74 felt sufficient to prevent the feeling of not being able to breathe through my nose
woke up a lot of times with extreme dry mouth when only using the tape without anything else
actually felt better this morning than in a few days, despite the constant wake-ups and dry mouth and low amount of actual sleep last night. i still feel like garbage, but less garbage than i normally feel
it seems clear to me looking at my data that i am an inveterate mouth-breather. i have tried nearly everything to keep my mouth shut. maybe i could do like a collar, chin strap, tape combo but it just feels like it’s so uncomfortable i really want to try to keep the setup as minimalist as i can.
tonight i have two options i’m considering: (1) try a full night with cover-roll tape and scunci on top of it. this feels relatively unobtrusive. if that doesn’t work, i could consider doubling up on the tape. i also have kinesiology tape. (2) try using the x30i oral-nasal mask that is arriving in the mail today. i have tried full face masks in the past (f20, dreamwear full face) with very bad results - a ton of leaking. but i have trimmed my beard down and am thinking maybe i can work harder on getting it to seal now
i am leaning toward trialing the x30i though i’m concerned it’s just going to be another bad night with lots of leaking, and that maybe i should focus on finding out if i can make the tape + scunci combo work. (or possible the mueller velcro strap i’ve used in the past. i moved away from that because i was concerned it might be pulling my jaw back too much from the pressure it exerts.)

Please be aware that mouth breathing during sleep can be an involuntary action to breathe, not just a mouth leak when using a nasal/pillows mask. I made the mistake of trying to force myself not to mouth breathe by collar/tape/chin strap.My jaw found a way to breach all three so air could pass through my mouth during sleep. This happens when I roll to my back during sleep. Some who only mouth breathe while in supine position use gadgetry to prevent them from rolling from side to back to prevent mouth breathing. None of these gadgets worked for me.

It is well established that some need full face masks to allow them to breathe through the mouth and nose with therapy, and attempting to prevent mouth breathing by a hermetic seal covering the mouth is like attempting to suffocate yourself.

A Sconci headband is porous fabric, isn't it?

I have a full beard. It is very difficult to get and maintain a mask seal with it. Trimming helps a lot but what makes the biggest difference is TIGHT straps in the right place with the right balance of tension between the upper and lower straps. If this is the slightest bit off....LARGE LEAKS are the result. I can wake, hit the head, return to bed, put on the headgear and go from no leaks to large leaks with the same headgear adjustment made only 3 hours prior. How can this be, you may ask. It's the position of the headgear. Each time it is put on, it is not in the exact place it was before. Last night, it was a tiny bit forward after the break, so I had to tighten the upper straps to stop leakage around the nasal part of the mask. I had gone to sleep with a well-sealed mask.

Due to either my beard or the shape of my face. ALL my FF masks have needed strap tension that is more than what most would find comfortable and I think over the prescribed tension of many instructions. I've read a mask should "float," upon the face. Those who say that do not know what 18 cm of pressure is like. At 8cm a mask could possibly float on smooth hair free skin and keep a seal for someone who does not move during sleep. For a full bearded, 14cm, extra oil producing, moving face, gentle strap tension means no therapy and bad data due to large leaks across the sleep session so very tight straps it is. I read that too-tight straps can cause a leak. I have yet to experience that.

Cervical collars are worn by those who chin tuck due to the head moving forward, which pinches off the airway. A collar will not stop a jaw from lowering for mouthbreathing. A thin pillow can prevent chin tucking. You can test for the effect of chin tucking by lowering your head to see if breathing changes. Doing this does not change my breathing, so the three collars I tried were a waste of time in trying resolve my clusters of supine position apneas. It was higher pressure that resolved them. Some do well with collars to prevent chin tucking, resulting in AHI improvement and loss of clustered event flaggings.

I have double-taped with Cover Roll and PAPMD and still managed to mouth breathe, resulting in a very dry mouth. Once you try a full face mask again, make very sure it is well sealed, then check OSCAR for the leak rate. If lots of leaks still happen, it was not well sealed, and the straps were not tight enough.

Please consider that what seems to be aerophagia can be acid reflux.

