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Leakage during the night
Leakage during the night
Hi guys! I recently got a S9 autoset and I'm on to my second mask being the Quattro Air. The first one was the mirage Liberty and for some reason it kept leaking and waking me up many times during the night.

Since I have the Quattro Air, I notice that things are much better but I'm experiencing major leaks throughout the night. I check my data with Sleepyhead and it happens like twice or three times per night where I have MAJOR leaks.

I strap my mask on soooo tightly I have a hard time understanding what can be causing this. I'm also using a chin strap to prevent mouth drops.

I'm thinking about getting one of those X pillows since I think my leaks are caused by me tossing and turning while in my sleep. Do you think it will help? Any similar experiences out there?

Thank you so much Big Grin
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RE: Leakage during the night
Hi jpchartrand,
WELCOME! to the forum.!
Maybe you are tightening the mask too much? Hang in there for suggestions and best of luck to you with your CPAP therapy.
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RE: Leakage during the night
Hi jpchartrand

Over-tightening a mask in my experience, usually does not improve the leaks situation.
But not every mask works for everybody. As you use a chinstrap, why not talk to your DME about trying out a nasal or pillow mask instead of a FFM.

;-> gjw
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RE: Leakage during the night
Maybe if you glued it on!!! Just kidding! It seems to me that if the headgear was causing leaks because it was too tight it would be leaking all night long about the same. Did you get a fitting guide with the mask and if so, have you tried it the way the fitting guide recommends?

Do you get really massive leaks or are they just somewhat larger than normal? How many liters per minute are your large leaks? A screenshot of a typical leak trace might be helpful.

Best Regards,


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RE: Leakage during the night
I've tried really tight and not tight and EXTREMELY tight. I still get leaks. Weirdly always around the same time. Around 4-5-6am only.

The leaks cause the pressure to go way up and I wake up feeling like I'm falling from an airplane with my mouth open lol

I've ordered a CPAP pillow. Hopefully this will work...
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RE: Leakage during the night
It's not the PRESSURE per se that causes the "wind" but rather the LEAKS.

Wind (or noise) REQUIRES a pressure differential so when the mask leaks, especially beyond the machines capacity to "keep up", the machine is trying continuously the bring the pressure up to the required setting.

This may be due to adjusting the mask at a low "start" pressure (especially if you are using ramp) and then when the pressure NEEDS to increase it causes an initial leak, followed by this runaway feedback, more pressure more leak more pressure until the machine can't keep up.

Alternatively, movement of the mask due to sleep positions or your disturbing it either intentionally or unintentionally.

The main ways that I disturb my nasal pillow mask are:

1) Scrubbing my cheek against the pillow (i.e., rubbing by snuggling into the pillow)
2) Bumping my hose inlet area of the mask with my hand or my extra pillow
3) Rubbing or scratching around my nose or upper lip

#3 is actually easiest to deal with -- don't do that, and I discipline myself to avoid this as much as possible. There are also certain ways to reach under or around the mask that typically cause no trouble.

#2 just takes practice and occasionally a mistake happens anyway.

#1, can sometimes be corrected by gently scrubbing BACK in the opposite direction or by carefully choose exactly WHERE to lay my head so that my "snuggle movement" confirms the mask position rather than pulling it out of alignment.

I wrote a procedure for "adjusting a mask" and it is here somewhere on the forum. In my opinion this is a GOOD method to get a good fit with most any mask.

1) Read the actual instructions (again) including with the mask
2) Watch one or more videos (e.g., YouTube or manufacturer) on adjusting the mask
3) Follow the printed and video instructions step by step while using the bathroom mirror to get the INITIAL fit
4) At the machine, apply FULL PRESSURE (that you will use) and re-adjust the mask according to the instructions
5) While adjusting the mask at the machine under FULL PRESSURE, try the following:
Ignoring the headgear, manually position and press on the mask with your hands to find a fit with NO LEAK
Make a mental note of the feel of this position
Make the small adjustments to DUPLICATE this same feeling of the mask on your face

Note: In step 5, you may need to pull the mask away from your face or even loosen the straps.

It's really this step #5 (along with step #1 & #2) that make this work quickly for me.

Step #5 allows me to "get it right" without having to fool with headgear and straps, and then just duplicate that feeling until my mask doesn't leak. The earlier steps allow me to learn the recommended methods and get the mask CLOSE to a correct adjustment, or at least to understand fully what the adjustments are doing when I make changes.

Seriously, I used to need to adjust diving masks for "perfect comfort" and this is a procedure that I adapted from that work when my job was as a commercial diver. (We off course had no YouTube Smile )

Sweet Dreams,

Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
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