New CPAP user - seeking help

[zeplike]

Hi all. First post here! I am a new CPAP user that has been struggling with treatment and seeking some guidance as I have been very frustrated by my experience so far. 

Some background:

I had a sinus surgery due to deviated septum and nasal polyps in 2020, before this I was unable to breathe through my nose for the past year prior and severely impacted my sleep. During the examination for the sinus surgery the ENT doc said I do show signs of sleep apnea (large tongue and teeth grinding). Far before my sinuses were an issue I always felt like I never got good sleep, waking up exhausted, brain fog, bad memory etc. After the surgery I could breathe through my nose again and sleep vastly improved but still had the same symptoms as before where I just don't feel rested after 10+ hours of sleep. I was prescribed CPAP in 2020 after a sleep study which showed I had mild sleep apnea (AHI ~11). It took me a while to get around to getting the CPAP but I started treatment on 9/14/22. 

I started with the Airfit P10 nasal pillows mask but didn't like the hose in front so i've since switched to the N30i mask which I found more comfortable.

Currently using AirSense 11 with a pressure of 11-14cm but since i've started CPAP treatment I have struggled with bad leaks (sometimes as high as 60). I think this is because my tongue falls back and my mouth opens while I sleep. I am awakened many times throughout the night having mouth leaks or even pulling off the mask completely sometimes. It's been a very frustrating experience so I am looking for some help or opinions on what I might be able to do or try next. Right now my DME approved me for an F30i mask which I am waiting for to see if it can help get the leaks under control.

**EDIT having trouble with inline images and can't post links until 4 posts, maybe I can post them after a few replies* Here are my sleep study results along with last night's OSCAR data. I'd really appreciate any replies that might help this situation!!

[zeplike]

Will drop the OSCAR data and sleep study here when I can if that helps

[zeplike]

Mistake on my part for not just attaching the image

[Sleepster]

Using a full face mask like the F30i will stop the mouth-leaking. You are correct in that mouth-leaking can disturb your sleep and it can render your CPAP therapy ineffective.

[zeplike]

yeah I figured that it might resolve the leaks. Kinda worried about being a side sleeper/having a beard and how it will work out with the FFM

[Jeff8356]

zeplike,

I use the F30 and have a beard/mustache as well as being a side sleeper. It did take a little getting used to finding the right position in the beginning but now it's not an issue anymore. You may need to experiment some with the tightness of the straps. I find it better for me when I tighten them a little more than what is recommended in the Mask Primer, but everyone is different.

[zeplike]

Thanks Jeff, that is good to know. I'll definitely review that mask primer now and again when the new mask arrives. I am really hopeful this does it for me because I haven't seen any improvements so far and it's been kinda demoralizing

[Sleepster]

I am really hopeful this does it for me because I haven't seen any improvements so far and it's been kinda demoralizing

Finding the right mask can be difficult and you may have to try several. When I was going through this I would sometimes switch masks in the middle of the night because of poor fit. Eventually, though, you will get yourself adapted to the right mask. The essential thing is to keep an eye on your leak rate graph.

[zeplike]

Yeah thats been the biggest challenge for me, it looks like the nasal masks aren't going to work. I tried a chinstrap and mouth tape but leaks still are pretty bad. I am wondering.. what was your experience like after switching to the FFM?

[Sleepster]

Yeah thats been the biggest challenge for me, it looks like the nasal masks aren't going to work. I tried a chinstrap and mouth tape but leaks still are pretty bad. I am wondering.. what was your experience like after switching to the FFM?

I started on a nasal mask, then nasal pillows. I'd tried chin straps and taping but I still had terrible looking leak graphs, even though my leak statistics were good. It was about 2 years after starting CPAP therapy that I decided to try an old FFM that came with a CPAP machine I bought on craigslist. I tolerated it so I contacted my doctor and visited my DME for a fitting of the FFM I still use now.

There a was a huge difference in how I felt. Much more rested. I figure that the mouth-leaking may not have affected my therapy much, but perhaps the mouth leaking disturbed my sleep.

Look at your leak graph in OSCAR. Look for large chunks of time where the leak rate is well above the base line (some people describe the shape of the graph as a plateau). That's a sign that you're mouth-leaking.