Recent decline in cpap therapy

[DanielBillig]

            I have been a CPAP user since 2006 with mostly decent results.  Unfortunately, in the last 3 weeks my cpap therapy has left me zombie like.  I have tried to take a deep dive into my data to understand the problem, but I need help.  I use a swift fx mask.  I tried going from Med to Large and it did not improve much.  I tried switching to a P10 for a night and it did not help.  I tried a chin strap for a night and it was worse.  I have low AHI but I do have a leak.  The leak rate has not changed over time, so I am not sure if that is the cause.  I have raised the min pressure from 6 to 7 and it still is not solving the issue.  I would really appreciate some help.  I am struggling.

[Expat31]

On first sight looks like mouth breathing (air leaking). 

Tape up?

[Sleeprider]

It would be interesting to see an example of therapy from when you thought it was better. You are using auto pressure in a fairly wide range with no EPR. I'm sure you'd be more comfortable with limiting that pressure to a narrower range and adding EPR. Pressure is moving on flow limitations, and EPR can reduce that problem significantly and increase the quality of sleep by reducing respiratory effort related arousals. So lets turn on EPR full-time, setting 2 and see if that helps.

[DanielBillig]

Dear Sleeprider,

Thank You for your EPR suggestion.  I will definitely try that.  What pressure range do you think I should have?

[Sleeprider]

My impression is you could do just fine with a range of minimum 8.0 maximum 12.0, but just keep the 7.0 minimum pressure for now and we can look at those results with EPR before making a change.

[DanielBillig]

Ok, I will give that a try.  I really appreciate you prompt replies.

[DanielBillig]

Thank you so much for your comments.  Last night I tried the chin strap again, and it was really not very comfortable.  I think it cut down on the time I was leaking 45M vs 2H and somewhat on the amount of leak, but my sleep quality was difficult and some other stats spiked.

 I did order a CPAPMax 2.0 pillow when this started and that just arrived today!  I am hoping that might help.  One of the issues I did not mention is that in the middle of the night I need to turn on my side and put an earplug in one ear to block out noise from nearby snoring....I think I am getting more leaks when I am on my side, I hope the pillow will help.  Interesting fact, two earplugs interferes with the mask pressure.

Also, I had a big issue with dry mouth that I had not had before.  I did add EPR 1 so I am not sure if it was the chin strap of that.  Please note big spike in pressures.