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Nasal Pillows and Mask Leak
#1
Question 
Hello all,

I'm new to CPAP and I just got my CPAP machine Tuesday of this past week (ResMed AirSense 10 Auto). The doctor wrote the prescription with a ResMed AirFit P10 nasal pillows mask. I used this same mask in the titration study and was surprised that it worked so well. I like the simplicity of this mask and find it very comfortable. I'd really like to stay with the P10 nasal pillows if at all possible.

Now that I've had a few days to get accustomed to the mask, when I put the mask on before bed, I have no problems with mouth breathing or leaking (without CPAP I am definitely a mouth breather). I've used the CPAP machine everyday for at least 6 hours since I got the machine. I've noticed that about 5:30 or 6:00ish that I wake up from mouth leak; the leak is so bad that it becomes nearly uncontrollable. Every few minutes I'll have another leak and eventually I just wake up completely. I'm definitely not getting enough sleep because of this and after a few days I just completely crash because of sleep deprivation.

I'm not a fan of trying a chin strap because air can still leak around the sides of the mouth. Taping is definitely out; not safe IMO. Would you all recommend a full face mask? I would be willing to buy a good FFM just to have as a backup as some do to use when they are sick.

On a side note, I've noticed that many people seem to have issues waking up early and that overtime it gets better as the body learns to adjust. Should I just hang in there and see what happens?

Thanks in advance for the help!
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#2
Same situation with me, though I've been at it for over 3 years. Couldn't keep my mouth shut (in more ways than one . . . ). I got a chin strap and wore it for a few weeks, and it seemed to "train" me to keep it shut. Recently started with the mouth leaks again, so I've been reading up, looking at straps, and experimenting with the Amara View mask (pretty good, so far, but not quite used to it after the P10).
There's a few threads in here on chin straps, and I've almost pulled the trigger on both the Ruby one and the Pap Cap. If I can re-train myself, I'll probably stick with the P10 and not switch to a FFM.
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#3
(09-04-2016, 03:39 PM)resaebiunne Wrote: Hello all,

I'm new to CPAP and I just got my CPAP machine Tuesday of this past week (ResMed AirSense 10 Auto). The doctor wrote the prescription with a ResMed AirFit P10 nasal pillows mask. I used this same mask in the titration study and was surprised that it worked so well. I like the simplicity of this mask and find it very comfortable. I'd really like to stay with the P10 nasal pillows if at all possible.

Now that I've had a few days to get accustomed to the mask, when I put the mask on before bed, I have no problems with mouth breathing or leaking (without CPAP I am definitely a mouth breather). I've used the CPAP machine everyday for at least 6 hours since I got the machine. I've noticed that about 5:30 or 6:00ish that I wake up from mouth leak; the leak is so bad that it becomes nearly uncontrollable. Every few minutes I'll have another leak and eventually I just wake up completely. I'm definitely not getting enough sleep because of this and after a few days I just completely crash because of sleep deprivation.

I'm not a fan of trying a chin strap because air can still leak around the sides of the mouth. Taping is definitely out; not safe IMO. Would you all recommend a full face mask? I would be willing to buy a good FFM just to have as a backup as some do to use when they are sick.

On a side note, I've noticed that many people seem to have issues waking up early and that overtime it gets better as the body learns to adjust. Should I just hang in there and see what happens?

Thanks in advance for the help!

IMHO. Well, your top pressure is WAY to high for a pillow. If you are willing to make some adjustments, people here will lead you in the right direction. And if so, small baby steps are a must. I was the LL king when I got here, same complaints you have.

On your side note, you are correct, it takes time to "learn" how to control your leak issues.

NOTHING says you have to keep the settings the DR. prescribed. I changed mine on my own in tiny increments until I found the "sweet spot". I was so afraid when I took my SD card to the DR. that it would be a big fight. I had charts, data, screen shots and I was going to stand my ground.

Well he was so stunned when he looked me up in the cloud about the improvement in leaks that he never asked to see my SD card and we never had to go toe to toe.

It took several months to dial in what "I" needed. So be patient my friend.

i would still try your way and give it some time 1st. And don't be afraid of a chin strap, it worked for me in conjunction with my adjustments.

I have a 7 day minimum rule between changes in machine settings. AND I took notes daily as to make sure if I was moving in the wrong direction, I could find my way back

Regards,
Chuck
Sleep-well
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#4
Do you sleep on your back? I found that turning on my side solves any mouth leak problems because the bed pillow holds my mouth shut.

