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help with leaks and wake ups
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Nyrie Offline

New Members

Posts: 3
Joined: Dec 2012

Machine: REMstar Auto A-Flex system one series 60
Mask Type: Full face mask
Mask Make & Model: Quattro fx
Humidifier: Phillips Respironics
CPAP Pressure: unsure
CPAP Software: Not using software

Other Comments:

Sex: Female
Location:

Post: #1
help with leaks and wake ups
Hello,Any ideas about what i can do to minimize the leaks? I would really appreciate sleeping for several hours at a time. I've read some of these so I think I know what you will ask.

My sleep study showed I had 69.1 AHI per hour. Mostly my sats stayed in the 90's but I went as low as the 70"s.

My machine says my AHI was 8.1 for yesterday and 4.7 for past week.

Thank you.


You can ignore the rest, it's mostly me griping about the lack of care and info I have received from my health care folks.

New to both forum and CPAP. I got my machine in mid October. They gave me a nasal pillow which I took back asap. When I went back to change it the guy told me I had 2 to choose from (AFTER my 30 days were up I had a appt with a very nice woman who told me I had many choices). Since the mask I have tighten, loosened, rotated and thrown it across the room. I wake up with leaks every night, pretty much every hour. Hit the ramp and go back to sleep until the next time. I feel terrible.

You may ask did I go back and ask for help? I did. He told me that it takes some people longer to adjust. Now I read on this forum about mask fittings (nope), adjusting the pressure (nope), changing to a different mask (nope).

I did finally have an appt with a very nice woman who sent my the quattro fx mask for free (past 30 days) when she heard I had gone back twice.
12-09-2012 06:28 PM
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zimlich Offline

Preferred Members-2

Posts: 392
Joined: Feb 2012

Machine: Respironics PR System One BiPap Auto SV Advanced
Mask Type: Nasal mask
Mask Make & Model: ResMed gel Nasal Mask
Humidifier: System One
CPAP Pressure: 8-20 ASV, 8 EPAP,PS 12
CPAP Software: Not using software

Other Comments: I use the Quattro FFM when necessary

Sex: Female
Location: Norfolk, VA

Post: #2
RE: help with leaks and wake ups
Nyrie, my last resort for leaks are Macks Silicone Earplugs. You take a few of the earplugs and roll in palms until softened and the roll into a string the diameter of a pencil. Place this string of silicone around the perimeter of the mask. It usually lasts one or two nights. I then take the silicone off the mask, roll into a ball and place in an airtight container. Repeat as necessary. I can use the same silicone for quite a while by reusing.
Good luck,
Mary
12-09-2012 06:43 PM
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trish6hundred Offline

Advisory Members

Posts: 6,450
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #3
RE: help with leaks and wake ups
Hi Nyrie and WELCOME! to the forum.!
I'm sorry you are having such a rough time with CPAP therapy. I will tell you that it can take quite a while 'till you get things that work just right for you. The mask is the hardest part of this whole thing so your PATIENCE is REQUIRED.!
Hang tight for more suggestions and best of luck with your CPAP therapy and don't give up.

trish6hundred
12-09-2012 06:44 PM
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b360155 Offline

Preferred Members-2

Posts: 265
Joined: Feb 2012

Machine: ResMed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro FX & Quattro Air
Humidifier: ResMed H5i
CPAP Pressure: 11.4
CPAP Software: ResScan SleepyHead

Other Comments: CMS50-D Plus Pulse Oximeter!

Sex: Male
Location: North Richland Hills, TX

Post: #4
RE: help with leaks and wake ups
I went through 4 other masks before settling on the Quattro FX. This mask has worked great for me as I get zero leaks most nights now. Some suggestions for this mask which can be tricky to fit correctly:
1) Check out YouTube and search on "Resmed Quattro FX". There are several videos that talk about the "swing and seal" technique which is unique to the Quattro FX.
2) It's very important to get the correct size mask and headgear. The top of the mask sits "mid-bridge" on your nose. The bottom should sit in the indentation between your lower lip and chin.
3) I wash the silicone face cushion every morning in hot water and liquid Ivory soap and rinse well under running hot water rubbing my thumbs across the cushion until it's squeaky clean and let air dry. I also wash my face with Ivory soap immediately before going to bed.
4) You just have to kind of experiment with the headgear tension. Too tight is not good. The mask should "float" on your face and the straps should be just tight enough to eliminate leaks.