I can relate to the struggle to adapt to therapy. It took me many months not to pull the headgear off while asleep. I would wake the next morning, finding the headgear next to me with straps still attached. I still wake up from PAP therapy, 18 years in, because it is irritating and sleep disturbing, but without it, sleep is even worse. I continue therapy to prevent cessation of breathing 35 times an hour due to rolling to my back, mouth opening, tongue falling back, and airway obstructed. If you have similar OSA it may be a FF mask that is required to keep your AHI <5.

You may be one of us who must use a full face mask to get PAP therapy. During my sleep study, a tech woke me up and put a full face mask on me, explaining that I was mouthbreathing. Getting and keeping a seal with a FF is a daily challenge for me, and even with a good seal, movement can knock the mask loose from its seal. Sometimes the seal is regained quickly with me still asleep, sometimes large leaks occur, and therapy suffers. There is no perfection.

Your latest Sleep HQ report shows OSA well treated at 14cm. I see no variance in the average pressure, so I guess you are in fixed mode. I think I have written how using Auto mode with a range can help find the lowest possible effective IPAP pressure. Uncle Nicko of Sleep HQ made a video on using the Med pressure as the Minimum IPAP pressure on an APAP machine in auto mode. Finding the lowest effective IPAP pressure can be quite a challenge for those who are not prescribed a minimum therapy pressure level by an in-lab sleep study. If yours is less than 14cm, it would be worth finding it. Maybe you have already done this and found 14cm to be best.

I am surprised treatment goes so well during the periods of high leak rate, but there it is on the Flow Rate graph...very few events along with the leaks. The leaks may be mouthbreathing during use of a pillows mask. I have often read that mouth leaks as opposed to mouthbreathng, show up as a flatter line in the leak rate graph. I don't know if this is true, but it is a consideration. Some have determined that their mouth leaks are air moving only out of the mouth, and taping prevents it, but when the body uses the mouth to breathe, sealing it off from air does not sound like a good idea. Chin straps are to prevent a relaxed jaw from dropping, and will not prevent the jaw from lowering to mouthbreathe.

Leaks may disturb sleep enough to cause arousals and/or full waking, especially if they are from around the mask due to airflow over the face. If they are due to mouthbreathing, then a full face mask may be what is needed to prevent them. Some record a night vision video of themselves sleeping to get the picture of what is going on.

With each adjustment and change of gear, it will take time to adapt and hopefully arrive at restful sleep.

Congratulations on the high Vitality score and low AHI. Glad the humidity setting is working out well too.

Thanks for your input! I think what is frustrating me the most is not knowing what is causing the leaks.

My experience over the last few months has been this:

Early night: When I use just mouth tape (no chin strap/collar), I wake up with dry mouth even in the earlier, lighter sleep stages. Adding a soft collar and chin strap seems to fix this. E.g. last night this happened. I woke up with my mouth bone dry many times with the tape over my mouth. And the tape was still in place.

Morning/REM: I specifically notice air accumulating in my mouth when I wake up during or after what I assume is REM sleep - usually in the morning when REM cycles are longest. This happens even if I'm using both mouth tape and a chinstrap/collar.

So I can't tell if I'm dealing with habitual mouth breathing that I've trained myself into over the years (due to chronically stuffed nose) OR tongue-palate seal breaking during REM when everything goes paralyzed OR maybe both?

Like you suggested, maybe I need to video myself to find out? Or is there a way to figure this out from my machine data?

The fact that I need the collar even in lighter sleep makes me think there's a habitual/muscular component - like maybe my mouth naturally wants to open even when I'm not fully paralyzed. But the morning air-in-mouth thing seems more like the classic REM tongue seal loss everyone talks about. (But then, why doesn't that paralysis jaw drop happen to everyone who uses PAP?)

The problem: I hate using the collar. It's uncomfortable and restrictive. But tape alone isn't cutting it. I have also tried headbands over my mouth, but I worry they are pulling my jaw back.

I'm planning to trial the x30i mask tonight. Though TBH I am still hoping I can figure out how to make pillows work because I like the p30i a lot.

