Large Leak/Low Flow Rate

[Sleeprider]

I cannot for the life of me figure out how to add the attachment of the screenshot!! Says I've reached my attachment quota.
I /we wish every night could look as good as last night!
To answer your questions... before changing to 20cm his 14 day AHI was 2.45 with large leaks on many, but not every night. One night he had a leak of 108 minutes, then things returned to normal. Since changing to 20 cm, excluding some days with faulty readings due to a card issue, his AHI is 4.02. That being said, he also has had no RERA since the increase in pressure.
Today we will go through the mask fitting video and do that. I think that may be an issue. Every time I tell him his mask is leaking (buzzing) he tells me he has it as tight as he can get it. Now I understand that is not the answer to the leaks.

I also understand, thanks to the experience of the members here, that when he is having these leaks the machine cannot read properly.
However I'm still not convinced that his lying on his back and not breathing (normally) isn't causing the machine to think it is having large leaks. If one stops breathing or breathes very shallowly, the air has to go somewhere, right?

BTW, last night he had just 5 hypopnea, 6 obstructive for an AHI of 1.71. No large leaks or anything else!!

The most recent night is encouraging. You are going to have to consider if this increase in pressure is actually beneficial, and that will take a week or two to figure out. I would encourage you to evaluate not only AHI but how he feels. It seems he received adequate therapy results with the lower pressure, and might even benefit from a bilevel that would drop pressure on exhalation. Leaks remain your biggest challenge.

I hope you will remain engaged in his treatment and post updates. As your post count goes up, your allotment of attachments will also increase. You can also just link images hosted off-site. Best of luck.

[jms722]

His machine WAS set to sound an alarm and shut off during a large leak (mask removal). The alarm actually did go off and the machine shut off one night while he was wearing it. The alarm woke me up, so I can confirm this. I talked to the respiratory therapist who works for the equipment provider about my concern. She suggested turning the alarm off which in turn keeps the machine from turning off while he's wearing it during large leaks.
I am 99% certain that he is not taking the mask off during the night.
This problem seems to happen only when he is on his back, so we will fit the mask while lying on his back before he sleeps tonight.

[Sleepster]

What may be happening is that when he sleeps on his back his airway starts to collapse and his machine responds by raising the pressure. So it's the higher pressure that's pushing his mask off. You can try adjusting the mask. Another trick is to sew a tennis ball into the back of his night shirt to keep him from rolling onto his back.

[jms722]

I have a theory: I think when he sleeps on his back his mouth falls open farther, making the mask leak. I say farther because he says he sleeps with his mouth open all the time.
Sleeper: he is at a constant pressure of 20cm though