mask leaks

sleepy711 wrote:"My Little CPAP Book" from iTunes or Kindle has lots of information including bits about masks and pressures.

Your book is disorganized, inaccurate and sophomoric.

http://s743.photobucket.com/user/Bennny ... e.jpg.html

Last nights numbers. Slept with head strap last night it stayed on most of the night. It looks like alot of centrals. Leaks still high. Should I lower my numbers back to 16 and 12? my machine is at 16 and 20. Was originally 16 and 24. Not sure if I'm comfortable taping yet.

You can try the lower pressure again to see if the leaks improve.
Until the leaks get better managed....we don't know if those centrals are real or not because your leaks are so large the machine's sensors are having trouble doing their job. So I don't know if they warrant getting all worried.

The leaks have to be better managed before we can trust any of the data that gets reported.

How about a compromise....maybe 14 EPAP PS of 3 and max IPAP 18? that would give you 14 on exhale and 17 on inhale but can only go to 18.

Originally the RX might have been for 16 EPAP and 24 max IPAP but it was set with it being essentially 16 EPAP and a single pressure...not a dual pressure.

http://s743.photobucket.com/user/Bennny ... a.jpg.html

I looked back at the last 7 days. This appears to be my 2nd best night for ahi. The best was last wed when i had my pressure at 12 and 16. The only thing
is that last wed the leak was 73 and last night the leak was 40. Should i lower a little more or leave it at this for a while so i can establish a better baseline. I'm considering taping, but not sure if i feel comfortable with that. My wife suggested super glue

That 40 L/min leak which number is that? average or 95%...I know it isn't the maximum

Your leak line last night was an improvement over the previous nights that's for sure but it is still ugly.
You really can't rely too much on the AHI as a guideline when you see leaks well above the 30 L/min line for so much of the night.
Above 30 L/min we don't know if you didn't have any events or the machine missed them.
Above 35 L/min...there's a good chance the machine couldn't sense things and there's a good chance that the pressure allowed events to slip past the defenses with a drop in pressure below therapeutic levels.

I don't think that the pressure is your problem here...I think it is mouth breathing but I can't be sure until we keep the mouth shut and evaluate the leak line. Maybe it is at the mask level and not from mouth breathing but with the mouth uncovered...we can't say for sure.

Even with the possible mouth breathing...these leaks are an improvement over your other mask trials.

You know when I first heard/read about mouth taping I though "no way"...but then when faced with prospect of chin strap use (which various models wouldn't stay put and fiddling with them all night messed with my sleep) or tape...I decided to at least try it.
It wasn't nearly as bad as I thought it would be.

If you don't want to try the taping...then keep trying various chin straps.
My idea about taping for one night...just to see if we are for sure seeing mouth leaks here or mask leaks.
Maybe try taping part of the night just to get an idea?????? Remove it at first wake up hoping to get maybe couple of hours with tape on.
Maybe the leaks are at the mask level....I just don't know and if it is at the mask level....no sense in harping on keeping mouth shut or telling you that you have to use a full face mask because you can't keep your mouth shut.
Right now I am not suggesting that you have to tape forever...all I want is to know whether we can remove mouth leaking from the blame for the leaks or not..so we know if we need to concentrate on mask fit or keeping mouth shut.

You need to pick a pressure setting and stick with it for a little while though. Give the body a chance to adjust to something familiar. EPAP at 12 allowed considerable events to slip past the defenses though...so EPAP needs to be around 14...might go a little lower. With leaks of this magnitude it's really difficult to evaluate pressure needs accurately.
Pick something close and stick with it for a week or so.
Maybe 13 EPAP PS of 3 max IPAP 17.

I felt really good today, and still do. The best I think I've felt in 20 years. I'm 42. Oh by the way if I forget to tell you later, Thank you for all the help you and everyone has given me, not sure if I would of stuck it out without you all. I think I will leave the settings at 14 epap 18 ipap and ps 3 for
now based on how I feel today. Can tweak later. Going to keep trying the chin strap for now also.

Can I suggest that I change the type of mask in your profile?

you have the Quattro Air listed and I was getting confused about the discussion of mouth taping, until I went back 3 pages and found your comment that you switched.

Bennnyp wrote:I felt really good today, and still do. The best I think I've felt in 20 years. I'm 42. Oh by the way if I forget to tell you later, Thank you for all the help you and everyone has given me, not sure if I would of stuck it out without you all. I think I will leave the settings at 14 epap 18 ipap and ps 3 for
now based on how I feel today. Can tweak later. Going to keep trying the chin strap for now also.

http://s743.photobucket.com/user/Bennny ... 1.jpg.html

Here are last nights numbers. My leaks to contiue to go down since switching to a nasal mask. Less mouth breathing. Who says you can't teach an old dog
new tricks. I see that almost all of my apneas seem to be centrals. 30 of them between 2:33 and 2:57. Also on all of my charts my pressure
always goes up at the end of the night about 2 hours before i get up regardless of how long i sleep. If my graphs stay like this for another week what
would you recomend for pressures? Right now they are at 14 and 18 with a ps of 3. My original settings were 16 and 24 with ps 0.

Pressure increases in the wee hours of the morning right before we get up...most likely REM stage sleep events that need a little more pressure. That is the time frame where we have more REM stage sleep...and it's common to need more pressure in REM so it would not be unexpected to see more pressure increases at that time.
Also...sometimes we might not need that increase...REM events are funny that way. Maybe a little supine sleeping thrown into the mix. Whatever the cause...not unusual and nothing to be concerned over.

I don't see the leak graph from last night...where is it? I see snore graph instead. and it looks great.

You brain and body may learn to keep the mouth shut on its own as it comes to accept cpap therapy. A lot of time the mouth breathing is just habit from gasping for air during the night because of all the apnea events. Stop the gasping and maybe break the habit.

I don't know what to make of the centrals. That one ugly cluster right before you turned the machine off in the middle of the night...maybe you were awake or something.

I don't know where they came up with 16/24 settings. I don't see anything that supports it on these reports.
In fact if the Obstructive Apneas and hyponeas stay reduced...I would reduce the pressure EPAP and not increase it.

http://s743.photobucket.com/user/Bennny ... 3.jpg.html

Last nights numbers. Any comments or suggestions.

You have snore graph in there and not leak graph.

How did you get the snore graph above the flow rate graph? I thought it was below flow rate and pressure?

95% pressure number is 50...I see green apneas..that means the leak was so bad the machine couldn't sense what it was...central or obstructive or hyponeas..just something.

Your AHI...is nice and low but we can't trust it.
Don't know if it is low because nothing happened or the machine didn't know because of leak.
When I see green apneas I have to question the machine's ability to even sense anything.
Maybe no events are being missed...I just have no way to know with any certainty.

http://s743.photobucket.com/user/Bennny ... a.jpg.html

Repost of last nights numbers with leak graph.

You had more time at 26 L/min or below than you have been having.
So those times we can trust the AHI.
It's close enough to 24 L/min that I don't see it making any huge difference.
Above 35 L/min...I don't trust the data to be apnea free like it migh t show.

Keep trying to find some way to keep your mouth shut.

Are you still feeling somewhat better though?

I am definately feeling better since changing my settings. Still waiting for the cops to show up. How could they have missed the mark by so
much. Was it the person who did my sleep study or the doctor or the dme? I will keep trying to keep my mouth shut. My wife says that will be hard to do

I too had trouble with leaks. I am on bipap with pressures 8-25. The machine senses what level I need and readjusts as needed.
I switched to a mirage Quatro and have not had a problem since.