Did the doctor write the prescription for the machine to run wide open like that? It would help to see your Sleepyhead charts to find what a narrower range could be
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#5
Wide open will not "hurt", it simply will not work as well. If the machine is working correctly, it will not go higher than necessary to stop the apneas. However, having it go all the way back down to 4 after the apneas is probably not the best for therapy. There are many here that know much more than I, I will assume they will chime in soon.

If I were you I would try a couple different chin straps and see if I could find anything I could stand and that stopped the mouth leaks. Personally, I love the P10, but was never able to stop breathing through my mouth, so after trying glue, tape, chin straps and everything else I could think of, I changed to an F10. It is not as comfortable as the P10 (for me) but it seems to be easier for me to control the leaks on - not perfect yet, but better.

Good luck.
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
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#6
(09-04-2016, 06:00 PM)FrankNichols Wrote: Wide open will not "hurt", it simply will not work as well. If the machine is working correctly, it will not go higher than necessary to stop the apneas. However, having it go all the way back down to 4 after the apneas is probably not the best for therapy. There are many here that know much more than I, I will assume they will chime in soon.

If I were you I would try a couple different chin straps and see if I could find anything I could stand and that stopped the mouth leaks. Personally, I love the P10, but was never able to stop breathing through my mouth, so after trying glue, tape, chin straps and everything else I could think of, I changed to an F10. It is not as comfortable as the P10 (for me) but it seems to be easier for me to control the leaks on - not perfect yet, but better.

Good luck.

Just to verify, if in CPAP mode, I think the machine will max out and stay at max minus whatever your EPR setting is if you enable it. In CPAP it does not react to events but rather stays constant.

For example: 4 would be the starting point, then ramp (if set) up to 20 and stay. In APAP, then the machine would react to an event in that range to stop the event.

You ARE ABSOLUTELY correct that the range is to wide in my opinion in either mode. AND the chin strap is a game changer also, as is side sleeping. Some of my success is the way I route my hose so as not to pull on it as I move from back to side sleeping however many times I move per night.

Look at my settings for example, it doesn't show but I start at 5 and ramp to 10 in 5 minutes (not everyone likes or needs ramping), then in APAP my machine stays between 10-13. I look at my data weekly, and by trial and error over several months last year, I found that I neither go down to 10, nor max to 13 at any time during the night and my events are well within the parameters required for "proper therapy". Minus the huge leaks.

My DR. had me at 14 in CPAP and I felt like I was in a wind tunnel with massive leaking. Even with EPR enabled!
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#7
I expect the machine is in APAP mode.
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
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#8
Hi all, thanks for the replies. I'll post back with some screenshots of sleepyhead data tomorrow.

Yes, the machine is in auto mode and is wide open with a min of 4 and a max of 20. It is interesting that before I fall sleep, the machine will ramp up to 7 or even 8. I believe the EPR is set to 2, but I haven't checked for this specifically. I'm not sure I want to change any of the settings in the clinician mode (the unit is setup with cellular access), and anyway, I haven't even had the machine a week yet. It's a bit soon to go changing any of the settings without data to back it up. Ramp is disabled and I don't think I need it anyway.

The results from the titration study stated that 7 was enough to eliminate any issues.

Quote:Do you sleep on your back? I found that turning on my side solves any mouth leak problems because the bed pillow holds my mouth shut.
Typically I sleep on my side or stomach. I can sleep on my back, but I prefer not to.

I have found that mouth leaking doesn't occur simply because my mouth is open. I do use my tongue to help the mouth seal, but like I said, the air just leaks around and puffs up my cheeks and escapes through my lips.
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#9
Hi resaebiunne and welcome to the forum!

Hope you get this sorted out soon. Maybe now you are on CPAP therapy 6 hours sleep is enough? I know I sleep less hours than I used to probably because the hours I do sleep are far more 'productive' with therapy. Or perhaps you've entered REM stage and the machine has increased the pressure to higher than the P10's allow to stay comfortably on you. Hopefully SH will shed some light on your issues.
APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

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EVERY ACCOMPLISHMENT BEGINS WITH THE DECISION TO TRY!
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#10
Here is last nights data:

http://k1vzx.com/files/screenshot-20160905-221912.png

Doesn't seem like any significant leaks to me? Or it could just be that I turn the unit off when I can't prevent the mouth leaks.
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