Mouth tape leaking, burping in morning. Too much pressure?

[MonasteryCarpet]

Hi all,

I've been using my CPAP for about a month and I'm having some issues. I'm using a P30i mask and taping my mouth at night. If I don't tape my mouth I wake up in the middle of the night with air spouting out of it!

However even with my mouth taped something odd happens, every few nights I wake up to the sensation of my mouth slowly inflating like a puffer fish, eventually the pressure builds up and it creates a small leak on the corner of my mouth. Another thing that I have noticed is that when I wake up in the morning and I sit up, I have to burp. This never occurred before therapy, the burp is fine, no pain, not big, but it's like air is getting trapped in my stomach during the night.

I've read that all of this may be due to too much pressure, or at least too much exhalation pressure. I read that changing the Mask settings from Pillows (which is what I have it set on as per the P30i instructions) to Full Face will actually drop the pressure a little bit. Also read that changing from the Slimline tube to the 19mm should also help reduce pressure.

I tried this for 1 night last night however the 'puffer fish' occurred.

I am wondering, should I tried and lowering the pressure? My EPR setting is Full Time, Level 1, which I understand to mean a 1cmH20 reduction in exhalation pressure, I'm also wondering if increase this to 3 might help. Another suggestion I read online is a V-Com device which is supposed to help reduce exhalation pressure.

The good news is my AHI is around 1! But the puffer fish wakes me up at night :.

This is a screen shot of 2 nights ago when I was still using the Pillows setting instead of Full Face

[Old Steve]

I don't see an OSCAR chart...

[OpalRose]

Be sure you are following these instructions when posting a Screenshot.

Attaching Images and Files on Apnea Board

[MonasteryCarpet]

Whoops, let's try again.

[MonasteryCarpet]

Any suggestions?

[Old Steve]

Your leak rate is almost nothing so your mouth tape appears to be working.  You could try setting your EPR to three and see if it helps.  You may get more clear airways or apneas though.  Your upper pressure is almost hitting 9cm when you are sleeping, so that may be the cause of the puffer fish too.  I use a nasal mask and the same thing happens to me occasionally although, I run in CPAP mode only with 3 EPR.  If the EPR to 3 does not work for you I would suggest the following.  Try setting setting your minimum pressure at 8cm, and the EPR at 2 or 3, the higher minimum pressure my stop some of the up and down pressure fluctuations.  If nothing works for you after four or five days you may want to try CPAP mode only at a pressure of 8cm or a little higher and see if that helps. 
 
I think that the V-com is for use if you are running your machine in the CPAP mode only with out any EPR.  

[MonasteryCarpet]

Hi Steve,

Thanks for that. I set the EPR to 3 a few nights ago and had another puffer fish last night. The mouth tape definitely works, it's just the sensation of my mouth inflating and hearing the small leak that wakes me up. I'll try raise the minimum raise to 8cmH2O like you suggested and reported back.