Yet another Large Leak help request

[apneavolt]

Friends,

I'm asking for some assistance in keeping a good seal throughout the night.  I'm consistently having large leaks.  I've tried so many different things and I can't seem to kick it.  I figured instead of listing out every single thing I've tried (unless you'll find that beneficial) that I would simply keep this a blank slate and tell you how I prefer to sleep and my current setup.

I am a side or chest sleeper.  

My preference is on my chest with my arms up fairly square beyond my head so I end up sleeping a few feet down from the top of the bed so my hands don't touch the headboard.

I find my side to be second favorite position, left or right doesn't matter, but I will have my one arm that is touching the bed out straight higher than my head where my head is on my arm with the pillow in between.  I've found with my pillow which I would call medium density has enough in it that my arm doesn't fall asleep by the pressure of my head.  The opposite arm I usually tuck my hand barely between my legs or scrunched up against my chest.

I've found that I cannot sleep on my back at all even before sleep apnea diagnosis.

I'm male, late 30's, 160 pounds and 5'-10".  I'm currently using a ResMed AirCurve 10 ASV.  I'll include screen shots from OSCAR of some recent dates which also contain settings.

I'm currently using a ResMed P10 in Medium with a medium density pillow and a bed that would be considered medium firm.   I've changed the P10 nasal pillows out to fresh new ones and the consistent large leaks still happen.  I have the Phillips Dreamwear Nasal mask 116681 on its way that I'll be testing which is similar design.

I believe the issue is that whether I'm on my side or my chest that the nasal pillow with even the slightest movement will break the seal since it is literally touching the pillow.  I've tried being on the very edge of the pillow but the pillow itself still touches the facemask even if it isn't touching the nasal pillow portion.  

I am willing to try anything at this point and at any cost.  Different equipment.  Different pillow.  Different bed.  I'm happy to experiment!

[Jay51]

Here are some tips from our Wiki to help stop mask leaks:   

• Mask Primer
  Hopefully you will find something in here that helps you. 

[phattyre]

@apneavolt

I am having these large leak spikes like you. I am 61, 6'4", and 200lbs. I am new to CPAP, side sleeper, and limited movement. I have the Tempur mattress and pillows, and I have been trying to sleep on the edge of the pillow.   I too have the AirSense 10.  My ClimateLine has plenty of room and has no drag or pulling issues.  I am using the N30 nasal cushion mask, but I have a N20 and P10 ready to be tried out.

Like you, I am looking forward to eventually discovering some good sleep.

[Deborah K.]

I have happily used Bleep for years, but recently my skin is not tolerating the tape, so I switched back to an old ResMed P30i for now.  It has been leaking like crazy, usually showing the red frowny face on my machine.     Last night I spread a little Lanisoh Nipple Cream all over the pillow and no frowny face!  I plan to keep using it.  Maybe it will help you too.  

[Deborah K.]

 Well I reported too soon on Lanisoh helping with leaks.  I only had the leaks help for one night.  Now I'm back to big leaks.

[REMmi]

can one use Oscar to determine, what is acceptable leak amounts? I know it will list "large leaks" but say for someone using a resmed airfit F20 FFM, what would one expect to see as normal on Oscar? and certain number of liters or how many spikes or ? Also how does one determine , which AHIs or leaks or flow limits are artifacts, and not true data? eg, how does one tell if they are sleeping by looking at the flow rate, or is that possible, to decide what is noise and what is signal? or is it mostly signal, except at the start and end of the night?

[SarcasticDave94]

Regardless of mask and using a ResMed machine, you need to be decently below the leak redline of 24 L/Min. When I was on the ASV, Max IPAP was at 25, I could get leaks to be 12 L/Min plus or minus 2. You need to have a decent semblance of control over the leaks.

[TiredOne789]

I've worn the P10 mask for many years. To stop the P10 from leaking I do not separate the straps on the back of my head as ResMed instructs. 

To put on the mask, I insert the nasal pillows and leave both straps at the top of the back of my head. I secure both straps with 2 closeable hair clips – one on the left and one on the right of my head. I usually have zero leaks with the P-10.

I also tape my mouth with 2 pieces of 3M Nexcare strong hold tape before I put on the mask. I use a 5-inch piece of tape centered across my mouth. Then a 6-inch piece on the lower half of my mouth and chin. Always fold back little “handles” for easy and quick removal. It takes a little trial error to get the right size of tape that works for one's face.

I try to sleep on my side on a flat pillow.