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I’ve been using APAP for about six weeks now. My AHI was around 48 before treatment, but during my trial, I was getting 0.5–1.8 AHI, and leaks around leaks averaged 7-10L/h which was awesome.
Problem is, ever since I switched to my own setup, I can’t get my leaks under control.
Some Background
I’ve had 6+ sinus surgeries (FESS, septoplasty, turbinates, adenoids, polyps, tonsils, and DRAF III).
My nose was basically sealed shut for years, so I was a lifelong mouth breather. Still getting used to nose breathing, but like it.
Side sleeper.
Mainly Hypopneas and OA's and a couple of CA's on my sleep study.
Jumped out of bed feeling like superman after 4 hours on the first night.
One huge plus—haven’t had a single sinus infection since starting APAP!
Finding the Right Mask
Did a month-long trial, tested 12 masks (ResMed, F&P, Philips).
Nasal pillows: Too much pressure in my nose/ears/sinuses, don't like things touching my nose.
Full-face masks: Felt bulky, and I hated mouth breathing on APAP.
Nasal masks: Best fit. Landed on the ResMed N20 + chin strap to stop mouth leaks.
Tried AirFit and AirTouch - AirFit gets much lower leakage.
Trial vs. My Own Mask
During the trial: Great AHI (0.5–1.8), leaks averaged 7-10L/h, only issue was a red mark on my nose.
Bought the exact same setup two weeks ago, and suddenly… leaks everywhere.
Other info
Pressure: APAP 7–15cm H₂O (max apnea pressure required was around 9.5).
Machine: ResMed Airsense 11 Auto.
EPR: Set to 3, helps a lot with exhaling.
Ramp: 35 mins
CPAP Mode: Tried 8cm H₂O per doctor’s advice—felt like CPR, hated it.
Mask adjustments: Tried loose, tight, over-tight, over-loose—tweaking it slightly every night.
Mouth taping: Gave it a shot a few times, but felt anxious about it. Didn't improve leaks anyway.
Chin strap: Still using it, don’t think my mouth is leaking?
Pillows: During the trial, I gave two specialty CPAP pillows a shot, hated them.
Looking for Help!
I’ve attached screenshots from my last 3 nights - can anyone take a look and help me figure out what’s causing these leaks?
LeakySleeper,
Welcome.
Your EPR is set for ramp only, try full time and see if that helps with the leaks.
Have you tried a soft cervical collar, might help with any chin tucking once you fall asleep.
Can you post a copy of your sleep report with your personal info redacted?
That is the sleep report thanks for posting.
You have a high AHI when on you back, 48.7. A soft cervical collar might help if you are tucking your chin. When a person is lying flat on their back, it's called the supine position for sleeping.
Those who have trouble breathing when they sleep may find that lying on the back makes this worse. It also may cause louder snoring in people who snore.
Nose blockages and mouth breathing may allow the lower jaw and tongue to more easily shift back and obstruct the airway.
02-15-2025, 07:37 AM (This post was last modified: 02-15-2025, 07:45 AM by jdougc.)
RE: Struggling with Leaks – Need Some Advice
Not sure mouth tape would help but I use a modified chin strap from Amazon. Make sure your chin strap pulls straight up as much as possible, not back which would make your sleep apnea worse.
See my picture
Thanks for the detail! I have a feeling my chin-strap was pulling backwards - so moved it more to the top of my head.
Had an.... interesting night, and can't work out what happened: Looks like I stopped the machine at 12.15am and started it again at 2am.
First time ever I've seen Cheyne Stokes appear, and this AHI is much higher than I normally get - don't think that's got anything to do with the EPR at 3 full-time though?
02-15-2025, 04:51 PM (This post was last modified: 02-15-2025, 04:56 PM by jdougc.)
RE: Struggling with Leaks – Need Some Advice
Seems that over 60% of your Ahi of 5.93 were clear airway events. Maybe you held your breath as I do when I toss and turn/roll over. Or these clear airway events could be caused by EPR being on. More experience people can tell you here.
One night is not much to go on though.
Also you minimum pressure is too low to have an EPR setting of 3. Maybe try 8 or 9. Again More experience people can help.
Finally consider either turning ramp of or only 5 minutes with a higher starting pressure
First night with the soft cervical collar.
Data doesn't lie - leaks have definitely improved - not a single OA.
Appreciate the recommendations!
However my AHI took quite a big hit: mainly with CA's.
I wonder if this is because EPR is now on full-time, and my body is still adjusting to treatment (almost 7 weeks in)?
Great results, except for the CAs, might be due to the change as you suggested or holding your breath as you tossed and turned?
Your Flow Limits are great, maybe considering lowering EPR to 2 for a few nights? The CAs might drop. Or don't make any changes and see how you feel.
Are these CAs causing you to wake up slightly?
How did you feel when you woke up? Tired or a headache, or other symptoms?
