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Mask Leaks
#1
Mask Leaks
First time cpap user just diagnosed with moderate sleep apnea (17.6 AHI/hr) a few weeks ago.  I have never slept well and always feel tired even after sleeping for 8+ hours a night, so I'm pretty excited to see what life is like sleeping good!  I purchased a ResMed Airsense 10 autoset with heated hose and humidifier along with a ResMed Mirage Quattro Mask (medium).

I've only used it for two nights and already feel way better in the morning, but I'm struggling with getting a good seal on the mask.  I've watched every video available on using this mask and no matter how I set it up I get leaks at higher pressures.  Last night it woke me up with "seal barking" and air blowing into my eyes.  Any tips or suggestions?  I did not have the mask fitted by a provider, I went to ResMed's website and downloaded their fitting tool, so maybe my mask is too small even though it looks similar on my face to the videos I've watched on proper fitting of the mask.

Much thanks

Ian
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#2
RE: Mask Leaks
Ian, the mask fit is one of the biggest challenges in therapy. Fit is generally good with a loose fit, or the mask size or style may not be ideal. Keep working at it and if the fit does not settle in in a few days, talk to your DME about an exchange. The Mask Primer in my signature has lots of good tips.

Regarding your settings, we can make improvements that will help your results and comfort. At settings of 5 to 18 and EPR at 1, your median pressure is mostly between 14 and 17, which is a reasonably close range. It is flow limitations that is pushing your pressure higher, and using more EPR may help reduce flow limitations. EPR (exhale pressure relief) on your machine acts like bilevel, resulting in a greater difference between your inhale (IPAP) pressure and exhale (EPAP) pressure. We have a pretty good wiki article on Flow Limitation that explains it in a more detailed way, but I think increasing EPR to 3 will be helpful to you. Your minimum pressure could stand to be higher, but the machine is doing a good job of increasing pressure as needed.
Sleeprider
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#3
RE: Mask Leaks
Hi Ian and welcome to the forum. 

Sleeprider said "Ian, the mask fit is one of the biggest challenges in therapy." I say - truer words were never spoken. In joining this forum you came to the right place for help. I use a full face mask and have found leaks to my biggest problem. The mask information on this forum will be very helpful to you. Mask size is key but I have found very few (actually only one) provider that was helpful with this aspect of therapy. Just keep working with trying to get the setup that works best for you. It takes patience and persistence. Stick with it and you can improve or eliminate this issue over time. 

Happy new year,

Stan
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#4
RE: Mask Leaks
Thanks for the replies!  I've read the articles on flow limitations and mask fitting and will try the suggestions in there to see if I can get better results.  I bought the mask from cpapman. Link removed.
They have a 30 day exchange policy and are local so trying a different size or mask isn't an issue.  Cheers.











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#5
RE: Mask Leaks
There's an interesting recent thread about fixing the leaks with an F20 ... although it's not about the Mirage, maybe it'll be useful:

Airfit F20 homemade mask liner
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#6
RE: Mask Leaks
Thanks to all for the great info.  After playing with the mask and regrettably shaving off a portion of my mustache (major heartburn with that!) I had much better results last night.  I also adjusted the EPR from 1 to 3, much more comfortable. A few leaks but overall much better, the only other issue is that I'm waking up way too early from feeling too rested!  Cheers
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#7
RE: Mask Leaks
That looks better. If you want to drop your AHI to less than 2 and potentially less than 1, consider getting a soft cervical collar. The flow limitation and clusters of OA in your chart appear to be positional apnea related to chin tucking. A soft cervical collar is a really inexpensive and effective way of eliminating it, and it may also solve your leak problem. Here is a current thread where the same issue is being discussed. http://www.apneaboard.com/forums/Thread-...nd-big-AHI
Sleeprider
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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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#8
RE: Mask Leaks
Still battling bad leaks over the last few nights with the Mirage Quattro (see attached).  I've read that some people have had success with mask liners and so I constructed one out of an old t-shirt using a template I found online (attached).  I did a short test with my flow set at 17-18 and did 5 minutes on left, right and back and I'm happy with the data (attached).  Also, the OA on my short test was when I held my breath out of curiosity lol. I'll try it tonight to see how it works.  In the meantime I've ordered another mask to try, the ResMed Airfit 20.  Cheers


Attached Files Thumbnail(s)
       

.pdf   diy-cotton-mask-liner.pdf (Size: 221.59 KB / Downloads: 84)
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#9
RE: Mask Leaks
If you haven't read it read the Mask Primer. Why are you using a full Face mask? I always suggest trying masks from the least intrusive, Pillow Masks which rest on, not in, the nares of the nose to the most intrusive, the full face mask. That is Pillows, nasal, FFM. Which mask is best for you, and don't take this wrong, is the mask that works for you.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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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#10
RE: Mask Leaks
Your leaks are still bad and on your charts, you only have LL OA and H selected as events. Events for CA, UA and RERA are turned off. These can be turned on at the lower left of the chart. I second the recommendation to try something like the Resmed Airfit P10. It's a very easy system to seal as long as your mouth stays shut. Here are a couple thread links showing mask liner solutions some other members have come up with:
http://www.apneaboard.com/forums/Thread-...#pid277171
http://www.apneaboard.com/forums/Thread-...#pid158213
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files

How To Deal With Equipment Supplier


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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