When we use a nasal pillow mask and we see some leaking the first thing we think of is mouth breathing/opening but there is another cause of leaks and that's simply the nasal pillows sliding around a little and losing the seal. It can come and go and can happen even if we cemented our lips shut. Been there and done that myself.

I looked at this last report of yours particular the leak line and while isn't the prettiest of leak lines....it isn't horribly horrible either.
The ResMed machine is actually fairly accurate with larger leaks up to somewhere between 30-35 L/min and above 35 the machine runs into trouble identifying what kind of apnea event it might sense and then it calls it a UA or unidentified apnea.
You spend very little time over 35 L/min and if those leaks aren't waking you up then I would ignore them.
Now if the leaks are waking you up often then they need to be reduced but more from a "it's messing with my sleep" thing than they are negatively impacting therapy.

Last night's data is updated: https://sleephq.com/public/teams/share_ ... /dashboard

Another bad night. My notes:

1/5
* Pressure: 14/10
* Setup (changes from default):
* mask: p30i
* humidity: 3
* temp: 74
* tape: kinesiology (small piece horizontal over mouth), cover roll stretch tape (cheek to cheek)
* scunci headband over mouth
* trigger: high, ti range: 0.8-3
* Quality (1-10): 2
* Aerophagia (0-3): 1
* Wake: 1
* Day:
* Night:
* mouth-air wakeups: yes

* I think I had a few times to where I woke up with a really dry mouth and the tape was wet. But I'm having trouble remembering. I started the night with just the tape set up. But after the first wake up, I put the headband over my mouth.
* Unfortunately, a few times I seem to have removed my mask and so there are some significant periods where I don't know how I did, but I do know that I was sleeping for those periods
* Woke up feeling terrible this morning and frustrated because I don't have enough data from last night to figure out what to do for tonight other than try to make sure I don't remove my mask

Thanks for your input, Pugsy. Responding below.

When we use a nasal pillow mask and we see some leaking the first thing we think of is mouth breathing/opening but there is another cause of leaks and that's simply the nasal pillows sliding around a little and losing the seal. It can come and go and can happen even if we cemented our lips shut. Been there and done that myself.

Got it. I don't think the mask is sliding around much because based on my experience, I'm not feeling air rushing around the mask and/or waking up because of that.

Also, I was under the impression that the leak lines we are seeing my charts, with the slow rise and plateaus, are more associated with mouth leak than mask leak. At least that's what I got from reading a lot of posts and resources on here.

Also, I often actually experience the mouth leak in the moment. I will wake up and feel air rushing into my mouth. And sometimes the tape is peeling off the edge of my mouth.

So with that in mind, is it fair to assume this is mouth leak vs mask leak?

I looked at this last report of yours particular the leak line and while isn't the prettiest of leak lines....it isn't horribly horrible either.
The ResMed machine is actually fairly accurate with larger leaks up to somewhere between 30-35 L/min and above 35 the machine runs into trouble identifying what kind of apnea event it might sense and then it calls it a UA or unidentified apnea.
You spend very little time over 35 L/min and if those leaks aren't waking you up then I would ignore them.
Now if the leaks are waking you up often then they need to be reduced but more from a "it's messing with my sleep" thing than they are negatively impacting therapy.

I'm surprised to hear you say it doesn't look horrible because it looks horrible to me. A lot of extended periods in leak (the night of 1/4 I'm talking about, btw). I guess you have seen worse, lol.

But the issue is that they ARE waking me up and negatively impacting my therapy. A lot, I think.

Last night there seemed to be less leak but I also remember the air pushing in my mouth a few times and I think it's what caused me to rip my mask off in frustration a few times, as you can see in the chart. Any advice for stopping myself from doing that? Bind my hands?

I'm frustrated about last night because with the mask ripping off a few times, I don't feel I have enough data to evaluate today how it went.

Btw, I tried the X30i mask last night and struggled just as much as I did in previous attempts to use a full face mask. The nasal pillows sealed fine but the air was just going crazy in the mouth portion of the mask. I have my beard trimmed down pretty tight, although it's not completely bare to my face. The respiratory therapists at Apria insist I need to go clean-shaven for masks like that to work. But I'm skeptical that even doing that is going to solve the problem.

