Looking to reduce leaks/optimize results

[DrGonzo90]

I've been using Cpap for a few years but I've been having some trouble with it recently. I've lost a decent amount of weight (25ish pounds) and cut way back on alcohol consumption (went from 10-12 drinks per day to about that many or less per week). I've also started having a lot more large leak duration, waking up with my mouth completely dry and my lips stuck to my teeth which is obnoxious. Chin straps don't help, I'm not really opening my mouth but just slightly puffing out my lips which breaks the seal and starts the air flow out. 

I was thinking that maybe the reduced weight/alcohol means that I don't need as high of a pressure. On nights when I do consume alcohol, I have almost no leaks. My plan was to start dropping the pressure by one notch every night until the leaks stopped but I'm not 100% sure that this is the best idea so after a couple of days I decided to post here and see if anyone else had any ideas. 

I feel like I'm sleeping decently well but not as well as I could be and I would really like to optimize my machine to get the best sleep possible. My doctor referred me to get another sleep study because of the weight loss/alcohol reduction but my insurance denied it so hopefully someone here can help me.

I can provide whatever OSCAR data would be the most helpful, but for now I'll just post two representative examples, last night where I had about 5 drinks and Wednesday with 0 drinks. Thanks in advance.

[Sleeprider]

Therapy looks good, and you may be able to tolerate a lower pressure. With the Elite you are using a pressure of 9.0 and EPR 3 so 9/6 pressure is the result, and is not particularly high. You can try resetting pressure to 8.0 and see if that improves comfort and leaks. I don't expect a major change in therapy. I really don't understand why your doctor would want another titration. This is something you can do yourself, and observe the changes in Oscar and how you feel. Maybe next time, your doctor will prescribe the Autoset so you get automatic pressure adjustments when you need it. I tend to relax more and can have very low event rates on nights I have some drinks. There is a variety of tolerance among individuals to drinking and efficacy, and you seem to be comfortable with it.

Looking at your charts, on the 12th I see you started off with some high respiration flow, which is common before we settle down and respiration slows. You seem to take deep slow breaths as you start therapy, and that is consistent in both charts. There is a cluster of obstructive events which I think you can disregard for so early in the night, and the rest of the night is very quiet and even except for some high leaks. On the 15th you had some trouble settling and restarted twice. The events are not a big concern and leaks are much better on this session.