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P10 mask Leaks -- Need advice please
#41
RE: P10 mask Leaks -- Need advice please
(05-27-2018, 10:49 PM)sheepless Wrote:
(05-27-2018, 09:18 PM)Walla Walla Wrote:
(05-27-2018, 08:25 PM)sheepless Wrote: when I look at the attached graphs, besides the clusters W2 & others will point out Smile (agree, and still looking locally for a soft collar), I see leaks that rise with pressure (which rises in response to obstruction) and more at lower pressure that look to be more closely related to events and flow limitations. I realize these things are all interrelated, even if I don't completely understand how, and I sure don't know what's chicken and what's egg.  but it does look to me like apnea and flow limitations are associated with leaks (if not the cause), even when pressure is at the low end of the settings. btw, I was aware of leaking from the lips during the first sleep, between 1 - 2 pm.  don't know where other leaks were coming from but other leaks do appear to be climbing before pressure rises and at the time of apnea and flow limitations (see for example around 5 - 6 am).  am I missing something here? 

besides commenting on whether unresolved apnea tends to produce leaks (where does the air go when not into airway & lungs?), feel free to weigh in on efficacy of therapy after looking at this chart.

thanks for bearing with me.  just trying to "get it".

I'd set your maximum pressure to 11.5cm to prevent the pressure from running away due to leaks . I think a collar will clear up most of the events with a pressure below 11.5cm.

thanks WallaWalla.  I'm a little worried that maybe now I really have inadvertantly hijacked gwc2795's thread.  I have a question about limiting max pressure.  mods, please advise me re proper etiquette.

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#42
RE: P10 mask Leaks -- Need advice please
One side of my P10s started leaking the other night. It was a rhythmic leak, worse on the exhale. I fixed it and went back to sleep. In the morning I realized that nostril was very congested, almost totally blocked. I'm wondering if some people's leaks are due to congestion and the mask popping out because of it.

Side note, I often wake with one nostril more congested than the other. I think it bounces back and forth. Not sure if this is a sign of deviated septum or just natural.
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#43
RE: P10 mask Leaks -- Need advice please
(05-27-2018, 10:49 PM)sheepless Wrote: thanks WallaWalla.  I'm a little worried that maybe now I really have inadvertantly hijacked gwc2795's thread.  I have a question about limiting max pressure.  mods, please advise me re proper etiquette.

no problem about the hijacked thread. This is great information.
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#44
RE: P10 mask Leaks -- Need advice please
thanks gwc2795 for your permission to continue. I think this thread should continue in service of understanding possible causes of mask leak and what to do about them - particularly the issues you are having with the airfit p10.

my follow up with wallawalla about my settings and efficacy should move. thanks apnea infant for the suggestion. W2 - I'll start a new thread or repost your advice and my further queries in my "18 months of apap..." thread later.

prompt to get back on track: your experience with p10? other ideas how to limit p10 leaks?
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#45
RE: P10 mask Leaks -- Need advice please
tedvpap, I really do think I'm thick or slow or something.  would it be possible, and not too much to ask, for you to explain again what you said in post #35 in the context of my attached graphs from last night?  maybe having a visual reference will help me get it.  I'm having trouble looking past the obvious or at least apparent association of leaks, events and flow limitations.  I really want this to break through my muddled brain but I understand if too much trouble or if you think it won't be helpful.
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#46
RE: P10 mask Leaks -- Need advice please
sLEEPLESS
I sent you a private message.
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#47
RE: P10 mask Leaks -- Need advice please
(05-28-2018, 04:44 PM)sheepless Wrote: tedvpap, I really do think I'm thick or slow or something.  would it be possible, and not too much to ask, for you to explain again what you said in post #35 in the context of my attached graphs from last night?  maybe having a visual reference will help me get it.  I'm having trouble looking past the obvious or at least apparent association of leaks, events and flow limitations.  I really want this to break through my muddled brain but I understand if too much trouble or if you think it won't be helpful.

I will try.  
My explanation is about the physics as it is important to understand what physically is happening and not happening in order to understand what is relevant and what is not.
So physically I am trying to explain that regardless of whether there is an apnea or not, the pressure is essentially unchanged.  The flow rate varies through out the breath. 
The P10 vent is designed such that it flows 37 l/min when exposed to a pressure differential of 12 cm-H2O (it flows 43 at 16, and 49 at 20).  So when there is no breathing (such as during an apnea or between breaths), the flow rate is 37 l/min.  When you breath in, the flow rate increases.  When you breath out, the flow rate decreases.  So the flow rate is always varying around 37.  

Regarding your data, a couple of observations.
Your Leak Rate data does not show a total leak rate, only a mask leak rate.  My machine shows a total leak rate (vent rate + mask leak rate) and a mask leak rate.  Your machine only shows the mask leak rate.  I am pointing this out just to avoid confusion when looking at other people's data.  
It does not look like you leak rate increase when you are having events.  Look at 5:15-5:45 where the leak rate changes were opposite of apnea event.


More importantly, your leak rate varies too much.  It should not.  My leak rate stays below 5 and I am at a pressure of 17 - 20.   Some times your leak rate is low (less than 5) and other times it is 20.  You are either mouth leaking (which is what I suspect), or you move around which causes the bed pillow to push the nasal pillow around.

The amount of leaking is not excessive as the event data is still valid, but it could very likely interrupt your sleep.  This must get resolved. 
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#48
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.

fyi: the ideas above that apnea might be causing leaks and the machine might not adequately resolve apneas before leaks have been debunked by tedvpap and others.  I should have been clearer that these were speculation on my part.
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#49
RE: P10 mask Leaks -- Need advice please
"the problem is my lips part just barely enough to let the air escape.  I haven't successfully taped because of facial hair."

Yes, same problem here with the lips opening slightly.  Try Sominfix mouth tape.  I have facial hair too and it usually stays on throughout the night. I think I'm the only one who has mentioned this product on the forum but I think it could help a lot of people.  And no, I have nothing to do with the company.  
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#50
RE: P10 mask Leaks -- Need advice please
thanks so much mrzennie. probably a good suggestion for many here. had read some reviews: most raved about it but bearded types complained it didn't work. based on your experience, though, I definitely want to try it out. mouth leak has become a significant problem for me and few solutions available short of shaving (every day! ugh. right up there with being choked by a tie around my stubby neck.)
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