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[Pressure] Another New Player with Some Leak Issues
#1
Another New Player with Some Leak Issues
Hi Everyone! I started using an AirSense 10 for Her with P10 Nasal Pillow in September, and went from an AHI of 104 at testing to 2-8 on Autoset (Ramp 4, Pressure 20), and rediscovered life and a sense of humour. Beats starting the day by passing out in my breakfast bowl!
I started out using a medium nasal pillow, but it was pretty obvious that it wasn't fitting comfortably, so I bought a small nasal pillow. Unfortunately I have a deviated nasal septum and the small pillow at times cuts into this so much that I had to stop using thr machine for 5 mights till my nose healed.
I'm back to using it very carefully again and trying to avoid pressure on the septum. At the same time, on the small pillow, both the leak and AHI have risen again,from an AHI of 2 and leak 8-10L/min to Total Events of 8.4, AHI 3, and a leak of 13L/min. I taped my mouth very tightly last night, and was aware of air being forced back into my mouth.
These are not great variations against the background of an AHI of 104, and I really feel heaps better than I was before starting treatment, in ways you'd all be familiar with, but I'm not sure whether the air leak is something I should worry about. I think I may have to try a nose cone, because of the septal issue, but am wondering if I should just go straight to a face mask because of the air coming back to my mouth.
I'll need an education if you want me to post my SleepyHead results. Thanks for your help, and all the encouraging posts there are on the forum.
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#2
RE: Another New Player with Some Leak Issues
Hi Platypus,
WELCOME! to the forum.!
The mask is the most challenging part of this therapy, so don't be shy about asking to try different ones 'till you find a mask that works for you.
Hang in there for more answers to your questions and good luck to you on your CPAP journey.
trish6hundred
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#3
RE: Another New Player with Some Leak Issues
If the size small nasal pillow fits in the nostril, then it is too small for you. The pillow should not be inserted inside, but sit comfortably under the nose and inserted a tiny bit. I would suggest you give the size medium another chance.

After putting your mask on with pillows adjusted, use your mask fit check on your machine. Once the air is on, you can wiggle the nasal pillows and or pull away slightly from face and let settle back. The air will inflate them and they should form a seal. Most of us wear one size larger than we were fitted for.
If that doesn't work, try a different nasal pillow mask, as you just may be between sizes.

Also, be sure to use a nasal gel like Ayr nasal gel. That helps with irritation.

Your leak rates are in the acceptable range, where the machine would not be affected by them.
But even small mask leaks, or mouth breathing can affect your sleep. You may need to consider a chin strap or practice the tongue suck technique.

You will need 4 posts to send us SleepyHead data. Here is a tutorial to help and will show you how to organize your graphs and how to post them.

http://www.apneaboard.com/wiki/index.php...ganization

http://www.apneaboard.com/wiki/index.php...pnea_Board

I'm also trying to figure out what pressure your machine is set to.
It looks like a minimum of 4 and max of 20? That should be narrowed down to center around your 90/95% pressure. We can advise once we see your data.




OpalRose
Apnea Board Administrator
www.apneaboard.com

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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.
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#4
RE: Another New Player with Some Leak Issues
If you have continued problems with a nasal pillows mask you may want to consider the Dreamwear mask. It rests between the upper lip and the nose so might be more comfortable for you.
Coffee

Happy Pappin'
Never Give In, Never Give Up




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. 
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#5
RE: Another New Player with Some Leak Issues
I wish you luck getting the nasal pillows to work, I'm really trying to get the DreamWear to work right now, I've also been running into mouth leakage. I think in the long run it will be awesome to not need a full face mask, so I would keep trying..
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#6
RE: Another New Player with Some Leak Issues
Can't address some of your technical problems but I can tell you this will be a journey. Try everything at least once.
My DME told me I was a small pillow. That lasted one night before I went to a medium. Then for kicks I tried a large. Much better. It has to be comfortable.

As for your AHI and leaks, well, as I started sleeping better and better, my AHI and leaks went up. As I trained myself to stop opening my mouth while sleeping (yes, you can do that) my leaks went down.

Bottom line, as one aspect gets worse, another gets better. Overall life has improved tremendously. Tackle each problem as it presents itself and you will get there.
CPAP is a journey like “The Wizard of Oz”. It’s a long slow journey. You will face many problems and pick up many friends along the way. Just because you reach the poppies, it doesn’t mean you are in Kansas. 
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#7
RE: Another New Player with Some Leak Issues
When in doubt, go larger, not smaller. It would not surprise me if the large nasal pillow turns out to be right. As much as anyone may like to think their nose is small, chances are the nares (nostrils) are pretty average; and the size large P10 pillows let the most air through and fit best for most.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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.
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#8
RE: Another New Player with Some Leak Issues
Thankyou everyone for your suggestions. I've taken OpalRose's and Sleeprider's suggestion, and gone back to the medium air pillow and Rcgop went larger also. I didn't know there was a gel recommended. I'm in Australia, there's something called "NasoGel" here, and I'll hunt around for it.
I find that I'm becoming better at re-positioning the mask, my pillows, or myself without waking up too much, as the weeks pass. I've learned how to use SleepyHead and get the data off the CD card and printed, but not yet backed up onto my PC.
Leak continues to rise, and is now 17L/min. Is that the Airsense10's record of highest leak spike? Because the SD result from last night shows time over leak redline at 6.332%, which surely is okay? A 'bad' night now for me has 5-8 events, which I do feel the effect of, now that my sleep apnoea is controlled, and I have realised that if I go to bed very late I'll have a 'bad' night.
Hang in there with the pillows, Sleepyguy, hopefully you'll find a way to stop the mouth leak. I find they occur most if I've slithered down from my 5 pillow perch. I don't know why, but if I beat the pillows into shape and sit higher, mouth leaks and mouth-breathing are less. I didn't mouth-breathe before airway obstruction started happening, so I'm hopeful that I can 'unlearn' the habit.
But overall, wow, I just feel great and am thinking of restarting things I'd dropped out of, because I couldn't stay awake at 9am. Smile
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#9
RE: Another New Player with Some Leak Issues
(01-15-2017, 09:05 PM)Platypus Wrote: I didn't know there was a gel recommended. I'm in Australia, there's something called "NasoGel" here, and I'll hunt around for it.

Platypus, something that has worked wonders for me on nose irritation is using a product called Lansinoh. It is actually a lanolin lotion used by nursing mothers and can usually be found near breast pumps in most large box stores. Was reluctant to try it but it cleared up an extremely irritated nostril problem I had from using the wrong size nasal pillows. Found the tip on this board and thankful I did. I still use a minimal amount every night before bedtime and have not had any problems.

Good luck and stay with it!
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