Confused about leaks

[David Clark]

I think I read on here about how mouth leaks appear more flat topped whereas mask leaks are more "spikey." These, and most of, my leaks look more flat to me which I would think are mouth leaks. The problem is I'm using a FFM and you can't have mouth leaks with one of those.

[clownbell]

David - I respectfully have a different view. In my personal case (and YMMV of course), my jaw drops open far enough that the mask seal breaks and the result is a significant leak. On the other hand, the snapshot provided seems to indicate you were not in Large Leak territory for THAT long. Probably does not effect therapy, but if it disturbs you then it must be addressed. If you are not absolutely in love with FFMs, may I suggest trying a pillow mask with mouth taping.

[multicast]

*My* mouth leaks appear spiky. IMHO the shown leaks are massive mask leaks as a result of poor fitting.

[ragtopcircus]

I can get huge leaks with a FFM. As soon as I fall asleep, my facial and jaw muscles relax. The mask gets looser and my jaw sort of falls away from the mask. Also, the straps for a FFM typically go to the back of your skull, near where the neck muscles attach. The mask fit can change significantly as you tilt your head up and down, flexing and moving the muscles.

Leak reduction tips for an FFM:
1) Your upper jaw, between the teeth and nose, acts like a fulcrum. Overtightening the upper straps can cause a jaw leak and vice-versa. It’s a balancing act, and sometimes a very small change can make a difference. Once they are in the ballpark, I typically adjust the straps by a millimeter or two and test. I find marking the straps with a Sharpy or ballpoint pen helps.
2a) A soft foam cervical collar solves multiple apnea and CPAP problems. It stabilizes the mask fit by stabilizing the jaw and neck muscles. It also helps prevent chin tuck and the resulting airway collapse.
2b) I used a collar for several years, then started having trouble sleeping in it for various reasons. Argh! To get along without it, I now tilt my head down a bit while adjusting the mask, because I WILL tuck my chin down a bit - might as well accept and adjust for it. This also means it takes more pressure to keep my airway open. I still highly recommend trying the collar.
3) The microfiber mask liners from Pad A Cheek (Supplier 31) help a lot. I’ve tried others that were made from T-shirt or sock knits, but they are just too porous IMHO.