Is it worth dropping pressure to get over leaks

[PaytonA]

I am against reducing pressure to reduce leaks unless it is a temporary reduction with a follow up slow increase back to the original pressure. That requires one to learn other methods to reduce leaks as you slowly increase the pressure back up to where it was. Part of my feelings are a result of the fact that I had a very good titration done and repeated that yielded the correct pressure for me and it was high-16/20 cm/H2O bilevel.

With the last Mirage Quattro mask that I had my leak rates were median-0, 95%-0, max=<10 cm/H2O almost every night. I have gone to a new Mirage Quattro of the same size and my leak rates are not quite as good but still not bad. I keep trying to get back to where I was before the new mask but I am not there yet.

My feeling is that is best to not reduce pressure because of mask leaks but if there is no other way then a temporary reduction is ok to get started getting good therapy and sleep but you must be careful that you do not cause deleterious oxygen desats.

Best Regards,

PaytonA

[cands]

Hi Richard,
I too use a full face mask. I used both masks you do and can never seem to get a comfortable and leak free fit.

Have you tried the Amara View? It is the only full face mask I am comfortable with. Most nights I get the green smiley face. Sleepyhead nearly always says my leaks are too much.

The thing is my therapy is working. I feel great and my AHI numbers are good. I think it is possible to stress too much about leaks, especially when using Sleepyhead to analyse the data.

I think the 1/8th of an inch adjustment advice is very sound. Keep trying and don't worry about it too much.



Kind regards,
Steve.

[rich2905]

Hi
I have been experimenting a bit

I have given up on the resmed mask and am sticking with the simplus mask for now

I would like to try the amara though as it sounds good

I have dropped my pressure to 12 and find that allows me to get a better comfortable fit. Once it settles down I will go back up again or try apap.

The other thing which seems to help with the simplus is that my wife made me a strap like the pada cheek anti leak strap. You can't buy them here.

This allowed me to get the mask to fit well without having to do the straps up to tight



This probably means I really just haven't adjusted the mask straps right or have them positioned correctly but in the end I find it a lot easier to use than to stuff around with the straps.

I have just started doing the above and the results are a bit mixed but generally ok and seems the way to go for me.

Richard

Ps my mask is medium but I have to wear it a bit low on my nose due to a bump from a broken nose, I forgot to duck while playing squash
The small is to small and medium is a bit to big.
The resmed mask did fit better but was a pain to deal with when you sleep on your side as I do.

[cands]

The other thing which seems to help with the simplus is that my wife made me a strap like the pada cheek anti leak strap. You can't buy them here.

Hi Richard,
Just to let you know Padacheek is happy to mail to Australia. I ordered mask liners for my Simplus, and they arrived in a few days.

Cheers,
Steve.

[Sleeprider]

Richard, from your posted graph at 12 cm pressure, I don't see therapy problems there. The flow limitation is a bit high, but events are within reasonable bounds. CPAP has a couple objectives, and one of the most important is to provide less disturbed sleep. So AHI is not the whole deal. If you sleep better with fewer leaks, and still have a treated AHI <5, then that beats disrupted sleep throughout the night. Keep working on it, and good things will happen as you eventually find that magic combination of mask, fit and pressure.

[rich2905]

Thanks all.

With the strap made by my wife and at 12 I seem to be have a lot less trouble with the mask

And my ahi is around 1.

I will keep it like this for a week then try going up a bit.

It's not their fault but I get annoyed having to pay the same amount for postage as I do for the product. Mind you it still is not expensive but the one my wife made seems to be working ok for now

Richard

[rich2905]

The combination of dropping pressure to 12 and the strap my wife made is producing good results
Low leakage and low ahi often under 1.

I will try going back to pressure of 15 soon but if I have problems I am going back to above.

I am traveling at the moment so have not tried the amara mask but will

Richard

[Gabby]

I can visualise 1/8" or a foot or a yard but I just can't with metric. We have been on the metric system for many years, just I haven't .

I will give it a go tonight.

Thanks again

Richard

Richard, I am a fellow Australian and could have written above! I just can't imagine metric lengths and carry a tape measure around, how weird is that?
Good luck with your mask.
The Nuance is a good mask next time you are shopping for one, I went from P10 to Nuance because of the headband.

[Sleeprider]

Thanks all.

With the strap made by my wife and at 12 I seem to be have a lot less trouble with the mask

And my ahi is around 1.

I will keep it like this for a week then try going up a bit.

It's not their fault but I get annoyed having to pay the same amount for postage as I do for the product. Mind you it still is not expensive but the one my wife made seems to be working ok for now

Richard

You'll have to explain to me the rationale of increasing pressure, when results at 12 are both comfortable and effective.

[PaytonA]

[/size]Unless one actually knows what one's oxygen saturation is during the night, it is prudent to attempt to return to the prescribed pressure. One should move slowly and make adjustments as needed along the way to reduce any leakage. The other alternatinve, in my mind, would be to leave the pressure where it is and get one's oxygen saturation checked for a few nights. If everything OK, go with it and as Sleeprider says do not worry about it any longer.

Best Regards,

PaytonA