Any Help appreciated. Struggling, OSCAR included

[bmjnyc]

[attachment=49583]Basic Facts: 51, 6'2, 175lbs, 18AHI

please excuse this rambling post but I'm so tired I'm struggling putting my thoughts together. 

So I'm back after a few days, still exhausted and frustrated with CPAP. I've only skipped 4 days in 8 weeks. I even use it for naps. I'm still feeling much worst than I did prior to starting CPAP. I've been on CPAP 8 weeks and it's only getting worst. Just 8 weeks ago I was running four miles 4x a week. I was functioning a pretty high level, though over the last few years I noticed some extreme morning tiredness and cognitive stuff that was affecting work day.  I always had to go to bed very early.  Since staring CPAP I've been utterly exhausted and sleepy all the time. Luckily I'm not working in my field as if I was I would have to take  leave. I feeling all the extreme effects of lack of sleep and sleep apnea that I read about. The other day I had to nap in my car after dropping my daughter off at school. Once I got home I spent the whole day on the sofa until pick up time. Sometimes I get worried that something else is wrong with me but having recently had my physical with blood work I think tis is all a result of lack of sleep or bad sleep. 

I will say that at this point I'm use to my P30I mask and the CPAP noise does not bother me anymore. I've also figured out the nasal pillows and don't get many audible leaks and when I do I can easily reseal the pillow even when half asleep.  After seven  weeks of CPAP my DR noticed lots of leaks. About a week ago he told me to try taping my mouth. I did that for a few nights reflected in the the OSCAR charts I posted. Even with tape my leaks are very hight 45-50 L/M. I don't understand how that's possible. I am not waking up with my mask of my face. Sometimes I wake and I can hear small nasal leak and fix it. My mouth is totally tapped shut. However even with these hight leak rates I'm getting the lowest AHI yet. 

I wonder if something is wrong with my machine/hose/mask. I often wake about 3-4 hours after falling asleep and check my leak numbers. Last night they were at 45L/m and in morning it was the same number. However when I look at my leaks on Oscar it shows that I was having leaks well after I checked my leaks on machine but the number is the same?

Any input would be greatly appreciated! 

PS- my doctor has prescribed a sleeping aid to "help me get over the hump" hope it helps!

[cdplatt]

I don't think there will be any "getting over the hump" if you continue to experience leaking as much as you are. Large leaks can be very disruptive to normal sleep cycles. Getting the right mask and getting it to fit comfortably without excessive leaking may be the biggest challenge to therapy. Until you're comfortable with the mask with leaks under control, the CPAP cure can be worse than the disease - particularly with mild apnea.
I took several breaks from APAP for days at a time when I was adjusting - to catch up on my sleep. Then I'd review my data, visit the forum, try some adjustments and go back at it.

When you test your mask fit, do you do it at the highest pressure setting and are you able to control the leaks while wearing the mask comfortably? If not, you may want to try another mask style. I tried four masks before I settled on one that worked well for me. I also have to tape my mouth - which was very helpful - though I still wish I didn't have to do it.

[Expat31]

I had terrible leaking also nearly 2 years ago, I taped my mouth well, I thought. Actually the problem was that air was tracking along a skin fold under the tape on the corners of my mouth. Took me nearly 3 months to find it. Like you, it was a pretty torrid period.

This may well not be your case, but make sure your tape is at least 5cms wide.

[staceyburke]

I won't address the leaks - you know it has to get fixed.  But I would also suggest you use EPR (exhale pressure relief).  Set it to FULL TIME 3..  That will help with the flow limits and should also help with the spikes in pressure that can cause leaks as well was disruptive sleep.