Extreme leaks whenever I have an apnea...need suggestions

[tstburn]

Hello everyone, I'm back again, I feel horrible and woke up covered in sweat (from I can only assume apneas?) and incredibly fatigued. I took the sd card out of my machine and it didn't find very many apnea events, but it found plenty of leaks. I don't understand what's going on with my seal. I used the Mask Fit option on my machine and it works well until it gets to a high pressure (what feels like a lot of wind blowing) and then it turns to a frowny face. It starts normal, but then goes bad. Is that normal?

I'm going to look into getting the RemZZZ's, but I seriously need some help. I am so fatigued that I feel like I could honestly die and can't even move. I've been to the hospital before with this feeling and they just say that it's not life threatening, and my PCP is not being any help. I feel so horrible I just don't know what to do. Can sleep apnea really really cause bad fatigue, like, so bad it makes you feel sick?

I'll look into that test kiwii recommended, thank you kiwii, I will try it later when I hopefully feel a bit better...

I appreciate your help Sleeprider, what do you mean sleep position? I commonly sleep on my sides and I tried a new machine last night and had the same issue. Here as a few screenshots in an imgur album. This is after adjusting the settings to your specifications (6 minimum, 10 max, 1 EPR). What really confuses me is that it seems like I'll have a leak BEFORE I have an apnea according to the data? The leak rate goes up and then I have an apnea is what I think is going on. I am confused how this thing works, why is there a giant dip and spike before an apnea in all of these pictures? Thank you for the help. I appreciate it so much more than you know

https://imgur.com/a/QTnFj

[jaswilliams]

The ripple in the wave form could be you moving and then knocking the mask off your face which then immediately goes to 130 L/min leak which pretty much means the mask is off your face and providing no effective therapy. Maybe you need to try a different mask type as it seems you are knocking your current mask off your face. 


Also an apnea is only scored at its end when breathing is resumed not the start so the level ripple line is the apnea and the tag on the graph is when the machine marked the event as an apnea


Jason

[kiwii]

Yes, apnea can make you feel the way that you've described. Ask me how I know.

I can't recall - have you tried a nasal pillow? There is, I believe, less chance for leaks. The AirFit P10 is popular. I've been using one for about a week and like it quite well. If that is an option you would consider, be sure to come home with ALL 3 of the cushions so you can change sizes if needed. Also, be sure to set the mask type on your machine to "Pillow" instead of full face.

I'm not Sleeprider, but positioning can be a matter of 'chin tucking' or perhaps even the pillow getting partially displace by the way your head is positioned on your pillow.

[Apnea Infant]

What I noticed from the original graphic, is that the leaks are a complete break in the seal, but the leak rate was very good in between the large leaks.  That may mean it is not the seal but the fit or sleep position.

Tstburn

I think Sleeprider means whether you sleep on your back, on your side or on your front. Moving about can also cause leaks in a full face mask. When I used the Airfit F10 in the early days, leaks happened continuously.

Your number is fantastic even with the low pressures SR set you and appear to be so for a bit. So clearly it is the leaks and thus the break in therapy which is knackering you. Many of us recommend the P10 as the quietest and best sealing mask. It is important to keep your mouth closed with nasal pillows.

[HalfAsleep]

IMO, it's not a productive assumption that heavy sweating must be from apnea events or sleep difficulties. It could be from a bazzillion more likely things, including diabetes, hypoglycemia, food poisoning, whooping cough, liver problems, etc etc etc...... Not to mention, the room might be too warm for you to sleep well (see sleep hygiene topics). If the sweating continues, I'd recommend talking to a PCP about it.

The Airfit and Airtouch F20 are a bit shorter and narrower than the F10. I've tried all 3. I needed the extra mmm in the F10 because when I smiled, the F20 leaked like heck. IMO the Resmed graphic to fit the F20 is off. You might just need a size up on the F20.



I got so fed up, frustrated, burnt out, uncomfortable, sleepless with leaks (starting with the P10 for a month), that I decided to train myself to adjust leaks. This is what I did. My mask(s) were so leaky, I determined that not a whole lot of treatment was going on. I lowered the top pressure (15) down to like 8. I was not going to get treatment at that pressure, but I was going to learn how to handle leaks! I kept it at 8 for a few days, until my leaks looked way better. Then I'd up the pressure to 9. A few days of that. It took a lot of learning. When I got 9 figured out, I moved up to 10. And so on.

This whole experiment took about 2 weeks. It was very effective. 3 days into it, I already felt way better about my treatment in general, because I knew I could address my frustrations. I almost certainly would otherwise have given up treatment.

If I get an eye-catching leak now, it's usually a "mask-off" or I had to scratch my nose.

Maybe you could try something like that?

[Sleeprider]

I'm wondering if maybe the problem is what happens between the events. Your tidal volume is pretty low with a median of 320. That might be enough, but we see through the night you have shallow breathing with occasional recovery breaths. I'm pretty certan the leaks are just movement where you knock the mask aside on your face and it eventually reseals. Not enough information here to conclude why you feel fatigued. You may want to get an inexpensive oximeter to monitor your oxygen levels through the night and see if the shallow breathing or leaks are a problem.

[HalfAsleep]

Is that a looooong apnea right before a big leak? At 6:42 ish? Your body might have been telling you it needed more air. You could look at the flow rate right before that to see if you were struggling but not registering an "event". To respond, you could have shifted your face (per SleepRider) or tried to pull the mask off in your sleep. Then you put it back. I'm a noob, whaddo I know, except that I sometimes pull my mask off and it seems to follow disturbed breathing.

I have found that long apneas do not make for high quality sleep.   Nor do moments that don't rack up "event" status, especially if several are strung together, or the breathing is very shallow and then gets troubled. I look at this as being as an "apneic phase" that doesn't qualify as full blown apnea, but is likely very exhausting 'cos I'm obviously not a getting a lung full, incoming or outgoing.

[tstburn]

Well, I'm in the hospital right now. Went in for my fatigue and yet again they said nothing is wrong with me that they can see in the ER. I will reply to all of you all in specifics a bit later when I am home, but I appreciate all of the help you all are offering. I did purchase an air meter Sleeprider and it usually goes to 95-96 when I am asleep with drops into 90-92 that resume after a minute or two back to 95-96. Would it help at all if I posted more data? I can post as much data as I get if it helps you guys figure out what would help me more. I really appreciate the help....

[kiwii]

It seems to me that you've identified one major problem (leaks) that has not yet been resolved.

I would focus on fixing the leaks.

Once the leaks are fixed, it may take some time to start feeling better.

[freetime]

I second HalfAsleep's post #25. I was not getting a good sleep because leaks woke me up.  

After I set the high pressure to my average pressure level stated in SleepyHead my leaks got under control, my AHI was good enough for me. More important I was less frustrated with CPAP.

For the life of me I could not figure out how to fit a used medium size FFM to a large face. Duh!