If all else fails, you may have to switch to another model mask until you find one that works for you as mask fit is very personal.
On the positive side, if you had 69.1 AHI per hour in your sleep study and your averaging 4.7 AHI now, you're making excellent progress.
Good luck with the Quattro FX and welcome to the forum.

We're all family here...you can call me B36 if you'd like!Cool
12-09-2012 06:56 PM
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JudgeMental Offline

Advisory Members

Posts: 324
Joined: Feb 2012

Machine: Respironics DreamStation Auto-CPAP
Mask Type: Full face mask
Mask Make & Model: Respironics Amara View
Humidifier: Respironics
CPAP Pressure: 11-14
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Florida USA

Post: #5
RE: help with leaks and wake ups
Well Nyrie, it appears that you are having a rough start in the world of sleep apnea. A lot of people, including me, will tell you, (until your ears ring,) that it takes time. N'uff said!!
You didn't mention about your pressure settings and it is missing in your profile. The higher the settings, the bigger the mask problem. Posting that might bring a suggesting, as well. I might ask also, just what you found wrong with the pillows mask and what mask did they use for your sleep titration, if you had one. The pillows are the most leak free if you can find them comfortable. I use the pillows most of the time and find they are very ez to sleep with. I move a lot and the pillows works well with side and stomach sleepers. I'll use the Mirage Quartto (FFM) every now and then just to remind myself to go back to the pillows.
FFM (full face masks) are usually the hardest type of mask to calm down the leaking with. The contours of your face just dont comfortably fit the masks. High cheek bones, expanded bridge of nose, hurts the bridge of your nose, etc,etc.
You have a top of the line machine, so the efforts toward XPAP compliance toward beneficial health will have to be in the mask area.
I think I would put some more effort toward the nice lady that gave you the Quartto mask. Sounds like she is the one who gets the Thank You card or Xmas poinsettia plant. Bigwink A good DME is hard to come by. Sometimes you just have to lean a little harder.
Read and learn all you can about cpap, masks, software and machine settings. This very friendly board is the ultimate for info.

Yesterday is history; Tomorrow is a mystery; Today is a gift; Thats why its called "The Present".
12-09-2012 07:05 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #6
RE: help with leaks and wake ups
(12-09-2012 06:28 PM)Nyrie Wrote:  I got my machine in mid October. They gave me a nasal pillow which I took back asap.
whats was the problem with nasal pillows? nasal pillows have minimal contact on the face and leaks the least
everyone is different. I would try NASAL mask first ... less bulky than full face masks
whats the machine setting and are you using mask fit check at set pressure
SleepyHead support PRS1 machines and there is patch for the 60 series machines also EncoreBasic works with 60 series
whats the percentage of large leak shown on the lcd screen
during large leak .. machine no longer possible to determine respiratory events with statistical accuracy
12-09-2012 07:23 PM
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jgjones1972 Offline

Preferred Members-2

Posts: 516
Joined: Nov 2012

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro FX
Humidifier: ResMed H5i
CPAP Pressure: 18 - 20
CPAP Software: ResScan SleepyHead

Other Comments: CMS50I PulseOx

Sex: Male
Location: Ohio - USA

Post: #7
RE: help with leaks and wake ups
Welcome

The Quattro FX is a touchy (but very good, imho) mask. I can't over stress the importance of cleaning the soft silicone cushion well every day. The cushion needs to be "squeeky" clean. Use some kind of oil-free soap (I use dish washing liquid) and rinse it well. I dry my hands and then shake it dry over the bath tub. After it dries it should feel tacky. Also, the Quattro is tricky with pressure changes. If you adjust it just right at 5cm and your pressure goes up to 12cm you'll probably lose your seal. I start out at 15cm and have to tighten it down kinda snug so it'll still hold tight when the pressure bumps up to 20cm while I'm asleep. So I would say it might be a good idea to look at your pressure variations and see if you can narrow the range down. This might be as simple as seeing if you can do without the ramp - it's only a comfort feature and some of us find it more comfortable to get rid of the ramp after we've gotten used to the pressure. All that being said, it just might not be the right mask for you - many people have to try several till they find the right fit.

