Looking for suggestions

[chzuck]

I have been using a ResMed Air Curve 10 VAuto since May 1922.  Therapy was going pretty good until the begining of this year when my events average went from 4 to over 7.  This past week events have come down. 
Currently, I have been plagued with mask leaks.  I have to have my AirFit F20 mask pretty tight and still at times am awaken by leaks that seem to cause the silicone seal to vibrate against my skin.  I was to see my DMA provider and was given a F&P Vitera full face mask.  I tried it a night and a couple hours the second night and became that frustrated with leak issues and the air coming into the mask seemed like a blast that was trying to blow my lips apart.  So, I went back and saw  a different person.  Well, such a BS story he told me.  I told him the leaking was making me awake and he told me that I must have already been awake and my body was done sleeping, but my brain wanted more sleep.  Unfortunately, I am not easily confrontational.  I just agreed and left frustrated.  I ask my doctor what I had to do to change DMA providers and vowed to never go back to that provider.  For whatever reason, it seemed to me he did not want to offer another mask to try.  I attached last night's OSCAR chart for evaluation.

Also, I mentioned to the DMA provider that the mask leaves red marks where the silicone seals against my face and I was told I have the mask too tight.  However, If I apply an ointment,  do not get the remarks.  I learned that anything with a petroleum product in it is harmful to the silicone, so I am now seeing what using a CPAP gel does in relation to the marks.

[staceyburke]

It would be much more helpful if you could put some different charts up.  I have a like to the charts we need to see in my signature at the bottom of the post.   Try to put all of those on the the same screen shot you post. (chart organization)

[chzuck]

OK, I tried to make the changes recommended

[staceyburke]

Look at your events, check the O events.  You can see 3 times you had clustered O events.  When we see clustered O or H events it shows you have some positional apnea.

Getting rid of as many as you can will lower your AHI.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.

The second thing is to lower your min pressure.  You have Ps 4, over 15-19.  I would change that to Ps 4, Over 10-19.

Try the change for a night and work on the positional apnea.  Let's see how you do with the changes....

[chzuck]

I have no idea how to tell what position I was sleeping in.  I sleep on my back or partial right and left side, mostly left.  I have too many leak issues if I try completely on my side.  I have been thinking about trying the collar.  Thinking it may be too hot, but probably worth a try.  Maybe try a cheap on.  Thanks.  I will try the pressure change as well.

[HalfAsleep]

The leaks are not so bad! See how the numbers show leaks at 0.00%? IME sometimes the scale of the Y-axis on the leak chart can make leaks look gigantic. But still, a farting mask is inclined to wake one up, so I can see your point.

Realistically, there's always some leakage. All kinds of situations can momentarily knock the mask away from the perfect spot. I mean, you could scratch your nose?

To help with the impressions on your face, yes, I would skip the vaseline. Instead try Pad-a-Cheeks. Get the ones designed for your mask.

Mask fart can happen because your jaw slacks in the night. I've recently tried some hacks from here to try and address this, so perhaps they'd work for you, too. The mask I chose is softer than the typical cervical ones (which sleep like lumps): I don't notice it at all in the night.

[chzuck]

It is the irritating leaks that bother me.  Ones that keep me from falling asleep.  Ones that vibrate against my nose and cheeks, mask farts as you call them.  The marks are faint red marks the outline of the face mask on either side of the nose.  Am I allergic to silicone?  I really need to keep the mask tight and as a result the headgear straps stretch a good bit.

[staceyburke]

I think the pressure change will help with  the leaks.  I have found a looser mask leaks less than being overly tight.

[chzuck]

I have tried making it not as tight and it farted more.  And of course my provider was no help.  They told me the red marks on my cheeks are from a mask too tight, but had no tips to try.  FRUSTRATING!

[UnicornRider]

Chzuck, here is some good information from our MASK PRIMER: https://www.apneaboard.com/wiki/index.ph...ask_Primer

Be sure to read Jeffy1958 after you have covered all of the prior information, Jeffy puts all of the knowledge gain in the link to practical application that is easy to understand.