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P10 mask Leaks -- Need advice please
#21
RE: P10 mask Leaks -- Need advice please
piggy nose is when the pillows are so tight you nose seems to be flat like a pigs nose.
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#22
RE: P10 mask Leaks -- Need advice please
gwc2795 I hope you find a solution cuz I need one too.

I've tried all three pillow sizes and they all kinda work but medium seems a tad better so most of the 1.5 years with P10 I've rotated between 2 medium inserts. they say they break down and should be replaced more frequently so that's next. strap is useless. stretched to the point I have shortened it by a 2 inch loop (4 inches total) using provided clips.

I'm not aware of the mask leaking but my wife recorded it the other night. when she nudged the mask it quieted down for a minute before leaking again. I suspected if it leaked it would only be at high pressure and that's true most of the time (the blast pushes mask away from nostrils) but it looked in sleepyhead to be only 9-10cm around the time my wife nudged it.

so I wonder if apnea itself causes leaks. maybe there are times when the resistance of apnea is greater than resistance of the mask / mask strap (or is that a no-brainer?). if airway is not opening or it's a central apnea, where is the air to go? doesn't it have to force a leak at the point of least resistance? that might suggest the need to find some other mask that isn't blown out of nostrils as easily but for me it can't simply be a tighter strap as I have the P10 strapped on as tightly as possible without becoming too uncomfortable. and yes, I've tried looser too.

it might also suggest it's not the mask so much as the machine (apap in my case) not adequately resolving apnea before the leaks. nearly all of my leaks appear to be associated with or at least start around events and/or flow limitations.

the culprit I do know about is worsening mouth leak. I notice it mostly when napping, maybe because it's a light sleep. my mouth doesn't open (no apparent jaw movement) so I don't think a chin strap would help. the problem is my lips part just barely enough to let the air escape. I haven't successfully taped because of facial hair. I'm thinking of strapping some kind of pacifier-like affair in/over my mouth. I have a tongue holder (sold as a snoring solution) that might work but as I remember, my biggest complaint with that was drooling, which would mean air leaks too. maybe strapped in/on will work better.

obviously I'm winging it here, theorizing. comments are welcome. meanwhile, I guess the primary option is to keep trying other masks.
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#23
RE: P10 mask Leaks -- Need advice please
(05-27-2018, 02:26 PM)sheepless Wrote: gwc2795 I hope you find a solution cuz I need one too.  

I've tried all three pillow sizes and they all kinda work but medium seems a tad better so most of the 1.5 years with P10 I've rotated between 2 medium inserts.  they say they break down and should be replaced more frequently so that's next.  strap is useless.  stretched to the point I have shortened it by a 2 inch loop (4 inches total) using provided clips.  

I'm not aware of the mask leaking but my wife recorded it the other night.  when she nudged the mask it quieted down for a minute before leaking again.  I suspected if it leaked it would only be at high pressure and that's true most of the time (the blast pushes mask away from nostrils) but it looked in sleepyhead to be only 9-10cm around the time my wife nudged it.

so I wonder if apnea itself causes leaks.  maybe there are times when the resistance of apnea is greater than resistance of the mask / mask strap (or is that a no-brainer?).  if airway is not opening or it's a central apnea, where is the air to go?  doesn't it have to force a leak at the point of least resistance?  that might suggest the need to find some other mask that isn't blown out of nostrils as easily but for me it can't simply be a tighter strap as I have the P10 strapped on as tightly as possible without becoming too uncomfortable.  and yes, I've tried looser too.

it might also suggest it's not the mask so much as the machine (apap in my case) not adequately resolving apnea before the leaks.  nearly all of my leaks appear to be associated with or at least start around events and/or flow limitations.

the culprit I do know about is worsening mouth leak.  I notice it mostly when napping, maybe because it's a light sleep.  my mouth doesn't open (no apparent jaw movement) so I don't think a chin strap would help.  the problem is my lips part just barely enough to let the air escape.  I haven't successfully taped because of facial hair.  I'm thinking of strapping some kind of pacifier-like affair in/over my mouth.  I have a tongue holder (sold as a snoring solution) that might work but as I remember, my biggest complaint with that was drooling, which would mean air leaks too.  maybe strapped in/on will work better.

obviously I'm winging it here, theorizing.  comments are welcome.  meanwhile, I guess the primary option is to keep trying other masks.

Apnea events do not cause leaks.  The machine targets a pressure so it flows enough air to maintain the target pressure.  
When you are not breathing the flow rate is nominal.  Flow rate increases slightly during inhalation, and decreases slightly during exhalation - assuming there is no leaking.  
Leaks get worse as pressure increases, as mask position changes, and as the shape of the face relaxes.
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#24
RE: P10 mask Leaks -- Need advice please
(05-27-2018, 04:27 PM)tedvpap Wrote:
(05-27-2018, 02:26 PM)sheepless Wrote: gwc2795 I hope you find a solution cuz I need one too.  

I've tried all three pillow sizes and they all kinda work but medium seems a tad better so most of the 1.5 years with P10 I've rotated between 2 medium inserts.  they say they break down and should be replaced more frequently so that's next.  strap is useless.  stretched to the point I have shortened it by a 2 inch loop (4 inches total) using provided clips.  