Don't give up!
Okay
12-09-2012 09:16 PM
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Nyrie Offline

New Members

Posts: 3
Joined: Dec 2012

Machine: REMstar Auto A-Flex system one series 60
Mask Type: Full face mask
Mask Make & Model: Quattro fx
Humidifier: Phillips Respironics
CPAP Pressure: unsure
CPAP Software: Not using software

Other Comments:

Sex: Female
Location:

Post: #8
RE: help with leaks and wake ups
Thank you Everyone.

nasal pillows: I tried this. Felt fine until I woke up in a panic unable to breath. I also breath through my mouth a lot and I read on the websites that a full face would work better. I'm ok with wearing a mask. It is a little hard as I like to sleep on my side. On this forum someone suggested using teo pillows. I tried that last night and got at least one 1 1/2 hr stretch.

pressure settings: I don't really understand my machine. The ramp was at 5 and I found some instructions on turning it up. It is now at 6. The max pressure listed in the settings is 20. I turned it down to 16.5 (my average was 17) to see if that would stop the leak. It just raised my AHI so I put it back. Can you tell me if the pressure ever goes down when you are in automatic or does it slowly go up and stay there?

I use the ramp because I can't get the mask to seal once it loosens and I know no other way to ease the pressure. How high can I put the ramp? It always feels like it isn't enough air.

jgjones, you said you fit it at 15cm? How do I do that? When it leaks, should I just tighten everything until the leak stops?
12-09-2012 09:39 PM
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Sleepster Offline
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Moderators

Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #9
RE: help with leaks and wake ups
(12-09-2012 09:39 PM)Nyrie Wrote:  nasal pillows: I tried this. Felt fine until I woke up in a panic unable to breath. I also breath through my mouth a lot and I read on the websites that a full face would work better.

Full face masks are harder to fit as they are more prone to leaking. If you don't like nasal pillows you can try a nasal mask.

A chinstrap can be used to help prevent mouth-breathing.

Quote:Can you tell me if the pressure ever goes down when you are in automatic or does it slowly go up and stay there?

It's supposed to go back down. You can use free software to tell for sure.

Quote:I use the ramp because I can't get the mask to seal once it loosens and I know no other way to ease the pressure. How high can I put the ramp? It always feels like it isn't enough air.

Don't over-tighten the mask. That can cause it to leak. The ramp is fully adjustable.

I know you said you hated nasal pillows because you felt you weren't getting enough air. I would suggest you try them again. Try wearing them whie you're awake, just relaxing and watching TV, reading, or listening to music. Most of the the things that bother us about CPAP therapy stop bothering us after a while. We humans acclimate and adapt very well.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
12-09-2012 10:02 PM
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jgjones1972 Offline

Preferred Members-2

Posts: 516
Joined: Nov 2012

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro FX
Humidifier: ResMed H5i
CPAP Pressure: 18 - 20
CPAP Software: ResScan SleepyHead

Other Comments: CMS50I PulseOx

Sex: Male
Location: Ohio - USA

Post: #10
RE: help with leaks and wake ups
It sounds to me like your machine is set to range anywhere from 5cm to 20cm and your machine runs an average of 17cm to suppress OAs. It sounds like your ramp is set to start at 6cm - so this effectively makes your machine range from 6cm to 20cm.

I can't tell you what to do with your pressure settings, but I'll tell you what I did with mine. The DME set my pressures to range from 5cm to 20cm. I never could get the mask to work with such wide pressure swings. I didn't want to lower the top number because I wanted high enough pressure for effective treatment, so I started slowly raising the starting pressure. I ended up with a starting pressure of 15cm and I left the max pressure at 20cm. This leaves only a 5cm pressure range for the mask to have to accomodate. I messed around with the ramp for a couple of nights, but gave up on it and leave it off now, it made it hard to fit the mask and I felt like I wasn't getting enough air because the whole point of the ramp is to start off at a lower pressure than what you need. When I go to sleep my pressure is at 15cm. I use the Mask Fit feature on my AutoSet, so when I put my mask on and hit the Mask Fit the pressure goes up to around 19cm and I adjust to make sure there are no leaks. After 3 minutes it goes down to 15cm and I go to sleep. Before I had an AutoSet I had an Escape Auto without a mask fit feature and for the first couple of months I didn't know how to set my own pressure, so I would put the mask on and fake snore until the pressure got up to 15cm or 16cm (I couldn't control it very well) then adjust the mask and try to go to sleep before the pressure got so low I felt like I couldn't breath. Thanks to Apnea Board I have control of my own settings now!

And yes, if your airway isn't being obstructed the machine will lower the pressure. You had a higher AHI when you lowered the max pressure because you were keeping the machine from providing sufficient pressure for effective treatment.

Hope this helps.
12-09-2012 10:18 PM
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