09-18-2016, 08:32 PM
Pressure vs. leaks dilemna
Here's the (Ha!! A) problem. I'm having lots! But, right now I'm wondering what to do when (a) My 90% pressure rate is consistently hitting my top setting lately, YET (b) it seems to me that - as soon as I fall asleep - my machine jacks up my pressure to the point that it causes bad leaks! The squeaks, blaats, and other annoyances of course wake me up again, and I need to shut off and restart my machine to get the pressure down & to have a prayer of sleeping. It seems that I should set a lower top pressure, yet I'm afraid that the high 90% rate is indicating that I NEED at least that, or higher yet for theaputic value!
What do ya'll think? My doctor is less than forthcoming.
RE: Pressure vs. leaks dilemna
If you are a back sleeper, try side sleeping. On any position, try to keep your chin from tucking in toward your chest. Somewhat like looking upward but not exaggerated.
I'm guessing that you're having OA's since Resmed's aren't suppose to increase pressure if CA's are detected.
RE: Pressure vs. leaks dilemna
Well, let's start with if you are using a F10 and your max pressure is 12, you should not have any leaks at all. I run my f10 at 19 to 20 and only have leaks if I bump it while flopping around in my sleep and they seldom last long enough to affect the event detection.
I used to have all kinds of problems, and it took a while to tame the beast, but you can do it.
The F10 must be worn as loose as you can get away with. It seals by inflating the silicone lips around where it contacts your face.
To put on the mask, you should adjust the straps until it is as loose as possible. Then lay down on your back with the Mask Fit Test option on. Lift the mask with one hand and slowly let it settle down onto your face, a little up toward the top of your head movement will sometimes help - just breath normally and notice when the seal inflates.
Now, slowly start to tighten the straps - tighten them evenly about 1/8 to 1/4 inch at a time each. Stop for a moment and lift the mask and let it settle down again after each adjustment. If you hear/feel a leak, then adjust again, if not breath normally and watch the screen a moment to see if you get a red or smiley face. If it says you are leaking, repeat tightening again. Repeat until it stays green while breathing normally on your back. Occasionally lift the mask and letting it settle down again to get used to the seal inflating and how that feels. If you knock the mask in the middle of the night and get a big leak, just lift it and let it settle to reseal.
Even at 19 I still have about 1/8 to 1/4 inch separation between the hard part of the mask body and my face/nose bridge which is sealed by the silicone seal - which feels a little spongy and like a balloon between me and the mask.
If you feel the hard part of the mask hit the bridge of your nose loosen the top two straps a little (1/4 to 1/2 inch) and tighten the lower two the same. That will rock/tilt the mask down away from the bridge of your nose - you really want that seal to inflate between you and the mask everywhere, and no solid/hard part of the mask pushing onto your face.
It took me about a month to get from a pressure of 15 up to 19 without it playing a symphony at night. It takes a while to learn and get it just right, but it can be done.
Also, if after you get to no major leaks it still wakes you in the middle of the night with an occasional burp or whistle, the cloth mask liners will silence it. They do increase the nominal leak a little, but they will silence the symphony.
Good luck.
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
RE: Pressure vs. leaks dilemna
Oh, and on the "do I need more pressure". I would not make any pressure adjustments until you have the leaks under control. The machine can not accurately detect events when there are major leaks. Once the leaks are under control, and you are tolerating the therapy well, then get the Sleepyhead software (link at the top of this page) and post some screen shots of what your charts look like, and people will be able to help you with the setting adjustments - if any - that you need.
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
RE: Pressure vs. leaks dilemna
Listen up all you leak-martyrs! Combining the 2 answers I got here last night, I had the BEST NIGHT'S SLEEP I've had since...ever! To begin with - body positioning. I'd been under the mistaken impression that it was best to have my pillow propped up by a 2nd one underneath it. Well, duh, that had the effect of tucking my chin into my chest! So, first improvement was changing that. Then, Frank, thank you SO MUCH for going into such detail on mask positioning!! I tried as best as I could to do things just as you described, and - hot damn - it made a HUGE difference!! Now... I'm practical enough to know that tonight might go south again... even doing the exact same stuff... But this morning I woke EARLY, RESTED, and well, CHEERFUL. My API was low, AS WAS MY 90% PRESSURE and LEAK RATE. The leak rate had dropped over 10 points from the previous night! So, I will continue trying to stabilize the leaks and my sleep "comfort," then tackle any further adjustments after that. Someone had suggested earlier that "sleep/wake junk" might be interpreted by my equipment as Central events and - what with the leak-caused inaccuracies - I'm thinking that even the new Centrals might not be such a concern, any more?? So, thanks again "hose heads!" I am ready to carry-on, again.
RE: Pressure vs. leaks dilemna
I had a similar problem over the summer and again recently and positioning made all the difference. I think I just need to replace my pillow instead of using 2 semi-flat ones. 
RE: Pressure vs. leaks dilemna
(09-19-2016, 10:31 PM)Mosquitobait Wrote: I had a similar problem over the summer and again recently and positioning made all the difference. I think I just need to replace my pillow instead of using 2 semi-flat ones.
I use two feather pillows which are scrunched into an acceptable position every night, and carefully fluffed and smoothed in the morning so no one knows how I really sleep
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
RE: Pressure vs. leaks dilemna
 Nothing like a good success story!
As for the centrals, I'd give a couple of nights for things to settle out and then have a look at them. I get more scored on my S9 than on the DreamStation and more with some masks than others. I am pretty sure that none of them are true central events. Which is not to say that yours are not true centrals.
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