Air leaks with Aircurve 11 ASV for CA

[chrishark]

I am wondering if you all have any advice with regard to my air leaks. I have included two nights data with my Aircurve 11. First was 9.5 hours on machine which was a record (but aided by some jet lag and an ambien). Second was the following night of about 5 hours on. I am getting quite a bit of aerophagia and it looks like quite a few air leaks. Also included a screenshot of my settings.

[Jay51]

Those are a lot of mask leaks.  They look to be mainly mouth leaks and not mask leaks.  Mouth leaks go on a long time.  Mask leaks are quick spikes up; then drop back down.  

Here is some reading from our Wiki on how to stop mask leaks:  

• Mask Primer
  Higher pressure(s) on average can increase mask leaks.  Hopefully the "Mask Primer" has some tips that help.  If not you could try to reduce the max pressure slowly and see if you can bring it down any without negatively affecting your therapy.  
  

[chrishark]

Thanks. That makes a lot of sense and fits what I think I’m experiencing in the night which is a lot of air filling my mouth. I’m using the ResMed N30i nasal mask and I tape my mouth shut with hostage tape. I’ve been using the dreamware nasal mask for years on the Philips ASV and haven’t had this issue but have not been getting good therapy with the Philips. I have not tolerated the full face masks in the past due to skin irritation on my face. Is it worth trying to taper my maximum pressure to see if that helps?

[RickEiben]

I used an Aircurve 10 ASV for about 8 months. The mask kept leaking with the default settings that were too high. It wasn't untill I reduced the pressures to;

Min. EPAP 7.0
Max IPAP 16.0
P.S. 3.0-8.0

No more leaks, and average AHI of under 1.5 down to 0.0. I was using it for regular obstructive sleep apnea and irregular breathing. I was mis-diagnosed with complex sleep apnea. There were no true centrals. As you may have read, too high a pressure can cause CSA's.

[SarcasticDave94]

However, you can use High pressure on the ASV and won't get CA, because the ASV is specifically used to treat CA. You do want to get the leaks under control, as even the ASV could not keep up once leaks pass over the 24 L/Min threshold.

It would be the better answer to address leaks than lower pressures and risk hindering therapy. You may find your mask or mouth leaks persist even on low pressure.

[Sleepster]

How long has it been since you tried a full face mask? What didn't work in the past may work now. You may have to go through the process of trying several to find the one that works for you, but it seems a full face mask is your only solution.

I realize you went with a nasal mask in the past that worked for you but our minds and bodies change, and it appears you have morphed into a full on mouth-leaker. A full face mask that fits will be a game-changer for you.

Mouth-leaking may or may not not disrupt your therapy, depending on how bad it is; but even if it's not bad enough to disrupt your therapy, it disrupts your sleep.

[chrishark]

Thanks for all of the input. It has been a couple of years since I used the full face mask. My biggest issue was fighting a face rash where it contacted. I tried using the mask liners but those just seemed to result in more air leaks around the mask.

[SarcasticDave94]

I can't guarantee this will help sensitivity and rashes, but I'm a big fan of the Fisher and Paykel masks. They've got all 4 types, nasal pillow, nasal, full, hybrid. They all go on with light tension. I tried a few ResMed masks and it didn't work as easy as F&P.

[chrishark]

Okay, thank you. I will definitely look at those. I have only tried the Philips and ResMed masks