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OSCAR understanding mask leaks & mouth leaks
#1
OSCAR understanding mask leaks & mouth leaks
New to therapy but expect discussion here will be generic enough that I did not put this in my own thread about treatment. I want to understand particularly mouth leaks (which I am trying to reduce) and how OSCAR data/display can assist. Attached so there is something concrete to point to as example is part of my own session when for the first time I used mouth taping (Somniflex) to address mouth leaks which as far as I know had never been bad, but forum suggested I address. Please correct and add to my understanding:

  1. It seems from other posts that mouth leaks even those that are not Large Leaks should be reduced as much as possible as such mouth leaks reduce the effectiveness of treatment.
    Generically for OSCAR noted leaks that are presumed to be mouth leaks what leak rate pressure and/or brevity of duration might be considered inconsequential?
    I realize that what seems like a simple question to me in reality might not have a one-size fits all answer since any answer most likely is best given in the context of other OSCAR data and subjective person report. 
  2. I had been told on forum that spikey Leak Rates in OSCAR are more likely to be mask leaks and that areas that are flatter and of longer duration are more likely to be mouth leaks. If that is accurate it seems that the attached OSCAR example are all? mask leaks??
  3. What else might one look at in OSCAR to give greater confidence that something is mask versus mouth leak? I expect that there will be times during treatment that one has a goal of reducing mask leaks or of reducing mouth leaks so understanding how one might use OSCAR to track progress and the impact of what you have changed about treatment is feedback that is important e.g. trying a new mask, or making adjustment to strap tension, or positioning of a chin strap.

    As always thanks for cutting my leaning curve.

    If there are good threads that are a primer in using/understanding OSCAR data please note those; the Wiki on OSCAR is pretty sparse on most of the data understanding/interpretation e.g. Tidal Volume, Inspiration/Expiration Time, etc. But let's keep this thread focused on the mask leaks & mouth leaks topic.

    and zoomed view as well     
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#2
RE: OSCAR understanding mask leaks & mouth leaks
Practice this over and over until you stop mouth breathing. It won't take too long and before you know it you be good to go.
Then all you will have to worry about is mask leaks which will show up in OSCAR.

Tongue Suck Technique:
Place your tongue to the roof of your mouth with tip of tongue behind front teeth. Slowly suck upwards and back.
This places the tongue in a natural position, with the back of tongue sealing the back of the throat so that if you open your mouth/jaw while sleeping, no air will escape.
My worst night on CPAP is 10X better than my best night without it  Eat-popcorn 
Good night Chesty, wherever you are..Semper Fi
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#3
RE: OSCAR understanding mask leaks & mouth leaks
(02-24-2020, 07:57 PM)3rdMarDiv Wrote: Practice this  ...

Tongue Suck Technique: ...
Thanks for reminding about the exercises. Been doing that already and other exercises, but none of that has anything to do with my ?s about looking at OSCAR data.
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#4
RE: OSCAR understanding mask leaks & mouth leaks
(02-24-2020, 01:20 PM)Liteheart1 Wrote: New to therapy but expect discussion here will be generic enough that I did not put this in my own thread about treatment. I want to understand particularly mouth leaks (which I am trying to reduce) and how OSCAR data/display can assist. Attached so there is something concrete to point to as example is part of my own session when for the first time I used mouth taping (Somniflex) to address mouth leaks which as far as I know had never been bad, but forum suggested I address. Please correct and add to my understanding:

  1. It seems from other posts that mouth leaks even those that are not Large Leaks should be reduced as much as possible as such mouth leaks reduce the effectiveness of treatment.  Large leaks will make treatment ineffective, but smaller leaks won't affect treatment.  What they often do, however, is disrupt your sleep.
    Generically for OSCAR noted leaks that are presumed to be mouth leaks what leak rate pressure and/or brevity of duration might be considered inconsequential?
    I realize that what seems like a simple question to me in reality might not have a one-size fits all answer since any answer most likely is best given in the context of other OSCAR data and subjective person report.  For all leaks, if they aren't in large leak territory and you're sure they are not disrupting your sleep or leaving you with a painfully dry mouth or bothering a bed-partner, they are basically inconsequential.
  2. I had been told on forum that spikey Leak Rates in OSCAR are more likely to be mask leaks and that areas that are flatter and of longer duration are more likely to be mouth leaks. If that is accurate it seems that the attached OSCAR example are all? mask leaks??  I'm not really sure how to size up those particular leaks just by looking, but if you're using Somnifix and it is staying on firmly all night, you can safely conclude these are mask leaks.  (These have spiky tops but they are plateau-like in general contour.)
  3. What else might one look at in OSCAR to give greater confidence that something is mask versus mouth leak? I expect that there will be times during treatment that one has a goal of reducing mask leaks or of reducing mouth leaks so understanding how one might use OSCAR to track progress and the impact of what you have changed about treatment is feedback that is important e.g. trying a new mask, or making adjustment to strap tension, or positioning of a chin strap.  Again, if you're using Somnifix successfully, you can pretty much count on the leaks you see as being mask leaks.  And it's a little off-topic, but while you should certainly continue to practice the tongue-suck method, which works well for many people, be aware that it won't solve the mouth-leak problem for everyone, since some aspects of our palates, tongues, teeth, and jaws just won't cooperate at night, under pressure, even though we are nose-breathers during the day.

    As always thanks for cutting my leaning curve.

    If there are good threads that are a primer in using/understanding OSCAR data please note those; the Wiki on OSCAR is pretty sparse on most of the data understanding/interpretation e.g. Tidal Volume, Inspiration/Expiration Time, etc. But let's keep this thread focused on the mask leaks & mouth leaks topic.

and zoomed view as well 
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#5
RE: OSCAR understanding mask leaks & mouth leaks
Dormeo thanks for excellent answers and information about the questions I had raised. And also good to know that the Tongue suck exercise might not be successful for everyone with suspected mouth leaks.
And for everyone the example real OSCAR data I had posted was from session when I was using mouth tape by Somniflex successfully with it remaining in place for entire session and therefore while the mask leak data shown is both spikey but also has plateaus, presumably the only thing going on or at least the dominant thing were mask leaks. My tentative conclusion is that plateau shape might imply that the leak is mouth related yet that shape is not always conclusive.
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#6
RE: OSCAR understanding mask leaks & mouth leaks
For mouth breathing the other place to look is a 3 minute zoomed view of the flow rate.
There is expiratory mouth breathing where you are inhaling through the nose and exhaling through the mouth. The flow rate should have equal area under the curve for both inhale and exhale. When the inhale looks normal and and the exhale looks flat with lessor volume that is expiratory mouth breathing.

If your apnea is well managed IMHO leaks are somewhat less important. They can tend to hide other issues if your apnea is not well managed. Going into large leak territory you are compromising the machines ability to compensate for the leak.
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#7
RE: OSCAR understanding mask leaks & mouth leaks
Thanks bonjour for input that helps flesh out a better understanding of OSCAR and the questions I asked in OP. This is the kind of thread that for makes this forum so valuable - learning enough to fish for oneself.
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#8
RE: OSCAR understanding mask leaks & mouth leaks
If you are interested in learning more about how mouth breathing and many other sleep activities affect your OSCAR chart data, you may wish to look into setting up a camera to video yourself sleeping. By setting up a camera you will be able to record the exact time that you observe yourself mouth breathing and other activities you can then go to that time in OSCAR and see the results.

Coffee
My worst night on CPAP is 10X better than my best night without it  Eat-popcorn 
Good night Chesty, wherever you are..Semper Fi
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