Locating leak? Telling difference between exhaust and ?

[TheManseHen]

Hiya, it's me AGAIN....

Laying here with mask on face as I try my setting adjustments out...

I have the ResMed p10 airpillows size medium.

With being awake and hearing higher pressure and also using the EPR (put it back to 1, higher seemed to make me feel more back and forth flow and pacing which confused me and made me feel rushed)

I am suprised how much air comes out the vents below the nose pillows by the tubing.

If I hear air coming out somewhere, that's likely to be the pillows yes? I find I have to wiggle them or adjust the mask straps (which are a bit on the loosish side and a bit aggravating in their imprecision) to be sure there is no air leaking from top front of nose pillow. Maybe I need the large not the medium? I have a smallish nose and the DME picked them for me. I note that my mask pack had 2 mediums in it and I thought they were supposed to have a S M and L in them maybe? It makes sense if they switch out pillows to just the size you will actually use, but I wonder if 3 usually come, why I didn't get 3? Maybe I'm wrong and it's not 3.

Anyhoo...Thanks if you have any suggestions for mask leak discernment. It's not like I can take a tiny candle round the thing like one does an old houses windows!
Thanks,
Susan

[retired_guy]

The P10 comes from the mothership with a small, medium, and a large pillow. Sometimes the DME's take away the ones they think you don't need to sell to other patients. In this case it sounds as if they at least gave you 2 mediums in trade for the small and the large. Very often a larger size pillow works better even when we think we need the smaller size. In your case it does sound as if the medium is suitable. But if you cannot stop the leaks sufficiently, then it's time to call the DME and ask for a large.

As to placement, the easiest way to seat the mask is when it is on and doing it's thing, lift it gently straight up from you nostrils and allow it to settle back down and reseat itself. You're right that when it's placed correctly you won't really hear any air running, unless your hand gets in the way of the vents. That's a major feature of the P10.

As far as EPR is concerned, sometimes people experience sort of a "air hammer" effect when going from exhale to inhale if the EPR is set on 3. So trying at 1 or 2 to begin with is a fine idea. I'd go for the 2 however.

[OpalRose]

Hi Susan,
I too use the P10 mask. The air coming out the vents is normal. Sometimes I think I feel air coming from the top, but then I realize the pillows are not seated properly. My DME gave me the extra small size which I have been using for 3 months now, but I think I will move up one size to see if I have less trouble with the fit. I also agree with retired_guy concerning the EPR. I tried it on 3 but it didn't feel comfy breathing. I changed it to 2, and it feels more natural. I will repost after trying the size up pillow. Good luck to you. Take one step at a time!
I need my Coffee now!
Rosemarie

[Sleeprider]

Susan, the best way to see what your leaks really are is to check the data in Sleepyhead or a similar program. Leaks are graphed, and it's easy to see the baseline (designed leak rate), and where the mask leaks depart from that normal low rate. The P10 is a pretty quiet mask, and I have felt leaks like you describe as well, and made adjustments.

As you probably know, the tightest head strap position is when the straps are together. As the straps are separated the mask becomes looser.

[herbm]

If you can hear a *P10* it is leaking.

Sometimes the SMALLER size is also better. Sometimes you may think you have the perfect nasal pillow then try another size and find it works as well or better. Experiment.

Don't allow the mask to leak. It's noisy, annoying, can keep you awake (or wake you which is probably worse), and detrimental to your treatement's effectiveness.

[TheManseHen]

You all are just the best...informative, funny, practical.

My usual leaks numbers are under the proscribed "okay" level for the machine (They have been under 17L/min) Now that I've narrowed my range for now, to 8.0-13.3 that number has gone up to unacceptable levels but I've also had my first night of a AHI 2.0 in the 24 days of treatment I've had. So I shall tinker on and Lord willing and the creek don't rise, I'll get there.

Thanks,
Susan

[retired_guy]

That increase in your leak numbers may be because you started using EPR. That's an adjustment thing, so keep using the EPR and just focus on making sure your pillows are set well, and you are not "mouth breathing." Or maybe more to the point, "mouth exhaling." Let the cute little mask and the cute little machine do their thing for your cute little body and all will be well.

Without changing anything, I believe you'll see the leak numbers improve, the ahi drop some more, and I'll stake Herb's reputation that you will sleep through the night at least once in the next week.

Good job figuring this stuff out...

[Crimson Nape]

It's not like I can take a tiny candle round the thing like one does an old houses windows!

I was thinking about sticking your head under water and looking for the bubbles. . . .

If this is your first mask then you're at a disadvantage of not having a baseline for comparison of leaks. All masks will have a leak. This is to flush out the CO2 from the mask after exhaling. The P10, while it still can be heard, is very minimal compared to other masks. I would suggest that you purposely induce a leak, by slowly pulling it away from your face. That way you will hear the sound difference and give you a better grasp of the sound differences.

Good Luck!