N20 is leaking

[XticOtacXtoeO]

I’m new here and to my first CPap. First night was last night. I put my N20 on early as I wanted to feel more comfortable by bedtime. 

My CPap records to me in the AM and says 12:54 of usage. It tells me nowhere of my sleep time. That’s irritating, I wish to know good sleep numbers. 

My sleep study was scored at 40 API, no central Apneas and they set me at 14. My API last night was 1.6. AI 1.3 central 0.8. 

My biggest problem as you can see if my mask. I feel it’s on secure, no leaking while laying in bed reading. Then I try to go to sleep, I toss and turn quite a bit and notice while on my side I feel leaks, therefore, I tighten up my straps a bit. I’m not overly tight, no red marks on face this morning. I failed at leaks 64L/min. Wth? 

Now what?

Tic

---

I meant to add my numbers:

Woke at 7:30
Usage 12:54
Press 13.9.

The rest is above.

[mesenteria]

Hmmm.   Mebbe it's the mask. Side-sleeping is going to be tricky.  Back-sleeping is bad.  Whaddayagonnado?!?!?

I use the same mask and have no measured or noteworthy rates of leakage over the course of my 20 months of therapy.  But I do leak.  Some of the night.  It's just that it is small.

When I get leaks, I usually awaken.  This is because the leaks happen upwards toward my eyes, and the eyelashes fluttering give it away.  I'm instantly awake.  But, because I leak so little, and not all night long, when it happens significantly it wakes me up.  Are you being aroused similarly?  If so, you should be quite cranky by morning, and desperate for a nap by the end of anything passing for a lunch break.  Or sooner. 

When I first started out, I was convinced I'd have to get used to sleeping on my back because of leaks.  In fact, to this day I mostly fall asleep that way.  However, about month 6 or so I realized I was turning over onto my side, something I have always done, and was blissfully asleep in no time at all.  I routinely turn from side to side, and I have yet to get a red angry face next day.

So, it can be done.  The fit, and learning how to pound and shape your feather pillow, are key.   

You say your headgear is good 'n tight, but still there are no marks next day.  Great!  Maybe you just need to refine the way your face, your cheeks and mask, interact with your crooked arm, your curled wrists if you keep them tucked up there as I do, or the pillow.

Also, you mentioned tossing and turning; I'm afraid that is not going to do you much good for a couple of reasons.  If it slows or prevents the onset of sleep, that's bad.  If it tends to arouse you (you know of it, so you must awaken some of the times when you toss and turn....yes?), that, too, is bad.  You need to be able to sleep for close to 2 solid hours at a dash so that you can run through the stages of sleep, including REM.

At this point, I'll leave off any further comment.  I know some reading here have had to tame thrashing in bed, and I'll leave it to them .

Good luck.  This is going to take some doing, the odd slip backward, but you'll get there.  Persist.  Persevere.  It's worth it.

[XticOtacXtoeO]

Thank you, mesenteri.

I am aroused with my tossing and turning some of the time. Though mostly I can tell because I’ve untucked my sheet at night.

I think it’s not so much leaking from the mask as it is my mouth. I have a chin strap but I think it’s too slippery and slides around my chin.

I will keep at this. With all the leaking I had minimum AHI at 1.6. I felt better rested today yet still tired all day. I was more alert.

Thanks again,
Tic

[mesenteria]

Great!!  As you probably realize, how this feels to you, and your belief that you will improve, are as important as the AHI and keeping arousals to a minimum.  Psychologists call this 'face validity'.  If it has no apparent intrinsic or intuitive feel-right about it, you're going to struggle.

About the mouth leaking; I, too, will revert to mouth leaking as soon as I fall asleep.  I have gone to bed perhaps three times over the 20 months of treatment forgetting to apply tape to my lips, and I soon realize my mistake. 

The thing is, I do have to tape.  I, and several other reg'lars here, use tape preferentially.  It's not something we encourage, but in order to be ethical about providing honest and comprehensive service here, we do allude to our having to do it.  In case this is news to you, or in case you are getting desperate enough to give it a go, I will apprise you only of what I know works for me.  I use the 3M Corp's NexCare white surgical-type tape in a white plastic spool that is described by 3M as 'water resistant'.  It is about an inch wide, and the spool comes with about 35', or just over 11 meters. 

There are other tapes that hopefully others reading here will comment on.

If you are interested in pursuing this option, I can offer you some tips later.

[XticOtacXtoeO]

I appreciate your responses.  On this 2 Nd night, I tightened up my mask, which now feels really tight and I had 37L/min vs the 64L/min. Obviously some of the leaks are from the nasal mask. 

Not much tossing and turning last night, mostly on my right side. 

My numbers are mostly the same besides the leakage. 

Still not at 100% so my work here is not done.

[DaveL]

Hi,
I mouth breath too...
My mask is an N20 too.
I used a good chin strap for a long time. It's discontinued, and I haven't had any luck finding its equal. Feature--it had an opening that went around my ears, so it wouldn't slip off my bald spot. Age? darn thing stretched. So it would stretch and then not work for me.
I use a Dakota wedge pillow right now. It's not as comfortable.
I've tried tape; think I need to try it again.
BTW, I've tried a whole bunch of full face masks. I'm claustrophobic. I hate wearing them. Wake up and the full face mask is off...

[DaveL]

So my first N20 was about 6 months old. I had become more tired every day now than I remembered being when it was new. I bought a second N20 and took it home. Same mask. Same size.
Checked. There was a fit gauge in the box. I had the wrong width of mask. Took it back; got a medium instead of the large I'd bought 2 times.
So I compared the brand-new-never-worn N20 to my 6 months old N20
Difference:
--width of insert (medium was what I should have had all along)
--old head strap was badly stretched! almost an inch (from regular tightening to stop leaks)
--new insert felt different from the old one. Softer, and different texture. Old one felt rougher...

my conclusion? Darn masks wear out fast; even though mine was worn out it looked fine. Both the insert and the headgear were compromising my sleep results.

[DaveL]

So my first N20 was about 6 months old.  I had become more tired every day now than I remembered being when it was new. I bought a second N20 and took it home. Same mask. Same size.
Checked. There was a fit gauge in the box. I had the wrong width of mask. Took it back; got a medium instead of the large I'd bought 2 times.
So I compared the brand-new-never-worn N20 to my 6 months old N20
Difference:
--width of insert (medium was what I should have had all along)
--old head strap was badly stretched! almost an inch (from regular tightening to stop leaks)
--new insert felt different from the old one. Softer, and different texture. Old one felt rougher...

my conclusion? Darn masks wear out fast; even though mine was worn out it looked fine. Both the insert and the headgear were compromising my sleep results.

Thank heaven I have OSCAR.
Thank heaven I can talk to people here with more knowledge than I have.

[XticOtacXtoeO]

Thanks for the input. I might try a wedge.

[XticOtacXtoeO]

When I actually take time to sit at the computer vs my phone, I will download OSCAR. 

Thanks DaveL