I think my facial structure (recessed jaw) is just not conducive to getting a seal on the mouth portion of a FFM, though I'm open to alternate perspectives on this. I mean, if someone could tell me with 90% certainty that shaving my beard (I have had a beard all of my adult life, and am really not excited about the idea of shaving it) would get me a full night of great rest, then I'd do it. But I don't think anyone can make that kind of claim!

I would much rather figure out how to keep my mouth shut properly when using the P30i nasal pillows. I really like the pillows. they're the only type of masks that have been comfortable for me. They seal really well. And the airflow feels good.

I guess what I'm really trying to figure out is whether it makes sense to try to isolate the cause of the mouth leaks that I get. Because they do bother me and wake me up. I'm frustrated because I've read a lot of different potential explanations for the leaks and solutions for those explanations. Like for example I've read that it could be because I'm used to mouth breathing. And so if that's the problem, then the solution is to just get used to nasal breathing I guess. I've been trying to do that for the last six months after being a mouth breather my whole life and getting a surgery in May 2025 for turbinate and deviated septum. I've been able to nose breathe during the day fine and when I put on the nasal pillow mask, I can breathe fine through it.

If I'm lying down on my side, one nostril gets blocked. Still, I feel like I'm breathing okay IF I'm using the machine. If not, I don't feel I can breathe enough. BUT BUT, when I take my mask off, for example which I did multiple times last night (without realizing it because I'm a sleepy stupor) with the tape over my mouth, I end up breathing fine. No sudden wake-ups gasping. So it turns out that I really can breathe fine even with one nostril blocked and no PAP therapy.

So I don't really understand, in light of all this, why it seems I am so determined to mouth breathe. IF that's what's really happening, which is unclear to me. Is the problem that my unconscious mind is trying to pry my mouth open despite the tape I have over it (or in the recent past, despite a chin strap or neck collar or whatever else I'm using to try to keep my mouth shut)? Or is the problem something else?

Other potential explanations I've seen are:
- Air is rushing into my mouth on inhale because I'm not adequately keeping my tongue sealed to the roof of my mouth. I've read that most commonly on this forum. And for that problem, this solution I've seen most commonly is to just practice keeping it there. I have been doing that for months now and maybe it's gotten slightly better? But it's really hard to know.
- Too much air pressure is actually pushing my tongue away from the roof of my mouth and breaking the aforementioned seal. Do I have that right? If that's the case, I'm concerned about how I can solve for it because it seems to me that I need relatively higher pressures to stop flow limitations from waking me up. Based on my recent experience, it seems that EPAP of 10 or 11 and IPAP of 14 or 15 seem to work a lot better and making me feel better in the morning. And then there's a question of whether reducing pressure will negatively impact my ability to breathe well and therefore cause me to unconsciously open my mouth to try to get more air in.
- Maybe being on my back makes it worse? I used to sleep with a backpack but found it cumbersome and have stopped in recent weeks because I think I unconsciously know to stay off my back. But maybe I'm wrong and maybe I'm rolling on to my back more than I realize and that's causing me to get mouth leaks?

What's so frustrating about all this is that many people have different explanations and it's very hard to establish any kind of baseline to work off of. I am very fatigued every day despite good AHI numbers and I am just trying to figure out how to make the PAP work GOOD ENOUGH to get me through the day. I'm not looking for a miracle but I don't want to feel like a 1/10 every morning (which I do this morning).

Maybe I should take a video of myself sleeping at night so I can see what's happening with my mouth? Do you think that would be helpful?

futoncouchsofa wrote: ↑

Tue Jan 06, 2026 8:10 am

I'm surprised to hear you say it doesn't look horrible because it looks horrible to me. A lot of extended periods in leak (the night of 1/4 I'm talking about, btw). I guess you have seen worse, lol.

But the issue is that they ARE waking me up and negatively impacting my therapy. A lot, I think.

