Mystery leaking... can you help me figure it out?

My husband JD has recently had mask leaks, and it wasn't an issue just a few months ago. He changes masks (his favorite old Mirage is no longer made, and it's started leaking, too) trying to get one that works.

He has lost a lot of weight! He went from 284 to 230 over the last few months. Hooray! Hmm, maybe he needs a smaller mask.

Last night, it started leaking, got louder, louder, (and I got more awake!) and I turned the light on low, and looked to see if it was leaking out his mouth. That's what I suspect, because at times, it would be leaking, then suddenly quit leaking without him shifting at all. That made me think it was him closing his lips and he wouldn't move for that. But I couldn't see that it was leaking out his mouth, and I put my hand up to feel, and couldn't feel any air except out the exhaust port.

During the night, he got up, saying his mouth was very dry, his tongue sticking. He said it felt like there was a ring around his mouth.

If his mouth is dry, is he mouth-breathing?

He's on a Resmed Autoset T from 2000, a Fischer & Paykel heated humidifier, and last night was using his Activa mask. I looked at the data, and it showed a lot of leaks, only one apnea, and it had cranked itself up to its highest setting, which he said was uncomfortable and woke him up.

He's never had a problem with mouth-breathing in the past, except for when he falls asleep on the couch w/o cpap.

If you have any ideas, let me know.
Thanks,
Amy

My definition of "mouth-breathing" is when pressures are too low and the patient is trying to get more air in through the mouth.

My definition of "mouth-leaking" is when, under "adequate" pressures the patient's mouth falls open and the air leaks out.

These are common problems with nasal masks and the remedies are:
Chin straps (most are not that effective)
Taping mouth shut (there are specific types of tapes that work better than others)
Polident adhesive strips (to seal the lips)
Full face mask (covers all the possibilities)

Den

he needs to try a Full Face mask.

Very difficult to observe someone and determine IF the air is escaping their lips losing therapy pressure unless they are making those motor-boat sounds.

Wulfman and Snoredog have given you excellent advice if your husband is mouth breathing. If the Activa mask is leaking, here are the most likely sources:

(1) If the exhaust ports are too close to the covers or pillow, the blocked air will make a lot of noise.

(2) If the swivel connection is not properly attached (make sure it moves freely), you will get a whistling noise.

(3) If the hard bluish green thingy that holds the soft, flexible mask to the hard plastic outer holder is not properly attached, you will get a lot of noise. Make sure that all three buttons "click" on and hold.

(4) If the mask itself is leaking around the face, you will get some annoying noises.

Amos

Thanks VERY much!

I believe the mask itself wasn't leaking, except maybe where it seals against his face. It was a puzzle to me how it would suddenly stop leaking without him moving.

And thanks for the definition, Wulfman... I think he was mouth-leaking rather than mouth-breathing. It was a rush of air going one way.

So if he wakes up with a very dry mouth, is it a definite thing that his mouth was open?

We might see about a fullface mask, Snoredog. He had a bad experience with one 7 years ago, never could get it to work. But maybe the new ones are better.

JDS wrote:Thanks VERY much!

I believe the mask itself wasn't leaking, except maybe where it seals against his face. It was a puzzle to me how it would suddenly stop leaking without him moving.

And thanks for the definition, Wulfman... I think he was mouth-leaking rather than mouth-breathing. It was a rush of air going one way.

So if he wakes up with a very dry mouth, is it a definite thing that his mouth was open?

We might see about a fullface mask, Snoredog. He had a bad experience with one 7 years ago, never could get it to work. But maybe the new ones are better.

The dry mouth is, in my opinion, a positive indicator. Ironically, you can still have dry mouth experiences with a full face mask (I can verify that), but at least you KNOW what happened.....mouth fell open during the night.....however, the therapy is still intact.

The Quattro is an excellent full face mask for sealing....properly sized, of course.
I'm still partial to my Ultra Mirage full face mask, too.

Den

Snoredog wrote:he needs to try a Full Face mask.

Very difficult to observe someone and determine IF the air is escaping their lips losing therapy pressure unless they are making those motor-boat sounds.

And as DRY as he is, his motor's out of the water. FF Mask means he gets treatment, even if he mouthbreaths, as Den says Taping works to what doesn't work is what he's doing now. Jim