Chin Strap Adjusting

[Dafod]

I have been using the P10 for 4-5mths now I was finding over the last few months that what had been a solid seal with no mouth opening I had started to relax such I would awaken with my mouth open. My Sleepyhead stats had started to suffer so I have worked through a number of remedys.

Over the last two weeks I have been using a chin strap (Carefusion ruby adjustable) and while it can deliver some great numbers (super low AHI and low leaks) I have been finding its "adjustability" slightly frustrating. One night I might have it a little too loose and the leak numbers suffer while another night I will adjust it such that I awake with great numbers but a bit of a headache (that rapidly dissapears). I believe the headache is due to the strap being too tight.

The strap has an adjustment point at the top and lower back of the head. I have found since you cannot see how it sits (when putting on in bed) its not only the widths on the velcro attachments but also the angle you install it. With seemingly infinite variability I was wondering if others that use a chin strap have a method to limit night-to-night variation once they have locked in a good setting. Anyone?

Really I would like a chin strap with an indexing to the rear velcro (as this is the daily change) and also the angle.

Also, with the leaks, given I am using a Airset 10 and 24L/min or so it the large leak boundary, what is the maximum acceptable leakage (% time over leak redline) for effective treatment? At worst my leaks (prior to strap) were 1-4% in the large leak territory but I seemed to really feel it the next day.

[PaulaO2]

I didn't often adjust the chin strap once I had it sized right. Just peel it of and on. After a month, I had to tighten it slightly due to stretching. I used the Supplier #1 version of the Ruby. Washing tended to re-tighten it up some but the adjustments were minimal.

You could adjust it to your liking then peel it back off. Then mark where the ends meet the fabric. Number it somehow so you know what each one means. Then when you know you need Fitting 4, you just line the ends up with #4 and there you go. You'd need the light on for that.

[Dafod]

You could adjust it to your liking then peel it back off. Then mark where the ends meet the fabric. Number it somehow so you know what each one means. Then when you know you need Fitting 4, you just line the ends up with #4 and there you go. You'd need the light on for that.

thanks for the thought and response. I guess the only challenge with the approach you suggest is the velco I close the strap with (at least in my instance) is at the back of the head, above the neck. Unless I could somehow attach a physical "feel" mark I am not sure how to do it. I guess I could do it with two mirrors. Did you make the final attachment at the back of the head or was it another point such as the one at the top middle of the head?

[MobileBasset]

As far as large leak time, 4% time would be about 20 minutes if you slept for 8 hrs. That doesn't seem like too severe an impact if you assume your therapy is reduced and possibly disabled for that period of time. Especially if it is spread over several leak events which is usually the case. That said, I have worked to have zero large leaks and very low leaks of any level. It minimizes the chance of being aroused by leaks and decreases my anxiety level with respect to my therapy.
Given that your leaks are at that level or lower it would seem that maximizing your comfort would be the goal. If you are feeling the leak effects the next day you should work to lower them.

I would recommend sewing tiny beads on the edge of your Velcro strap at 2 or 3 points around where you like to hook it - in the same manner as Paula was suggesting the marks. Then you can connect by feel.

[Dafod]

Thanks Mobilebasset! That is a great suggestion re: the beads. Also, appreciate the feedback on the leaks

[me50]

once you find the right adjustment for the straps, you can take it off without undoing the Velcro and then mark it where you need it just in case. I never did that because I left it where it was once I found the right spot. I just slipped it on and off without undoing the Velcro. YMMV

[PaulaO2]

You don't need to undo it every time. Just pull it off. Or put it together then slip it on.