Not only have I seen worse ....I have experienced much worse but unlike you I find that it is rare that it wakes me up and that's why I ignore it most of the time.

futoncouchsofa wrote: ↑

Tue Jan 06, 2026 8:10 am

what caused me to rip my mask off in frustration a few times, as you can see in the chart. Any advice for stopping myself from doing that? Bind my hands?

Don't laugh....I read of someone putting on oven mitts at bedtime to try to prevent premature mask removal.

futoncouchsofa wrote: ↑

Tue Jan 06, 2026 8:10 am

Maybe I should take a video of myself sleeping at night so I can see what's happening with my mouth? Do you think that would be helpful?

Might be helpful as it might point you to something you could maybe modify a bit. Like if you found you only did it when on your back you could be more aggressive about doing something to prevent you from rolling onto your back.
BTW I always was of the opinion that doing stuff like tennis balls or back pack sleeping that caused a person to wake up and get off their backs was just plain stupid. Why in the hell go be doing something that causes wake ups which is the very thing we want to prevent...
Anyway, I had better luck using a buckwheat hull pillow laid up against my lower back and pelvis as a prop to keep me on my side.
It's much more comfortable than tennis balls.

ejbpesca wrote: ↑

Mon Jan 05, 2026 2:52 pm

Please be aware that mouth breathing during sleep can be an involuntary action to breathe, not just a mouth leak when using a nasal/pillows mask. I made the mistake of trying to force myself not to mouth breathe by collar/tape/chin strap.My jaw found a way to breach all three so air could pass through my mouth during sleep. This happens when I roll to my back during sleep. Some who only mouth breathe while in supine position use gadgetry to prevent them from rolling from side to back to prevent mouth breathing. None of these gadgets worked for me.

Right that makes sense, but it's not clear to me that I actually need to be breathing through my mouth because of changes I've made in my nasal breathing that have made it a lot better. And a turbinate and septum surgery I had last year. Basically I feel like I can breathe through my nose pretty well during the day.

It is well established that some need full face masks to allow them to breathe through the mouth and nose with therapy, and attempting to prevent mouth breathing by a hermetic seal covering the mouth is like attempting to suffocate yourself.

You can see in my reply to Pugsy but I tried the X30i last night and have tried other FFMs in the past and just cannot seem to get a seal on the mouth portion. It feels like a tornado in there and I doubt I would ever be able to sleep with it on let alone get any useful therapy.

A Sconci headband is porous fabric, isn't it?

Yes, it is and I'm not sure if it's the best thing for me, but I have found based on some limited anecdotal experience that having it covering my mouth with the tape on, maybe subconsciously encourages me to keep my lips closed? I'm not sure. But it does seem to help. I don't love the idea of using something with a tighter tension because I'm worried it will pull my jaw back.

I have a full beard. It is very difficult to get and maintain a mask seal with it. Trimming helps a lot but what makes the biggest difference is TIGHT straps in the right place with the right balance of tension between the upper and lower straps. If this is the slightest bit off....LARGE LEAKS are the result. I can wake, hit the head, return to bed, put on the headgear and go from no leaks to large leaks with the same headgear adjustment made only 3 hours prior. How can this be, you may ask. It's the position of the headgear. Each time it is put on, it is not in the exact place it was before. Last night, it was a tiny bit forward after the break, so I had to tighten the upper straps to stop leakage around the nasal part of the mask. I had gone to sleep with a well-sealed mask.

Due to either my beard or the shape of my face. ALL my FF masks have needed strap tension that is more than what most would find comfortable and I think over the prescribed tension of many instructions. I've read a mask should "float," upon the face. Those who say that do not know what 18 cm of pressure is like. At 8cm a mask could possibly float on smooth hair free skin and keep a seal for someone who does not move during sleep. For a full bearded, 14cm, extra oil producing, moving face, gentle strap tension means no therapy and bad data due to large leaks across the sleep session so very tight straps it is. I read that too-tight straps can cause a leak. I have yet to experience that.