I'm not aware of the mask leaking but my wife recorded it the other night.  when she nudged the mask it quieted down for a minute before leaking again.  I suspected if it leaked it would only be at high pressure and that's true most of the time (the blast pushes mask away from nostrils) but it looked in sleepyhead to be only 9-10cm around the time my wife nudged it.

so I wonder if apnea itself causes leaks.  maybe there are times when the resistance of apnea is greater than resistance of the mask / mask strap (or is that a no-brainer?).  if airway is not opening or it's a central apnea, where is the air to go?  doesn't it have to force a leak at the point of least resistance?  that might suggest the need to find some other mask that isn't blown out of nostrils as easily but for me it can't simply be a tighter strap as I have the P10 strapped on as tightly as possible without becoming too uncomfortable.  and yes, I've tried looser too.

it might also suggest it's not the mask so much as the machine (apap in my case) not adequately resolving apnea before the leaks.  nearly all of my leaks appear to be associated with or at least start around events and/or flow limitations.

the culprit I do know about is worsening mouth leak.  I notice it mostly when napping, maybe because it's a light sleep.  my mouth doesn't open (no apparent jaw movement) so I don't think a chin strap would help.  the problem is my lips part just barely enough to let the air escape.  I haven't successfully taped because of facial hair.  I'm thinking of strapping some kind of pacifier-like affair in/over my mouth.  I have a tongue holder (sold as a snoring solution) that might work but as I remember, my biggest complaint with that was drooling, which would mean air leaks too.  maybe strapped in/on will work better.

obviously I'm winging it here, theorizing.  comments are welcome.  meanwhile, I guess the primary option is to keep trying other masks.

Apnea events do not cause leaks.  The machine targets a pressure so it flows enough air to maintain the target pressure.  
When you are not breathing the flow rate is nominal.  Flow rate increases slightly during inhalation, and decreases slightly during exhalation - assuming there is no leaking.  
Leaks get worse as pressure increases, as mask position changes, and as the shape of the face relaxes.

Apnea events might not cause leaks but tucking your chin and cutting off the airway can certainly force the air out of the mouth. That's why soft cervical collars can be so effective in preventing event clusters.
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#25
RE: P10 mask Leaks -- Need advice please
sleepless I don't have the answer yet. I wonder if my nares are not symmetrical and one pillow leaks more than the other. I have noticed my left side leaks more than my right side.  I have ordered the HYB500 Hybrid CPAP Face Mask Kit by Innomed. It appears to me from reading and looking at the kit I can mix the nasal pillow sizes. I also have the F20 airfit and it is extremely efficient at stopping the leaks. The problem I have with the F20 is the top of the mash rests on the bridge of my nose and when pressurized it closes one of my nostrils, I have to keep moving the ask during the night to unstop one side of my nose. I show excellent treatment results and low leaks with the F20 airfit. I really want to use the nasal pillows because they are so light. I strongly recommend the F20 airfit except for my individual problem with the bridge of my nose. 

Ted I will have to wait to get a Bravado until money becomes available, I had already ordered the HYB500.

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#26
RE: P10 mask Leaks -- Need advice please
Tedvpap said: "Apnea events do not cause leaks. The machine targets a pressure so it flows enough air to maintain the target pressure. When you are not breathing the flow rate is nominal. Flow rate increases slightly during inhalation, and decreases slightly during exhalation - assuming there is no leaking. Leaks get worse as pressure increases, as mask position changes, and as the shape of the face relaxes."

tedvpap, I have no reason to dispute this but I don't understand it. is the target pressure the set pressure or is it wherever the algorithm is taking it? maybe you're saying the machine algorithm varies pressure necessary to maintain set pressure at/in the airway? still, I'm not sure what that would mean either.

when you say flow rate is nominal when not breathing, what does that mean? the min set pressure? but wouldn't that mean the machine would never raise pressure to the max setting?

if machine is set to 8 - 20cm and I have an unresolved obstructive apnea - I don't think it matters at what pressure - air at some pressure is blowing into my nostrils but not into my airway and lungs. where does the air I'd normally inhale go? some, but I think by design not all, presumably exits via the exhaulation port(?), but if that were adequate, why does the mask come away from my face at higher pressures? are you making a distinction between air pressure and air flow that I'm not getting? or what?

sorry, I'm so thick. as they say on reddit, explain it like to a 5 year old please. thanks.
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#27
RE: P10 mask Leaks -- Need advice please
also sorry if my questions amount to hijacking the OP's post. not my intention.
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#28
RE: P10 mask Leaks -- Need advice please
(05-27-2018, 05:25 PM)sheepless Wrote: also sorry if my questions amount to hijacking the OP's post. not my intention.

Still on topic and while a different slant than gwc2795's leaks, nevertheless relevant (and hopefully helpful or at least informative to OP).

I think you've "got it" though you don't understand it.  And I think it's best to let someone else rephrase it.  (At my great age, I've already declined below 5th-grade mentality!)
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#29
RE: P10 mask Leaks -- Need advice please
thanks shaunblake. seems to me the only thing I got (as in "got it") is a severe case of brain fog and general confusion! getting pretty close to that 5th grade level myself.
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#30
RE: P10 mask Leaks -- Need advice please
(05-27-2018, 02:18 PM)gwc2795 Wrote: piggy nose is when the pillows are so tight you nose seems to be flat like a pigs nose.

OK, got it there. 

No piggy noses should not result, in fact the P10 should be placed and seem as though it is floating near your nares.
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