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Mask Leakage
#1
Happy Holidays. Thank you for providing the website so I can better understand the CPAP treatment and ask questions.

I am new to using a CPAP, beginning on 11/17/14.

I have been experiencing a lot of mask leakage (up to 50% some nights) reported using the Sleepy Head software. To correct the leakage, I am using a Respironics Chin Strap which has brought down the mask leakage down. In 1990 I had the Uvulo-Palato-Pharyngo-Plasty (UPPP) surgery which has been suggested as being a contributing factor in my mouth breathing.

QUESTIONS

1. I awaken once per night, upon returning to bed there is an unmistakeable pattern of a “swarm” of OA, HA and CA Apnea Events after returning to bed, but before falling back asleep. Typically there are 8-12 Apnea Events over a 45 min period while I am still awake.

I would appreciate any thoughts as to why I am experiencing the “swarm” of Apnea Events. I have tried raising the CPAP pressure from 14.0 cm to 16.0 cm, this seems to help but I don’t have enough data to say that the pressure increase is the solution.

2. Does the Sleepy Head Software automatically adjust the leak rate based on the CPAP set pressure? At 14.0 cm H20 the leak rate threshold is 24 l/min, does the software change the leak rate when the pressure in increased to 16.0 cm H20?

3. In order to try to combat the mouth breathing problem, I tried using a ResMed Air Fit F10 full face mask. I set the Mask Option on the S9 to Full Face and left the pressure at 14.0 cm. Using the Full Face Mask was an unmitigated disaster; the AHI average for 37 days with the Nasal Pillow Mask was 2.57, two nights with Full Face mask the AHI jumped to 10.05. Sleepy Heads Welcome page told me how terrible my results and to go see the Dr. The full face mask seems to fit correctly without noticeable leakage. Does anyone have any thoughts as to why the problems with the full face mask?

I do have an appointment with my Dr on 1/15/15 and would like to understand what is going on so as to be able to ask better questions.
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#2
G'day MorseCode, welcome to the forum and compliments of the season.

A good rule of thumb in CPAP is to only vary one thing at a time (eg pressure, mask type) and go at least a week between changes to allow your brain and body to adapt to the change. Results over a single night are not necessarily a good guide - you're really looking for trends. Could you add the particular model S9 you're using to your profile? It will be printed on the body near the power button and may be Escape, Elite, Autoset or VPAP.

In response to your questions...

1. It's not unusual to get a cluster of events as you transition into and out of sleep. I don't think that's a worry. And if you're sure you were still awake at the time, then they can be ignored.

2. The leak threshold of 24 cm H2O is actually set by Resmed, not by SleepyHead. It applies at all pressures.

3. Again it's not uncommon to get a small change in AHI when changing masks, though a jump to 10.5 does seem a bit excessive. As I said earlier, I suggest you give it a full week before ruling that mask out. In the meantime can you see anything specific on your SleepyHead charts which show a correlation between the apnea events and anything else going on? It would be helpful if you could post a screen shot. (You need to have a few posts up before you can attach an image but until then you can link to an file on a hosting service like PhotoBucket).

Again, welcome to ApneaBoard, and good luck with your CPAP.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
What Deep Breathing said +. The leaks that you are reporting at 50% I believe are actually 50 liters per minute or maybe it is leakage over the target 50% of the time. With that much leakage your AHI may well be under-reported because the machine is having a hard time detecting them with that amount of leakage. Then when you use a FFM, if you are getting leaks under the target, you may be getting a correct reporting of the apnea events. It may not be the fault of the mask but may be that you are getting more accurate reporting of the events with the reduced leakage.

Another thing that can add to this problem is that some people have their AHI jump up for a while when they make changes. If I were you, I would stick with the FFM for a while to see if the AHI settles down.

Best Regards,

PaytonA
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#4
Hi MorseCode,
WELCOME! to the forum.!
CPAP can take some getting used to and the mask is the hardest part of the whole thing.
BTW, Which S 9 machine do you have?
Hang in there for moresuggestions to your post, much success to you with your CPAP therapy, and good luck with finding the mask that works for you.
trish6hundred
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#5
Welcome to the board.

I think an important factor is being overlooked, if you are awake when this swarm occurs than it is of no concern at all. Not to be funny but it is called sleep apnea for a reason, you must be asleep, any events you are seeing while awake do not at all count toward your apnea or treatment. So the $64 question is, are you awake or asleep when the swarm happens? My understanding from what you said is that you're awake.
If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
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#6
(12-26-2014, 12:54 AM)Galactus Wrote: Welcome to the board.

I think an important factor is being overlooked, if you are awake when this swarm occurs than it is of no concern at all. Not to be funny but it is called sleep apnea for a reason, you must be asleep, any events you are seeing while awake do not at all count toward your apnea or treatment. So the $64 question is, are you awake or asleep when the swarm happens? My understanding from what you said is that you're awake.

I thought I said that if MorseCode was sure he was awake then those events can be ignored. Of course the machine doesn't know if you're awake or asleep, so they still count towards the recorded AHI. In this case the real AHI is a bit lower than shown on the machine.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
(12-26-2014, 01:21 AM)DeepBreathing Wrote:
(12-26-2014, 12:54 AM)Galactus Wrote: Welcome to the board.

I think an important factor is being overlooked, if you are awake when this swarm occurs than it is of no concern at all. Not to be funny but it is called sleep apnea for a reason, you must be asleep, any events you are seeing while awake do not at all count toward your apnea or treatment. So the $64 question is, are you awake or asleep when the swarm happens? My understanding from what you said is that you're awake.

I thought I said that if MorseCode was sure he was awake then those events can be ignored. Of course the machine doesn't know if you're awake or asleep, so they still count towards the recorded AHI. In this case the real AHI is a bit lower than shown on the machine.

Don't get your nickers twisted in a bunch there. This wouldn't be the first time I said something you said or you said something I said, without first reading everything. Smile No harm, no foul, we're just trying to help the guy out, right?
If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
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#8
(12-26-2014, 01:28 AM)Galactus Wrote: Don't get your nickers twisted in a bunch there.

Ooh, no! That sounds painful. Grin

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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