Right I mean this is my experience too. But I think even worse than you because I have tried tightening it to a point that feels ridiculous and I still am not getting a seal on the mouth portion of the mask. I would really love to try a FFM in Earnest, but it just feels impossible given my face shape or whatever. And this is why I'm skeptical of shaving my beard because even though the respiratory therapist says that will help me use it, the impression I've gotten from reading and talking to people is that if you have a relatively trimmed beard, it should work. And since I have a relatively trimmed beard and the leaking is so really ridiculously bad when I try an FFM I am just very skeptical that shaving is going to solve the problem.

Cervical collars are worn by those who chin tuck due to the head moving forward, which pinches off the airway. A collar will not stop a jaw from lowering for mouthbreathing. A thin pillow can prevent chin tucking. You can test for the effect of chin tucking by lowering your head to see if breathing changes. Doing this does not change my breathing, so the three collars I tried were a waste of time in trying resolve my clusters of supine position apneas. It was higher pressure that resolved them. Some do well with collars to prevent chin tucking, resulting in AHI improvement and loss of clustered event flaggings.

Anecdotally the collar seems to work fairly well to stop me from getting mouth leaks for most of the night though not in the morning REM sleep. But I really find it uncomfortable and I'm trying to desperately find a way to get my sleep to be OK without having to use a collar. I would rather use a chin strap, even though I don't love those either.

I have double-taped with Cover Roll and PAPMD and still managed to mouth breathe, resulting in a very dry mouth. Once you try a full face mask again, make very sure it is well sealed, then check OSCAR for the leak rate. If lots of leaks still happen, it was not well sealed, and the straps were not tight enough.

Yep, same. I seem to mouth breathe no matter what!

Please consider that what seems to be aerophagia can be acid reflux.

I’m pretty sure it’s aerophagia for me considering I can sometimes feel myself swallowing the air, and I don’t normally have acid reflux.

I can relate to the struggle to adapt to therapy. It took me many months not to pull the headgear off while asleep. I would wake the next morning, finding the headgear next to me with straps still attached. I still wake up from PAP therapy, 18 years in, because it is irritating and sleep disturbing, but without it, sleep is even worse. I continue therapy to prevent cessation of breathing 35 times an hour due to rolling to my back, mouth opening, tongue falling back, and airway obstructed. If you have similar OSA it may be a FF mask that is required to keep your AHI <5.

You may be one of us who must use a full face mask to get PAP therapy. During my sleep study, a tech woke me up and put a full face mask on me, explaining that I was mouthbreathing. Getting and keeping a seal with a FF is a daily challenge for me, and even with a good seal, movement can knock the mask loose from its seal. Sometimes the seal is regained quickly with me still asleep, sometimes large leaks occur, and therapy suffers. There is no perfection.

I wish I could give a FFM a real try but I really don’t know if it’s possible!

You wrote: "Basically I feel like I can breathe through my nose pretty well during the day."

I nose breathe all day long. I nose breathe when I side sleep. It is ONLY when on my back, my mouth opens, the mouthbreathing begins, as well as severe sleep apnea. I am not saying you are mouth breathing dependent. I am suggesting the possibility that you are mouth breathing regardless of how clear your nose is, and that means a FF mask must be used.

Forcing yourself not to mouth breathe by tape/collar/chin strap and still getting dry mouth shows you may be mouth breathing even with all that gear (I do) and failing to force yourself to not mouth breathe. Or with tape if the tongue falls back but is airway is stinted open by PAP, air may be circulating in the mouth. I can use the strongest tape and still mouth breathe because my jaw forces it open. My jaw is not relaxing, causing Mouth Leaks, and it is forcing open for me to breathe. This is brought on (from me) on by the supine position. I roll to my back to relieve the pain that develops while side sleeping. Many people toss and turn sleep in various positions. This causes all sorts of misshapen breath waves and sleep disturbances. A video of sleep can help understand what's going on.

A thick, long beard may not allow a seal by simply too much fibrous material between the skin and the silicone. When I trim my beard to the very shortest, I get down to zero leaks. The longer the beard gets, the less seal I keep. The tornado you feel is a lack of seal. Maybe a trim will fix it. Yes, I tighten to the point of ridiculousness, which is part of PAP therapy and having a thick beard/mustache. Some give the beard up for therapy. I tolerate really tight straps to keep a beard I've had for 50 years.

