AHI all over the place and major leakage problem

[Dharmachef]

            I have been most frustrated in my attempts to get a good mask seal. I have experimented with
both the nasal pillows, (trying different sized pillows) and a full face mask. (Airfit N30i and Airfit M20 large)

When I run the mask fit option on my machine, (ResMed 10) everything is fine, but at higher pressures,
 nothing I do, including a very tight fitting, seems to prevent substantial leaks. 

I've been shaving daily to eliminate possible leakage through stubble!

I am taking Ozempic (.5 mg) and am losing weight. 3kg so far. 

My AHI and CA's seem to be all over the place. 

I have attached a summary of the last two weeks, and a Daily Report

I would appreciate any advice or recommendations you can make.

Thank you for your help.

           

[staceyburke]

You have 3 problems I see. One is leaks you asked about. You have both mask leaks and mouth leaks.  Mouth leaks can be addressed with “ tongue suck method, tapping or full face mask. 

2nd positional apnea- you are sleeping in a position that cuts off your own airway. It maybe sleeping on your back, to high of a pillow. It is also called chin tucking. Chin tucking is when your chin drops to your Sternum cutting off your airway. Nothing can help it with your Cpap, only you can help by not getting in that position. If you can’t do it on your own, you will need a collar. Please look at the link to collars at the bottom of the post. 

3rd centrals (known as clear airway). Again there is not much we can do with your machine to stop them. Many times they lessen a great deal as you get use to your therapy. Centrals happen when you just stop breathing- holding your breath. Our breathing while asleep is driven by CO2 in the blood stream. Your machine is getting rid of more of the CO2. Your body needs to get use to this (therapy) to breathe normally. IF these do not go away after a few weeks of therapy you may need a more expensive pap machine specially built to stop centrex. 

Last thing is use F12 to take screenshots. It formats it correctly

[Dharmachef]

Thanks so much Stacy! A collar was suggested by Sarcastic Dave awhile ago but I stopped when the heat waves hit us .... I'll try again with the full face mask and the collar and let u know how it works.

[SarcasticDave94]

I am not certain how things like the leak rate would affect the CA, but the session does look quite bad, CA and otherwise. How well did the collar help before?

[RNeil]

"Mouth leaks can be addressed with “ tongue suck method, tapping or full face mask. "

A chin strap or cervical collar can also help.

[Dharmachef]

Thanks everyone!!
I've used the collar the last thrre night and gotten much better results .... AHI down to 6.8. 
Seems my posture and stoop have a lot to do with my problems .... too much looking down at phones etc ... 
The collar is quite uncomfortable - it's effective at sdtopping my chiin dropping to my sternum .. but 
gives me a sore neck. I'm hoping in time that my head will get used to being kept off my chin at nght.. 
will keep working at it!

[staceyburke]

If the collar is causing problems maybe another model would work. There are many different brands out there.

[jlfinkels]

If the collar is causing problems maybe another model would work. There are many different brands out there.

And be sure to size it correctly. An inch or two too large and can be painful, but an inch or two too small won’t get the job done.

I asked the manufacturer I bought from and they said to measure from the bottom of the jaw to collarbone and also need to measure your neck size to make sure it is not so tight to be uncomfortable or cut-off your air supply.