Mouth leak prevention and help

[SomeUser00]

Greetings everyone

After using the nasal mask for years recently I've been struggling to sleep properly for some circumstances.

The argument of mouth leaks came through.

In a relaxed state my lips are open due to a difference in jaw size where my bottom one is smaller, to my knowledge at least the lips are not sealed but I don't feel a jaw drop.

I tried a normal mask that you use for viruses prevention etc to try and minimize the air leaks if there's any. I noticed for the first time briefly when I wake up during the therapy that there's warm air on my lips especially from the corners where I drool.

I'm not sure if the mask is causing this leak or this was always the case and I just didn't notice.

Trying a full face mask the drool keeps building up until it starts leaking through the corners of the mask and it wakes me up.

I'm not sure about mouth taping because it could be risky to hold drool inside? Because I drool a lot that is. 

Also we barely have any special products here like some type of tapes. Not even mask choices. All has to be shipped probably and takes weeks.

Lastly I have a kind of long story to where I got here and we barely have professional help for CPAP/bilevel matters where I live if any unfortunately. Do you think I'd get help here if I explain my situation? It could be about redoing the whole therapy settings.

[Jay51]

I used to have the Trilogy Evo (AVAPS) ventilator. 

Mouth leaks could be happening because of higher pressure(s).  What are your current pressures?  

If you download OSCAR (just below this post in my signature; and organize OSCAR charts and upload them, we can take a look at your therapy and give possibly suggestions to help).  

IMO, you might as well try again to get some help there with your therapy.  (You can try on our ApneaBoard forum as well at the same time.)

Here is some good reading from our ApneaBoard Wiki as well on preventing mask leaks (scroll up and down to read all of the topics):

• 1Mask Primer
  

[SomeUser00]

Is this good? I uploaded this a few days ago
https:// sleephq.com/public/teams/share_links/037e8ff5-7cfe-412a-9380-f85eb24bae90

[url=https://sleephq.com/public/teams/share_links/037e8ff5-7cfe-412a-9380-f85eb24bae90][/url]

[SomeUser00]

As for the pressure thing, it's part of the story but to summarize my old therapy setup was way higher than now it was on the system one device, I think the leaks might be due to lower pressure not higher? Or maybe I used to leak before but It didn't matter since the pressure loss wasn't affecting me.
To add to this there are no leaks while being awake during the therapy even if I open my mouth, and never noticed leaks while I was asleep until I used something to cover my mouth a few days ago.

[Jay51]

For some reason I was not able to access your charts.  

If you have been using higher pressures than 15/5 then you must have learned some things about leaks by this experience.  

Do you feel that your therapy pressure(s) are good enough for you the way they are set now?  How do you feel in the morning when you wake up?

[SomeUser00]

My current pressure settings which were changed a couple of months ago:
Philips Dreamstation machine (just a reference)
PC mode
Avaps
15 IPAP max
9 IPAP min
1.3 seconds Ti (should be 1.2)
350 target volume
12 BPM

due to some circumstances I was sleeping for years on higher settings which were not correct and unfortunately as a stupid kid back then since I didn't notice any major issue I didn't look up anything about it

Philips System one machine
PC mode
Avaps
15 IPAP min and max
2.1 seconds Ti
9 BPM and 450 target volume

When the system one broke, the Philips machines were not available so we only had a normal st machine, but the st machine caused side effects after a few days of usage so I had to seek medical help

Unfortunately reaching the only hospital where there's knowledge about CPAP and bilevel is not easy and let alone for someone who has a scoliosis and muscle weakness

During the wait time the dreamstation was in stock
But the side effects the st machine caused started to resurface again after a few days of usage.

After weeks I managed to go there and the result is:
- Did an x ray
- did CO2 measurements and it was fine
- the doctor saw me for a few minutes and readjusted the settings to what I posted at the top
- he said that the nasal mask doesn't work for bilevel because it leaks (I read online after that otherwise but it is what it is)
- was told to use face mask or else a nasal mask is at my own risk
- denied a proper sleep study
- I didn't sleep there for days using a face mask that leaks air and drool then was discharged with sleep deprivation that lasted for weeks

This is how things work here unfortunately 

I went back to the nasal mask hoping to sleep again but the issue lasted for a long time

on paper the new settings are fine to get the expected volume but in reality I wake up several times from sleep when I manage to sleep to begin with and I feel lack of sleep in the morning in the head (dizziness) and chest (being tired to some extent)

I don't necessarily find the new settings to feel bad during the therapy but I just can't sleep well with it for some reason.

---

sleephq.com/public/teams/share_links/037e8ff5-7cfe-412a-9380-f85eb24bae90


If it doesn't work I can upload a zip of the SD card if needed

[Jay51]

The settings on your machine are always your decision as to how you want to set them.  

I can give examples of my settings on my AVAPS ventilator for comparison.  

Normal tidal volume for an average size male is around 500ml.  That is what mine was set to.  350 seems a bit low IMO.  

Also, normal respiratory rate during sleep is approximately 12 to 20 or so.  Your 9 BPM seems a bit low as well IMO.  

Do you feel that you are not getting enough air at times during sleep because of these settings?  Is this what could be causing the dizziness, etc.?

[SomeUser00]

Right now BPM is set to 12،
It's
15 ipap max
9 ipap min
5 epap
12 BPM
1.2s ti (1.3 on nasal mask)
350 target volume

9 was the old setting in the system one

At night I wake many times after falling asleep is what I can tell whenever I manage to sleep, not sure what causes this exactly
I noticed at 1.3 seconds Ti for example I sometimes sleep longer

I'm kinda low in weight approx 40kg or smth and around 150cm in height because of the scoliosis so the volume is supposed to be low maybe?

[SomeUser00]

SD card zip
what kind of charts are we looking for if you need screenshots instead?

[SomeUser00]

here an example of 2 nights, one full face mask and another nasal mask, each imgur link has multiple images
ffm charts/data
nasal mask charts/data