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Mask Leak
#1
Mask Leak
Good morning!

So... Coming up on three months of CPAP on August 2nd.  Overall, I would say things are going pretty well. AHI's are mostly under one with  a few rogue scores in the low 2's. 
I have, however, been experiencing  A LOT of mask leaking lately (according to Sleepyhead).  I was using a Dreamwear nasal mask for a while, but switched back to the Swift FX nasal pillows to try to stop the leaks (and didn't find the Dreamwear that much better in terms of comfort). Still getting leaks with the Swift Fx, too.  I wear a soft cervical collar and I tape.  I'm assuming the leak is mask movement, but I have adjusted and adjusted and adjusted some more.  Anyway, here are my stats.  Please advise. TIA.

http://imgur.com/a/JLEaz
--Leslie

"It will all be fine in the end. If it isn't fine, it isn't the end."
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#2
RE: Mask Leak
Since no wiser adviser has replied, I'll give this a shot based on my similar experience, as a newish cpap user myself.
So, two systems may fail, as you discussed: your mouth/jaw, or the equipment.

As to mouth taping, I found that unless I taped the absolute living daylights out of my mouth/jaw/chin, it was still possible to have fairly significant leaks. I guess this is because your bottom jaw can still drop quite a distance, allowing the tongue to drop with it, which seems to let the air into your mouth.  I can't speak to the cervical collar aspect--it didn't work for me.

As to equipment, I found that the Dreamwear headgear can slide up in the night, and you may not notice the subtle shift, but it seemed to allow leakage for me.

(With other masks, ie, the N20, the headgear stretched out differentially-- a subtle, slow change which may go under the radar--and it affected the geometry of the system so that the more I tightened it,  the more the cushion dug into my nose and rotated upward, which created pain and leaks. The straps just couldn't grip my head properly and tightening just allowed it all to slip upward.)

So, what I have done:
1) quit taping.  I had no concerns whatsoever about its safety UNTIL I discovered one night that I have silent, painless reflux, and it was terrifying to wake up from a deep sleep, choking and unable to breathe with liquids quickly rising..
2) dumped the N20 for the Dreamwear Gel. I think this mask is phenomenal. It allows me to flip and flop to my heart's content and DOES NOT LEAK, for me. However, I did have to improvise to make sure the straps stayed down in the back of my head, in my case, using flat, metal, bendable barrettes or bobby pins. I also used the 'check mask leak' function on the resmed machine to determine which size pillow to use.
3) I experimented, post-taping, with chin straps.  The ruby-red still allowed leaking, but a deluxe, white model (wide white elastic bands) eliminated the leaking completely. However, that model is pretty heavy-duty and did not fit easily under the dreamwear, so I got some sort of scunci sport headband which is thin and pretty, and I rig that from under chin to top of head.  My experience with chinstraps is that the ones which span at something like a 45 degree angle across your head don't work as well, but the ones which apply a vertical force UNDER my chin work like a charm. It doesn't have to be tight, i can talk freely, but it just keeps my jaw from dropping.

I hope this helps you in some way. I know this is all very person-specific, but maybe your experience has some commonality with mine. I know it's a drag to wake up with leaking...

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#3
RE: Mask Leak
Very nice response orava. And, welcome to ApneaBoard. Welcome

Leslie: your leaks do appear to suggest mouth leaks.
Admin Note:
JustMongo passed away in August 2017
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~ Rest in Peace ~
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#4
RE: Mask Leak
Hey, Orava!

Thank you for the thoughtful response.  I do agree with your taping assessment-- I had to experiment to get the leaks stopped completely (use double the amount of tape), but so far, my mouth is staying completely sealed all night.  I can so relate to the adjusting of the straps and masks.  I have really long hair and have figured out that two braids help the strap from slipping around and I also use those barettes you mentioned (i love those things). I actually considered cutting all of my hair off (like a boy cut) just to not have one more thing to complicate the CPAP experience every night. 

 I'm going to consider a different mask and see what I can figure out.  Just feeling very frustrated.  Thanks again for responding.  Much appreciated.
--Leslie

"It will all be fine in the end. If it isn't fine, it isn't the end."
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#5
RE: Mask Leak
(07-24-2017, 10:51 AM)justMongo Wrote: Very nice response orava.  And, welcome to ApneaBoard. Welcome

Leslie:  your leaks do appear to suggest mouth leaks.

Hey, jM--

Despite the tape, I do wake up sometimes with a completely sealed mouth full of air and dry as the Mojave. I figured you experts would be able to look at my stats and tell me if it was a mouth leak.  Much to my chagrin, I think i might have to consider a FM then I won't have to worry about my stupid mouth leaks, right?

Thanks for your response.
--Leslie

"It will all be fine in the end. If it isn't fine, it isn't the end."
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#6
RE: Mask Leak
Orava, remarkable first post!  Welcome and please stick around.


Before you go the full face mask route...  Cervical collars come in different heights and our necks all differ.  You might want to try a taller one that keeps more pressure on your lower jaw.  

And full-face masks might compensate for mouth leaking, but you can still get Sandpaper Mouth.  I can attest to that.  That might have been due to a mask leak  at the same time but that makes it no less unpleasant.  

Another seldom mentioned possible solution is an adult sized <cough> pacifier.  I have not tried it but I expect it would cause the tongue suck in response to using.
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#7
RE: Mask Leak
Thanks, Chill!

I will investigate getting a taller collar and see how that works. I've hear about adult pacifiers.  One of my friends is speech pathologist, and she has me doing exercises to eliminate my tongue thrust and get my tongue where it belongs.  She said it could take a long time, but I may be able to get under control. I also think living for years with chronic sinus congestion is related to breathing with my mouth open at night. I certainly don't love the dry mouth, but I'm concerned that my AHI reading are not accurate because of the leaks, thus considering a full-face.  I can live with the dry mouth if I KNOW i'm breathing AND sleeping.  I had a few days where I couldn't keep my eyes open (like the old days), but I had a decent AHI-- made me realize these leaks are probably affecting my machine's ability to treat my apnea and give accurate scores. I am willing to try ANYTHING (pacifiers included) to make my CPAP work better so I can sleep.
--Leslie

"It will all be fine in the end. If it isn't fine, it isn't the end."
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#8
RE: Mask Leak
The OTC cervical collar available from Amazon comes in 3 heights as well as a good selection of neck sizes. I had trouble finding much variety shopping locally. I'm sure there are other good choices but it's inexpensive and easy to find.
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Soft Cervical Collar

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#9
RE: Mask Leak
Have you seen an ENT about your sinus congestion?  I assume yes.  I, and several others, have had surgery for turbinate trims and deviated septum straightening.  The recover is not so bad and it has helped my daytime and nighttime breathing.  It is worth considering if your ENT thinks that it is involved with your sinus congestion.
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#10
RE: Mask Leak
The Futuro neck brace is adjustable.(has a strap below your mouth and one for neck size) I use it at its tallest of about 4 inches. Bought it at CVS.
And welcome to the board.
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