Forum has helped...but now next step to improve

[nightgagger]

Not sure of getting you right: Do you use the F30 or the N20?  IHMO mouth taping is only useful using a nasal mask.

Im using that https://www.amazon.com/-/de/dp/B00DN6O7Q...O7QQ&psc=1 10 cm width, with great success together with the mask of my sweetest dreams, the trusty P30i.  Before applying the tape move your lips slightly inwards not only to protect the lips but for a better sealing, too.  And don't remove the tape quickly!  There will be no residues fron the tape on your face.

(Don't buy it in 5cm width, as the tape stretches fortunately only in the width-direction.  Hence having a 10cm width tape cut in 5cm length you may stretch it horizontally but not vertically, which is good as it won't stretch in the direction your mouth would open.  Just terrific.)

As you noticed, the collar is without any effect.  At the moment your therapy just blows out.

Currently, and on my third night, the F30i mask.  No tape.

I previously was using the N20 with mouth tape.

I think I have the tape application pretty well dialed in.  But occasionally will get a small amount of drool start from the corner of my mouth, and start to make the leak on the tape...as the spit finds either a crease or a point where the adhesive isn't on my skin...I do get 5 o'clock shadow quickly..I'm Italian :

[nightgagger]

Actually, I disagree that the positive pressure therapy is ineffective at this level of leak.  It would be great if the leaks could be resolved, but the reason we know it is still effective is we can still fully visualize the respiratory flow rate. That means there is pressure between the machine's sensors and your airway.  When leaks increase to the point that positive pressure cannot be maintained, we see that respiratory flow rate significantly diminish and lose resolution. I usually observe that when leaks exceed 60-70 L/min. In this case, the 95% leak rate is less than 40 L/min. Hardly ideal, but not enough to negate therapy.  It is certainly disruptive.

Last night I could feel the leak at certain points occurring at my right jaw, where the mask starts to curve.  One thing I noticed is the cervical collar is pushing up my loose skin...still have some extra skin from fat loss, and creating a mound and as I move I think it's opening up that seal. 

As multicast noted in an earlier post, the F30i is sensitive to assymetry, and will need to adjust the straps accordingly to compensate.  I started doing that, but in the back of my mind I remember reading somewhere that if you tighten the straps too hard, you'll create creases in the silicon material.  So I backed off last night.

My leak rate was around 36L/min at the 95%. 

Do I feel better today?  Sort of .. It was a unique morning, today.  I'll leave at that.

[multicast]

I certainly know about this drool ...  As I mentioned before, pull your lips inwards before taping to get a better seal.  And use some stretchable kind of tape.  And avoid wrinkles.  Once the saliva has made its way under the tape the sealing is gone.

Finally, I consider taping only useful when using an FFM; I had a good seal (without tape) in those former times I've used the F30. But it takes time to adjust that little diva correctly! Sort of taming of the shrew.

To succeed in the end, begin with a slightly tighter setting -- in contrast to adjust other mask. It should be only a bit too tight in the beginning, be sure that the mask doesn't leak. Notice that a tape is counterproductive using an FFM! Then, millimeter by millimeter, loosen the straps until it's comfortable. She's a little beast, isn't she?

Also keep in mind that you should try to find the optimal position without the straps but using your hand only. If you don't succeed in finding a right position solely with your hand the mask isn't suitable for your face.

[nightgagger]

When I was using the nasal mask and taping, I always pulled in my lips, the technique was noted when I would read this forum.  The other thing I would also do is the tongue to the roof of the mouth.  I think I have a bit of problem with these techniques because I'm also using a tooth guard.  This device prevent me grinding my teeth and it's used on the top teeth only.  It tends to put some space at the roof of the mouth and the front lips. 
I do shave almost every day, but not always and this pushes the tape, minutely..

The graph that was attached in the post above, albeit I was using the F30i, I did not have the mouth guard in.  Last night I had the mouth guard in, tightened the mask and I also used the Caldera, as opposed to the Corflex from the night before.

I do feel good today though...maybe the amount of hours, which for me is huge, of sleep or laying there...don't know.  I woke up various times of the night and had multiple dreams, but can't recall them.

The graph is attached.

[nightgagger]

Last night I got a pretty solid night's sleep.  I don't remember waking, but if I did it was slight, at least in my mind. 

