Mask leaks at higher pressure

Hi. This is my first post, but I've been reading the list and older posts for several days. I think my sleep doctor should start informing people about this web site because there's a wealth of useful information here. I'm hoping somebody here has already solved the problem I'm having with my mask leaking at higher pressures.

I've been using my machine for almost 6 weeks now. It's set for a low of 8 and a high of 18 and has a ramp feature that starts at 2. (I generally don't use the ramp, since I feel a little suffocated at 2, and don't have any trouble falling asleep at 8.) My 90% pressure is at 17.1 and my AHI is about 4.5, so, if I'm understanding what I'm reading here properly, I don't think reducing the pressure is a good option.

I'm on my second mask (a Comfort Gel full face mask because I mouth breathe). My problem is that my mask starts leaking at higher pressure levels, which wakes me up. In an attempt to stop that, I've tightened the headgear, but now the bridge of my nose is red and a little swollen.

I'm committed to making this a success. I stopped breathing for 57 seconds during my sleep study and my blood oxygen level fell to 66%. I don't think I'm safe without the CPAP machine, but I'm having so much trouble that I'm far sleepier during the day now than I was before.

An old post here suggested fitting the mask at the upper pressure level which seems like a good idea, but I don't have access to the software, so I think I can't do that. The only available technician at the business that provided my machine was worthless--she basically handed me the machine and mask and that was that. She was somewhat put out when I wanted to try a different mask, but she did order one for me. I don't think she knows much except how to take the machine apart to clean it and how to bill insurance companies.

Help?

Sue

What machine do you have?

I have found a good mask for higher pressure is the Respironics FitLife Total Face Mask. I wear a large and the straps are a bit too long so I wear a knit cap just over the crown of my head to take up some of the slack. Works well. I have also used Macks SIlicone Ear Plugs rolled into a bead the size of a pencil and used it around the circumference of the mask with good results. To make the silicone last longer I would take it off every morning and roll it into a ball and put it in an airtight container and put it on again the next night.
Good Luck. It's tough to get a mask to work at pressures that high.

Mary Z wrote:It's tough to get a mask to work at pressures that high.

This is true. My pressure goes up to 23 every night at some point. The ONLY mask that has worked for me is the F&P 431. BUT -- there seems to be a problem right now with the valves leaking -- I have a thread going now about that situation.

I think for each person, it's a matter of trial and error to find THE mask that works for them.

I hope you can find one that works for you.

Sue
You don't need to tighten down your straps so tight they will leave marks. Some of us use a cotton liner with our mask and that seems to help alot. Go to padacheeks site or remzzzs site and look for mask liner. You can do a search on this site also for alot of discussion on the subject, just type in mask liner. For home made mask liners we use a well washed white cotton t-shirt or (cough-cough) well wash cotton panties . Carefully lay your mask on the cotton and draw a line around it about 2/3 or 3/4 of an inch bigger than your mask. Cut this out and cut out a small nose hole....et voila, you have a mask liner. Do read the comments here on your search, I believe there is even a pattern for a couple of them. Good luck and good sleeping.
Cheers
Nan

Thanks for the mask suggestions and the idea about the tee shirt liner. I hadn't considered that, and I hate to start buying mask after mask in search of one that both suits me and can handle the pressure, so a few suggestions will be a big help. I also hadn't thought about a total face mask.

I'm sorry I'm not showing the equipment I'm using. I filled it in in my profile, but I don't know how to get it to show at the bottom of my post. I'll work on that.

I'm using a Philips Respironics RemStar Auto A-flex with a System One humidifier, and a ComfortGel Full Face mask.

Sue

Just testing to see if my equipment info shows up now.

Sue

Sue... to get the software... PM Uncle_Bob.

I'm not sure what you are talking about as far as the ramp. The lowest pressure you can set your machine for is 4 cm. So I'm not sure what you are referring to when you say "It's set for a low of 8 and a high of 18 and has a ramp feature that starts at 2"????

In any case, the trick when you have a wide range of pressures is to set your machine to your highest pressure (in this case 18) and THEN fit the mask. When you have it fit so it won't leak at that pressure, you can re-set the machine to your regular pressure range of 8 to 18, and it should not leak as the pressure increases to 18.

An old post here suggested fitting the mask at the upper pressure level which seems like a good idea, but I don't have access to the software, so I think I can't do that. The only available technician at the business that provided my machine was worthless--she basically handed me the machine and mask and that was that. She was somewhat put out when I wanted to try a different mask, but she did order one for me. I don't think she knows much except how to take the machine apart to clean it and how to bill insurance companies.

