First time poster struggling with mask seal

[Cammo]

Hi everyone!

I'm a newbie APAP user just starting my third week using a machine.  I was diagnosed with severe apnea with the at-home test recording 33 events per hour.  I am sleeping a lot better with the machine on however I'm struggling with mask seal figures.  (I tried to post my SleepyHead screenshot however as this is my first post I'm not allowed)
I've tried a few different options including mouth taping however I've been unable to get the leak rate below 24L/min.  I'm using medium pillows and I'm a pretty big guy - should I try larger pillows?

Thanks in advance

[mesenteria]

Hi!  If, when looking at your events chart, you see clusters, there's a really good chance you have what we call 'positional' events, or events related to sleeping position.  Usually that comes with supine sleeping, or on one's back.  Not necessarily so, but usually. For example, you may be on your side, but your chin dips toward your chest and you may cause a deflection of the mask in addition to more obstructive events as a result of closing down the air passages.  Or, your chin doesn't dip, but your head sags more fully into the pillow causing the mask to be pushed aside by the pillow around your nose and cheek.

I have taught myself some things and do them in my sleep.  One is turning on my side, but lifting my head and moving it back, contacting the pillow firmly, and sliding my head back forward keeping the headgear in tension.  This greatly reduces the deflection later.

Others will pipe up soon.  We do need to see your Sleepy Head charts, though.

[Cammo]

Thanks for that, hopefully with a couple more replies I'll get link privileges and will post that SleepyHead results.

[Cammo]

Hi!  If, when looking at your events chart, you see clusters, there's a really good chance you have what we call 'positional' events, or events related to sleeping position.  Usually that comes with supine sleeping, or on one's back.  Not necessarily so, but usually. For example, you may be on your side, but your chin dips toward your chest and you may cause a deflection of the mask in addition to more obstructive events as a result of closing down the air passages.  Or, your chin doesn't dip, but your head sags more fully into the pillow causing the mask to be pushed aside by the pillow around your nose and cheek.

I have taught myself some things and do them in my sleep.  One is turning on my side, but lifting my head and moving it back, contacting the pillow firmly, and sliding my head back forward keeping the headgear in tension.  This greatly reduces the deflection later.

Others will pipe up soon.  We do need to see your Sleepy Head charts, though.

Looking at the charts there do seem to be a 4-5 clusters that point to what you're talking about.  I am a side sleeper however I do end up on my back throughout the night and wondered about mask deflection.  I'm pretty sure I had the P10 straps too loose (seperated) and tried them tighter the past couple of nights with improved results.  Wonder if I should try going even tighter with the clips?

[jaswilliams]

Thanks for that, hopefully with a couple more replies I'll get link privileges and will post that SleepyHead results.

No need to wait you can attach your charts directly to your post without a post count limit follow the instructions in my signature

[Cammo]

Sorry about that guys, I was following the instructions on the forum showing how to use imgur to attach the Linked BB Code.
Appreciate your help!

[attachment=9375]

[Gideon]

Wellcome to the forum.
A common problem with p10 pillow mask is frequently users are asked/told to use too small a size. Feel free to Try the large and s÷ which works better for you.

A common problem with all masks is that people think tighter is better. It usually is not.

My bet is positional but not in the typical sense. With the p10 because of its light weight and loose fit the weight of the hose can displace the Mask when you move. Hose management is the solution. I use a simple hose clip, a loop of Velcro with a clip, attached to there the p10 attaches to the main hose and clipped to your Pjs or your pillow.

Fred

[Rcgop]

By all means, try a larger pillow. I can still get away with a loose fitting pillow strap. 

In my case, most of my leaks are mouth leaks which have been controlled by a chin strap and cervical collar. I was able to train myself to keep my mouth closed over time. Well, at least to an acceptable amount anyway.

[Melman]

You may want to consider an increase in your minimum pressure. The chart shows it going to 10 almost immediately and increasing from there with a median of 11.2. A minimum pressure closer to the median is recommended. I suggest a minimum of 9. It won't do anything for the leaks which is your biggest problem but Bonjour and Rcgop have given you good advice. Your AHI number looks good. The CAs may disappear as you adapt to the therapy.

[Sleeprider]

All events are CA and the pressure increases are from flow limitations. You might want to increase EPR to 3. This should help with flow limits, but might increase CA.