Very vivid dream about working past midnight to meet a deadline, on my last day of the job, with the boss yelling that I had a mental illness, and me responding, "no, I need sleep".  

Woke up feeling, tired, sort of hazy, but after 20 minutes, seemed to sort out.  Somewhat energetic....still in bed as I type this though, but wanting to get out and do stuff.

The mask is now good and tight, but comfortable, and leak numbers look real good from the previous 2 days of around 30L/min at 95th%.

Obviously I would like to get the leak down, maybe improving as time goes along and start really acclimating with the mask.

Looking at the graph, a very large cluster of stuff....maybe positional, not sure, as I slept with the Corflex Collar.  This is the one that really keeps my neck stiff.  I do sleep supine, so maybe the tongue dropping back?  I don't remember up thread if I mentioned that the sleep doctor, as well as my standard physician mentioning that I have a large tongue.

I'm assuming adjusting pressures next?  

Thanks for the help!  And for those reading this, and finding help, even though the board is free, find some pocket money to donate...well worth it if you're getting sleep after a long battle of not.

As I'm supping down my morning coffee...I'm feeling better and better.

[nightgagger]

It seems my leak rate is diminishing...but I do feel slight leaks around the nasal area with this mask.  It is comfortable, especially on the ridge of my nose, since there's nothing sitting there.  But sometimes will feel a little bit of air going towards my eyes, and that's when I notice a slight leak.

Not sure about the CA clusters, as well as some clusters of apnea.   I am using the Corflex CC. 

Any other suggestions?

I woke up somewhat tired...not really refreshed.

[nightgagger]

Quick addendum to the above.  Today I received a Corflex 2 1/2" collar.  I have the 3 1/2" that has felt a bit uncomfortable.   Just tried out the new collar...but awake, and it feels much better.  Will see how it performs tonight.  

Pretty excited on these improvements, thanks to the forum.

[becker44a]

I've noticed that you have or are using a FFM.  I have used a Fisher&Paykel Simplus a,d I also have their Vitera.  I am a side-sleeper, which is said to be problematic in producing leaks.  My leak stats are routinely median:0, 95% less than 10, Max less than 20.  I rarely have any Large Leak at all.  I also use RemZzz mask liners with the Simplus, and this helps diffuse any small leak around my eyes.  You might look into these masks, as they have been very effective for me, and a number of other users here have mentioned them favorably.

[nightgagger]

I've noticed that you have or are using a FFM.  I have used a Fisher&Paykel Simplus a,d I also have their Vitera.  I am a side-sleeper, which is said to be problematic in producing leaks.  My leak stats are routinely median:0, 95% less than 10, Max less than 20.  I rarely have any Large Leak at all.  I also use RemZzz mask liners with the Simplus, and this helps diffuse any small leak around my eyes.  You might look into these masks, as they have been very effective for me, and a number of other users here have mentioned them favorably.

Thank you for the response.  I looked at that mask on the web.  Maybe more effective, but the thing I like about the F30i so far, is that the mask doesn't go against the bridge of my nose.  This is one of the benefits of this mask that I'm really liking, but nasal position in the cushion has to be spot on.  
Previously I was using a N20 nasal mask, that goes over the bridge of my nose.  It wasn't too unpleasant, but using this new F30i, I'm hesitant to going back to something sitting on my bridge of the nose.  Then again, I do want to get my leaks down. 
Leaks are improving, except for last night.

I'm going to give it another week, then may also try my nasal again because the new pressure settings, and using APAP seems a lot more comfortable than previously being on the CPAP setting.  After that I have the 30 day return policy on the mask and I may try the mask you suggested.

Also last night I used my 2 1/2 cervical collar.  That was more comfortable, unfortunately I can't determine if positional movement is creating a bunch of RERAs and other clusters.

One main thing is, I tend to sleep on my back mostly....Side sleeping is a somewhat rare, but I will indulge occasionally.

I've attached another graph...and also a zoomed in section where my flow limitations, RERAs, and leaks are occuring. 
I'm still trying to wrap my head in understanding flow limitations, even reading the Wiki on it.  Specifically my inspired curve is flattening out.  Is this due to the pressure being to low or high?  Does that even matter when one has high leak?

[multicast]

Regarding your tremendous leaks not only the data provided by the machine are rather worthless but also your therapy ...