If the CPAP works for you, what is your expected AHI?

[OpalRose]

Agree that the leak rate is too high.   The thing is with a high leak rate, your AHI data may be inaccurate.  There are a lot of breaks in therapy.  Do you feel you are waking up from the mask leaks and/or higher pressure?

Are you still using a full face mask and does the mask fit properly?  You could try a mask liner.  

Try bringing your maximum pressure down a notch until you can get the leaks under control.
Also, use EPR at 2 or 3 as long as you don’t see a major increase in Clear Airway events.

I hesitate to recommend a change to even higher pressures if that triggers more leaks.

[Sleeprider]

Lots of OA and flow limits, and your breathing looks restricted even at higher pressures. I'd be very tempted to try a soft cervical collar and see if that helps and maybe increase the EPR setting from 1 to 3.

Alternatively we could try doing a more disciplined self-titration. It takes some patience, but it sorts out the issues better. To do this, put the machine in fixed pressure CPAP mode. Start at a pressure of 10 and observe results. If OA are present, increase pressure each night or session by 1-cm. If you reach 18 cm after 8-sessions of at least 3-hours each, and can't control the OA, then a different approach may be needed. If OA are not controlled by pressure or positional therapy (cervical collar), you may need to talk to your doctor about a bilevel titration test. Hopefully, we find a fixed pressure that works, and you can get the leaks under control.

[tommyngo]

[quote=OpalRose]

Thanks for your super-quick response!   

I did wake up a few times during the night due to air leakage.  Each time, I readjusted  the mask & resumed sleeping . I'll manage to
control this issue . So far, I either tighten up the straps or reposition the mask (i.e. lift the mask up & set it back down on my face ) .  I would appreciate any additional
suggestions to deal with this air leakage problems .

[tommyngo]

[Quote=SleepRider]

Thanks for your kind response !  Your suggestions sound very interesting . I'll digest the info and implement them for a satisfactory solution .

[Sleeprider]

Tommngo, it's worth remembering, that your baseline AHI was near 30, and as this thread started you were near 15. While you are still having relatively high results, you have cut that significantly already. I'm sure you will get there, and perhaps faster if you try the soft cervical collar.

The mask primer in my signature was written by member Bonjour. It is really good, and you may need to try other masks or types of masks eventually. One thing you will see consistently mentioned is that the right mask does not need to be cranked down tight. If you can't get a fit with a mask "floating" on your face, it's time to look at something else.

[tommyngo]

Much better when it is working, but you need to address the leakage issues when the pressure ramps up.
Try a soft cervical collar (about $10 at the local drug store) to help keep your chin up.
To help prevent mouth leaks, push your tongue into the roof of your mouth and apply light suction.
Do this so that it becomes 2nd nature, whether awake or asleep.

Once you get the leakage resolved, I'd look at moving the max pressure up if needed.

Thanks for your precious practical tips !  I'll try the soft cervical collar for sure .

[tommyngo]

pid='269941' dateline='1535378815']

Your ref. on Mask is first rate !

BTW, I  just bought the soft cervical support today . Hope it improves my apnea 

 Thanks  , Sleeprider & OpalRose , for all your compassionate help ...

[tommyngo]

[quote=CB91710; SleepRider]

I could hardly believe my eyes when I saw my AHI  reading this morning : 4.0 over 7 hours & 15 minutes   !

This is a big improvement . The fact is that I wore a soft cervical support last night  on your advice ! My breathing during the night seemed much easier and more regular than previous nights ! I still have to work on the leakage problem, though . In any case, this is some good news in two years using the CPAP machine on & off  !  I hope I am on right track ....Thanks CB91710,  SleepRider & OpalRose !

[OpalRose]

Glad the collar made a difference. You seem to be heading in the right direction.

[CB91710]

In addition to helping hold your jaw up, the collar can also help with positional apnea caused by dropping not only your chin, but your entire head.