Here's the "secret handshake". Dial in the setup menu, and then hold the big round button and the ramp button down together for about 8 seconds. There will be two short beeps, and then you are in the clinician's menu. Go to the pressure menu and set it for 18. Exit the clinician's menu, fit the mask. Now re-enter the clinician's menu and restore the original settings. No CPAP police will come after you, I promise. (BTW, does that mean they wouldn't even let you TRY on a mask before choosing one. That stinks! You need a new DME). You don't need software to change the settings, but you DO need software to monitor your own progress, so you should really consider getting it. The minimal information on the screen is not all that helpful since it's only 7 and 30 day averages.

BTW, that's a big pressure range, especially if your 90% pressure is 17. It would be helpful for you and your doctor to take a look at your data and see if it's possible tighten up that range. My guess is that the pressure is going so high because of leaks--the pressure is chasing the leaks, and not doing a very good job by the looks of your AHI. A tighter pressure range may give you better control. In addition, with your AHI so high at over 17 cm, the other thing I wonder is whether you are having a lot of centrals? I hope you are working with a sleep specialist that is doing more than simply recording compliance so your DME can get paid. You need someone to really work this through with you.

With that wide range it could be runaway leaks vs higher pressure. That was our problem at first until we narrowed the range. Don't know why Drs prescribe it that way. I'm also thinking the 2 you're referring to may be Cflex which is a comfort setting that reduces the pressure on exhale if you find it helpful. It has 3 settings, 1,2,3. Some people don't find it necessary once they get used to it.

I apologize for misstating the ramp start pressure. I should have said it starts at 4, not 2. My excuse is that I haven't paid much attention to it because I don't like the lower pressure. The 8 and 18 limits were set based on the results of my sleep study and reflect the pressure that was found to be necessary to control my apneas/hypopneas. The sleep study also didn't find any evidence of central apneas. (Which I'm glad about.) I'm thinking maybe my doctor will narrow the pressure limits based on the data he sees when I go in for my follow-up appointment, but he's not likely to decrease it much if at all.

Thanks for the info about how to get more data from my machine! I also appreciate the other information about masks, liners, etc. I almost didn't post because I thought I'd get something wrong, but I'm glad I did.

Sue

Sue,
Check out Padacheeks anti leak strap. It's great for the higher pressures and doesn't make the mask tighter on your nose. I use one.

http://www.padacheek.com/PAC_AntiLeak_Strap.html

Ed

Also, sleepnationtv has an inexpensive mask loan program. Read about on the 4th post down at
viewtopic.php?f=1&t=57997&st=0&sk=t&sd= ... epnationtv

If other forum members recommend masks good for higher pressures, check them out at cpapauction.com

Ed

I'm at a level 18 and also found happiness with the Respironics total face masks, the "Total Face Mask" and the "Fit Life". The dozen other masks I tried squealed and leaked and drove me crazy. I also wear a cap or a "Buff" under the total face mask. I tried a PAPCap, a cotton night cap, and a couple of kinds of caps before trying Buffs (which are stretchy tubes of fabric that can be worn about a dozen different ways).



Using the Fit Life, I first put on a Buff like a balaclava, so that it covers my forehead and mouth. I then put on the mask (which I think looks like a fighter-pilot mask). The first Buff, worn balaclava-style protects the silicon from my oily skin and helps seal all around, as well as helping to keep my mouth shut.Then I pull another Buff on over the top of my head, being sure to cover my forehead and top edge of the mask (the worst leak point), and the rest of my head and headstraps. I could do without the second one, but I find velcro annoying and the second Buff covers up everything.

Does this description make sense? I really should take a picture to explain it better. I feel comfortable and very stable all wrapped up like that. I'm not tempted to rip off the mask. It doesn't feel too warm or confining, because the Buffs are so thin and stretchy with little bulk. I buy knock-off Buffs online, much cheaper than the genuine product. While I have hat-head in the morning, I don't have to shampoo as often. In the morning, I just splash water over my hair and blow dry and fluff it.

Hi, Sunnyway. Thank you for the detailed response about how to deal with a total face mask. I'm hoping it doesn't come to that because the FF mask makes me feel just a little claustrophobic already. If it does, though, I'm definitely going to be referring to your post again.

BTW, I had my third night of restful sleep (spread out over the 6 weeks I've been using CPAP), and I feel great today. I think about every 10 days I'm just so tired that I sleep through the pressure issues. I'm really looking forward to getting everything set up nicely, so I sleep well almost every night. I know I'm going to feel worlds better than I have for years and years.

Sue