[Equipment] ResMed AirFit N20 - Mask Issue?

[MTGCarver]

Newbie here.  I have a AirSense 10 AutoSet and my mask is a Resmed AirFit N20.  I'm on my 4th night of treatment.  I've noticed that each night the leak rate seems to be going up. It's now between 22.80 and 38.60. As a result, today I am feeling really tired. I think it might be a combination of a few things.  First, me being a side sleeper and the pillow (the one I sleep on), pushing into the mask and making it leak. The other I suspect maybe I am a mouth breather. I've woken up with a lot of drool the past few nights and my throat being a little irritated.  I've compensated by adjusting the humidity and temp on the machine which has helped some.

I'm attaching a copy of my sleepyhead from last night.  Is there anything that stands out to you guys? Maybe I should switch to a different mask? FF? My nostrils get irritated easily, so that is why I opted for a nasal mask vs the pillow.  Thanks.

   

[OpalRose]

Hi MTGcarver,
Your leak rate isn’t that high that would cause the machine to have problems detecting apneas, but is high enough to cause you grief and disrupt your sleep.

Most folk find that sleeping on the edge of their bed pillow with the mask hanging off the side of the pillow helps.  

As far as a dry mouth, that is caused from mouth breathing.  You will need to address that by using a chin strap or a “soft” cervical collar.  This helps the jaw/mouth from opening and allowing air to escape.
The collar should not be too tall, about 2 to 3 inches.  Also, measure the circumference of your neck and add a few inches to allow for movement.  Check Amazon, as they sell many sizes.  

Alternatively, some just use a rolled up towel and place under their chin.

You can also start practicing the Tongue Suck Technique.  This takes time to master, but works.

Tongue Suck Technique:
Place your tongue to the roof of your mouth with tip of tongue behind front teeth.  Slowly suck upwards and back.
This places the tongue in a natural position, with the back of tongue sealing the back of the throat so that if you open your mouth/jaw while sleeping, no air will escape.


The one thing I notice on your chart is your minimum pressure of 4cm.  This is too low for most folk and sometimes causes a feeling of being air starved.  Your minimum pressure should be around 7 or 8cm.  This may help clear up a few Obstructives and Reras’s.
Good Luck!

[mesenteria]

I use the same mask.  Sleep has to take a different tone with a mask of any kind.  You will adapt, as I have.

When you turn over, or from supine onto your side, your head makes a certain contact with the pillow. You may be half-awake, and you'll fall back asleep fully as your head rests.  Trouble is, it continues to sink into that nice comfy and cooler side of the pillow.  That's where you begin to feel air flitting against your eyelashes and forehead, or you'll feel the bottom of your nose and its tip making contact with the inside of the mask.  These all indicate, or predict, a leak.

As suggested above, in your semi-awake state, remember to get your head closer to the corner or close edge of the pillow, but ALSO remember to tug a bit at the side strap on your headgear near your jaw/ear area and pull it backward a bit.   As you sag into the pillow, the gear will twist on your head and release the lowest edge of the mask away from its seal.  You have to prevent that by gently keeping it in place and forcing your head into a fully rested position...or as close as you can get to it.  When you fall asleep again, you should have minimal leaking.

I don't know if that made any sense, but this works for me.  For the few seconds it takes being forced into almost full wakefulness, making the necessary accommodations with the head fully into position, I fall asleep quickly, typically, and get the needed seal and sleep for an hour or more.

You may fear that it might prevent you from attaining the deeper stages of sleep, but that has not been my experience.  You may be different....I dream a great deal, and the studies show that you don't need the typical 80-100 minutes to get into REM as you do the first time you dream each night.  By morning, you can reach REM inside of a few minutes....yes, it's true!  According to my therapist, that's the real pay-dirt, those late night REM sessions.  You'll get there more easily if you learn to manage those leaks, even if you have to be alert to the process for a few minutes.