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Mouth Leaker?
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DariaVader Offline
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Posts: 1,819
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #1
Mouth Leaker?
My father was at my vacation house last week, and I took the opportunity to snag his SD card and make him a sleepyhead profile. His numbers look great, and pressures are not going up much at all from his min however, his leak rate is high consistently, so those numbers may not be valid. I told him he needs to wear his chinstrap; pretty sure the mouth is open... but he said he hates it. He also hated the face mask... wears big eye shields that won't fit with anything more than the P10. Does this look like a mouth leaking profile to you?

RemStar Auto with A-Flex (560P)
A-Flex x3 APAP (Variable)
Min 9 Max 20 (cmH2O)
P10 Airfit
[Image: dad.png]

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
05-27-2015 11:39 AM
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justMongo Offline

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Posts: 3,839
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #2
RE: Mouth Leaker?
He's leaking somewhere!

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.
05-27-2015 11:51 AM
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DariaVader Offline
Apnea Board Facebook Editor
Monitors

Posts: 1,819
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #3
RE: Mouth Leaker?
when I leak, my blower maxes out. his is so nice and calm... is that a diff between the PRS and Resmeds?

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
05-27-2015 11:54 AM
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justMongo Offline

Monitors

Posts: 3,839
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #4
RE: Mouth Leaker?
What I've seen on ResMed's, at high leak, is the blower maxes out; and the high data rate flow data shows a drop in pressure.

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.
05-27-2015 11:58 AM
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retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #5
RE: Mouth Leaker?
Hi DV, where the heck ya been?

This is a pretty small sample, so it's a bit hard to draw any conclusions. However you're probably right that he could use a chinstrap.

I don't blame him for "hating" his chinstrap. For some reason most of them are a little too big, or whatever. So as with masks, he might investigate different ideas for a chinstrap. Some that might appeal to him are ace bandages "gently applied," a sweat band, or whatever.
05-27-2015 02:00 PM
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Sleepster Offline
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Posts: 4,988
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #6
RE: Mouth Leaker?
Need to see a leak graph for the entire night. Look for periods of time lasting an hour or more where there are no leaks, and then periods lasting an hour or more where there are large leaks. That's what mine look like when I mouth-leak. If he's leaking all night you should be able to observe him doing it.

Check the on-screen display to see the percent time in large in leak. I bet it's high.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
05-27-2015 07:08 PM
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JVinNE Offline

Advisory Members

Posts: 262
Joined: Jan 2015

Machine: ResMed Aircurve 10 ASV Bilevel
Mask Type: Full face mask
Mask Make & Model: F&P Simplus aka Facedigger
Humidifier: HumidAir™ with climate line
CPAP Pressure: Min EPAP 5 Max IPAP 13 PS 1-2
CPAP Software: SleepyHead

Other Comments: New, ASV Barbie, now with morning fart action.

Sex: Female
Location: New England

Post: #7
RE: Mouth Leaker?
(05-27-2015 07:08 PM)Sleepster Wrote:  Need to see a leak graph for the entire night. Look for periods of time lasting an hour or more where there are no leaks, and then periods lasting an hour or more where there are large leaks. That's what mine look like when I mouth-leak. If he's leaking all night you should be able to observe him doing it.

Check the on-screen display to see the percent time in large in leak. I bet it's high.

Sleepster, does your Simplus cause deep lines in your face? I can't sleep on my back, so it's digging in, even when it's not too tight, and I use a Pad-a-cheek on it.
05-27-2015 07:16 PM
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quiescence at last Offline

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Posts: 753
Joined: Nov 2014

Machine: REMstar System One with Autoflex
Mask Type: Full face mask
Mask Make & Model: Quattro AirFit F10
Humidifier: yes typical setting = 4
CPAP Pressure: 5-13 Autotritrating CPAP
CPAP Software: SleepyHead EncoreBasic

Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing

Sex: Male
Location: US

Post: #8
RE: Mouth Leaker?
DV - from the plot, which you probably posted because it was the interesting part, there is no correlation between leaks and expected attenuation in flow rate. while the pressure setting is 9-20, his apnea is well controlled and constant at 9 (plus the standard PRS1 pressure spikes to 10.5). The plot shows no adjustments to pressure throughout this clip. it is interesting that the snores happened when leak was low. you might expect the flow rate to be attenuated at those points - which does not seem to be true, and you might expect that he is mouth breathing when he snores which would increase the leakage (theoretically). if he could somehow not leak when mouth breathing, it would probably show an increase in TV and flow rate. so, based on this, I would be willing to believe he is not mouth breathing. This leaves leaking at mask to face interface. Would he be willing to try pad/liner for a trial?

QAL


btw. Did his resp get bumpy between 23:35 and 00:25? If so, he may have been REM sleeping and pretty un-disturbed by the skin interface leakage which would normally awaken him.

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
05-28-2015 05:34 AM
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DariaVader Offline
Apnea Board Facebook Editor
Monitors

Posts: 1,819
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #9
RE: Mouth Leaker?
(05-27-2015 02:00 PM)retired_guy Wrote:  Hi DV, where the heck ya been?

This is a pretty small sample, so it's a bit hard to draw any conclusions. However you're probably right that he could use a chinstrap.

I don't blame him for "hating" his chinstrap. For some reason most of them are a little too big, or whatever. So as with masks, he might investigate different ideas for a chinstrap. Some that might appeal to him are ace bandages "gently applied," a sweat band, or whatever.

I have been up at Wallowa Lake for the majority of May... The internet here is horrible sometimes Big Grin and we have had a lot of company!
but my house there is a short walk from this:

[Image: 20150525_115851.jpg]

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
(This post was last modified: 05-28-2015 10:04 AM by DariaVader.)
05-28-2015 09:24 AM
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DariaVader Offline
Apnea Board Facebook Editor
Monitors

Posts: 1,819
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #10
RE: Mouth Leaker?
(05-27-2015 07:08 PM)Sleepster Wrote:  Need to see a leak graph for the entire night. Look for periods of time lasting an hour or more where there are no leaks, and then periods lasting an hour or more where there are large leaks. That's what mine look like when I mouth-leak. If he's leaking all night you should be able to observe him doing it.

Check the on-screen display to see the percent time in large in leak. I bet it's high.

That little clip is how long he spent on the machine that particular night. He goes to bed with the machine, and then gets up and sleeps in a chair without it when he wakes. He says he can't sleep on his side with any mask he has tried, including the P10, and that sleeping on his back hurts too much unless he is at an incline. Trying a mask liner is a good idea (for pillows???) He has psoriasis - which could be a contributing factor to mask discomfort. He is almost 80, has congestive heart failure following several heart attacks and he sports something like 8 stents. He wasn't using his CPAP at all until my sleep DR sent a text message to a Kaiser RT who is now managing my dad's case more diligently - he got a brand new machine, new masks and followup appts that they plan to continue - they are working with him in spite of his non-compliance. They are helping him, I am helping him, but he's stubborn Big Grin I don't generally watch him sleep, but while he was here at the Wallowa house I watched him nap and hang his mouth open.

apparently photobucket is too far of a reach this morning for my link so I attached more screenshots that might be more representative and are longer stretches. I hadn't noticed how short the night I first attached was. Big Grin (hope that bandwidth improves, I am supposed to be working from here. Lol. )
           

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
05-28-2015 10:03 AM
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