0/20 mask seal scores... please help!

[1978]

I've been getting 0/20 mask seal scores pretty frequently and hoping you guys can help.  it's been about 3 months using CPAP and I'm just recently starting to get some decent sleep but not sure if it's helping since i still get about 2 - 12 events per hour and very low mask seal scores.  I started feeling/hearing the mask leaking when I sleep on my side so I tightene the straps and recently replaced the nose pillow and it seemed like the leaks stop while i'm awake but not while i'm sleeping according to my myAir score.  would adjusting my settings help?

pressure is 7 - 14 APAP
EPR 1
Humidity 5 
climate control auto
Ramp Off
Response soft
mouth tape

i think that's all i adjusted.   let me know if you need any other info from oscar that may help with the analysis.

   

[Sleepster]

Look at your leak rate graph. It shows that you are leaking badly. I'd say probably through your mouth. You can try a soft cervical collar, a chin strap, or a full face mask.

[staceyburke]

You do not have a mask leak - it is a mouth leak.  In the leak chart, sharp spikes show mask leaks while high flat top leaks are from your mouth.  You can try a strap, mouth tape, full face mask.  Your AHI number can not be accurate with that much large leaks.  You have to find a way to stop the leaks before anything else.

You also have high flow limits.  Flow limits do a number of things.  But for now you need to know when you have flow limits the machine quickly increases the pressure tying to stop the FL from becoming a larger apnea O or H.  If you can control them it may help the leakage also but it may not help leaks.  FL also stop you from getting into a deep sleep and can even wake you up.

We help FL with an increase in EPR.  Yours is set full time at 1
Please change it to full time at 3 and see the difference.

There is also a method you can practice to stop mouth breathing.  I learned about it here and it took me about 9 months so that I can do it all night.  They call it a tongue suck.  You suck it to the top of your mouth and keep it there.  It takes a lot of practice to keep it in position while you sleep but I'm living proof it does work...

[1978]

I have a chin strap but doesn’t help with the leak rate and uncomfortable. I googled soft cervical collar and can’t imagine being able to sleep with that around my neck.  I’ve been using mouth tape every night but sometimes wake up with my mouth full of air that doesn’t escape.  I also wake sometimes to find my mask completely off. 

Opalrose told me about the tongue suck and it works great at first but having trouble with tongue staying in position and I forget to redo it. Will keep practicing it.  

Will set my EPR to 3 tonight. 

Will a full face mask help with my mouth leak issue?  Do I still have to breath through my nose with a full face mask?  What happens if I mouth breathe? Do I discuss changing masks with my pulmonologist or my cpap supplier?  

I’m able to fall asleep better and not waking up as much as when I first started cpap so it feels like I’m making progress but my leak rates makes me feel like I’m not making any progress at all. 

[multicast]

Please show a zoom of about two minutes around 4:10 and 5:40.

Mike

[Sleeprider]

Have you considered changing to a hybrid or full-face mask. Many masks today offer nasal pillows plus a mouth cup. Sometimes people can't control the positive pressure air from entering their mouth by the natural position of their tongue behind the teeth sealing that roof of the mouth, similar to just after you swallow. You appear to need a different style mask that accommodates that problem.

[1978]

@multicast - attached are images of 4:10 - 5:40 and a zoom of events in that time

@sleeprider - yes i would change to a full face/hybrid mask if it'll help with my leaks.  i'm using the n30i and like that the tube is on top and swivels.  Would the f30i help with my leaks?  would i be able to be able to breath through my mouth with this mask and not be considered a leak?  

@staceyburke - last nights screenshot attached with EPR at 3.  Felll asleep around 1:30a


                   

[Sleepster]

[quote='1978' pid='476419' dateline='1684649336']
Will a full face mask help with my mouth leak issue?  Do I still have to breath through my nose with a full face mask?  What happens if I mouth breathe? Do I discuss changing masks with my pulmonologist or my cpap supplier?

A full face mask is the best solution. You can breathe through either your mouth or your nose. If you mouth breathe it may cause you to get dry mouth. You discuss mask changes with your CPAP supplier.