I am in deep study of the Bilevel machine. After examining my breath shapes, it looks like I could benefit from an AirCurve Vauto in Vauto mode to make breathing more natural and ease the work of inhaling with 14cm at the mask. You tried Bilevel and came back to APAP? Maybe the correct settings of the Bilevel were not found.

futoncouchsofa wrote:The respiratory therapists at Apria insist I need to go clean-shaven for masks like that to work.

They are correct.

if someone could tell me with 90% certainty that shaving my beard (I have had a beard all of my adult life, and am really not excited about the idea of shaving it) would get me a full night of great rest, then I'd do it.

It is 90% certain that you will get effective therapy. However, IMO it's about 10% certain that you will get a night of great rest.

Air is rushing into my mouth on inhale because I'm not adequately keeping my tongue sealed to the roof of my mouth. I've read that most commonly on this forum.

That's stupid.

Too much air pressure is actually pushing my tongue away from the roof of my mouth and breaking the aforementioned seal. Do I have that right?

Nope.

Do this:

Put on nasal mask and concentrate on effective therapy. Then part your lips maintaining concentration. Then slowly open your mouth. Then stick out your tongue. Then try to touch the tip of your nose with your tongue.

This is a segment from January 4th which has the most severe, sustained leak episode (in a brief look-see of your data). By definition, this is an "unacceptable" leak. Yet, you are sleeping like a log:

Let that sink in for awhile.

Hey everybody. I'm back with some updates. After a few more nights waking up with an extremely stuffed nose in the early morning [using P30i mask], I decided it was time to listen to the advice I've gotten and give a full-face mask another try. (Btw, I tried raising the humidity to the max setting, and that didn't seem to help.)

I bought the X30i, the new hybrid nasal pillow/face mask. I've used it the last two nights. My thinking is that if I can eliminate two obvious issues I have—nasal blockage and mouth leaks/waking in the morning due to mouth opening—I might get a good night's sleep. I don't think I've quite gotten there, and I'd love input from the community.

1/17 data on SleepHQ: https://sleephq.com/public/80c691bd-077 ... c26368a6c4
1/18 data on SleepHQ: https://sleephq.com/public/abcb8823-f07 ... 46c766bd54

I tried CPAP mode, pressure 8 epr 2 on 1/17 and CPAP mode, pressure 9, epr 3 on 1/18.

I have a really hard time understanding what my flow rate graph is showing me. It looks like there are a lot of flow limitations (also based on the flow limitation chart) and that they may be what is preceding my wakings? But it's often unclear to me WHEN exactly I am waking up so it's hard to know what is causing it.

I know I am showing some AHI on both nights but based on my reading of many posts here and looking at my data, it appears to me that those breathing stoppages are after I've already been aroused from sleep.

Previously using the nasal pillows I was all the way up to S mode, 14 IPAP 10 EPAP. I decided to start with a lower pressure when switching to the full-face mask because I thought I might be able to get away with lower pressure now that I wasn't having to deal with my nose blockage all night. That pressure I used on 1/17—CPAP 8 EPR 2—was the one that was found to resolve most events on my last sleep study.

But it appears that I'm still dealing with flow limitations plaguing my sleep. I think?

Subjectively, I am feeling as bad as ever. I know that I'm waking up multiple times during the night and not getting restful sleep. I can confirm this with my Apple Watch recording a lot of fragmented sleep/wakings.

My hope is that raising my pressures further might resolve my flow limitations and get me some uninterrupted sleep, especially now that I'm not dealing with my very restricted nose. But I'm starting to lose hope. I was thinking to jack up the pressures tonight to something like 12 IPAP 7 EPAP and see if I can get smooth breathing and no more interruptions, but I don't know if that's a bad idea.

Bear in mind that nasal congestion can and will show up as increased flow limitations and no amount of pressure changes or increases will treat or take care of nasal congestion. Have to treat the nasal congestion in the traditional way....decongestants, nasal rinses, saline spray, etc.