+- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums)
+-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area)
+--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum)
+--- Thread: large Leaks and AHI...correlation? (/Thread-large-Leaks-and-AHI-correlation)
RE: large Leaks and AHI...correlation? - Allessio77 - 12-04-2017
(12-04-2017, 05:09 PM)Sleepster Wrote: The chin strap should be loose enough that it allows you to still open your mouth when you try, but tight enough that your mouth doesn't just fall open when you're asleep.
Mine was definitely too tight...I felt it squeezing my head, so I will try it again a little looser! Thanks
RE: large Leaks and AHI...correlation? - CB91710 - 12-05-2017
I'm a big fan of using a soft cervical collar after having used one for 6 months. I'll never go back to a chin strap.
On leakage, it CAN have an impact on your therapy for a number of reasons....
1 - Leakage results in a loss of mask pressure, which may result in more apnea events
2 - Leakage may result in "flushing" of normal CO2 levels in the mask, resulting in hypocapnia and possibly increased centrals (blood CO2 is what "tells" you to breathe)
3 - Mouth leakage can pose serious comfort issues... dry mouth, sore throat, annoyed sleep partner (wife calls it "Darth Vadering")
4 - High leakage rates make it difficult for the machine to properly log sleep-disturbing events
RE: large Leaks and AHI...correlation? - Sleepster - 12-05-2017
(12-05-2017, 12:13 AM)CB91710 Wrote: 1 - Leakage results in a loss of mask pressure, which may result in more apnea events
2 - Leakage may result in "flushing" of normal CO2 levels in the mask, resulting in hypocapnia and possibly increased centrals (blood CO2 is what "tells" you to breathe)
3 - Mouth leakage can pose serious comfort issues... dry mouth, sore throat, annoyed sleep partner (wife calls it "Darth Vadering")
4 - High leakage rates make it difficult for the machine to properly log sleep-disturbing events
I would add ...
5 - Leakage may disturb your sleep so you don't feel as well-rested during the day.
I ever do go back to a nasal mask I'll try the cervical collar.
RE: large Leaks and AHI...correlation? - Allessio77 - 12-05-2017
(12-05-2017, 12:13 AM)CB91710 Wrote: I'm a big fan of using a soft cervical collar after having used one for 6 months. I'll never go back to a chin strap.
This is interesting....The Cervical collars I have seen would not push up on the mouth enough to keep it closed...I have noticed that my leakage is not from my mouth spontaneously opening but the air inside my mouth seeping and bubbling out between small cracks in my lips...so what collar does this for you?? It sounds like it could be a more comfortable solution (if it works).
RE: large Leaks and AHI...correlation? - kiwii - 12-05-2017
The mask primer on the wiki tells about cervical collars, including how to size them:
Quote:You are looking for a comfortable fit 2-inches larger than the circumference of your neck and just tall enough to support the jaw when your head falls out of alignment (measure your neck from collarbone to jaw and subtract 1".
RE: large Leaks and AHI...correlation? - MitchS - 12-05-2017
In addition to using only enough pressure to help keep my mouth closed, I found it works best if I wear my chin strap more on my jaw than on my chin. This does two things, helps keep my jaw from falling back when it relaxes and the pressure from the strap pushes my tongue up and aids in forming a seal with my tongue.
I used a two-inch wide stretchy lady's headband across my lips to help with the air pushing past my lips. It ran across the lips, under the ears and around the nape of the neck. I put it on before my chin strap. Wearing it under the chin strap kept it from shifting. I've learned to control the lip leaks and have no longer use the headband.
RE: large Leaks and AHI...correlation? - HalfAsleep - 12-05-2017
I have lower (to non-existent) AHI during large mask leaks. Leaks depress my overall AHI. Evidently, the APAP just can't "see"events when there's a big leak. If you want to get an idea about the relationship between AHI and leakage, you can figure this out by highlighting the leak portion of your graph and looking at the numbers above the flow chart graph to see what the AHI is in that portion. Then you'd get a reasonable idea about what is happening to your AHI right then, e.g. is it distorting your night's AHI up or down.
I had to give up on nasal pillows and use a FFM. I've been very happy with the change. I should have done it sooner. I was getting so frustrated! The big leaks I have right now are from trying to scratch my nose; better to pull the whole mask off and scratch to my heart's content!
RE: large Leaks and AHI...correlation? - Sleepster - 12-05-2017
(12-05-2017, 09:07 PM)HalfAsleep Wrote: I had to give up on nasal pillows and use a FFM. I've been very happy with the change. I should have done it sooner. I was getting so frustrated!
+1
Going from a nasal mask to a FFM is not anywhere near as bad as I imagine starting out with a FFM would have been.
RE: large Leaks and AHI...correlation? - CB91710 - 12-06-2017
(12-05-2017, 08:51 AM)Allessio77 Wrote:(12-05-2017, 12:13 AM)CB91710 Wrote: I'm a big fan of using a soft cervical collar after having used one for 6 months. I'll never go back to a chin strap.
This is interesting....The Cervical collars I have seen would not push up on the mouth enough to keep it closed...I have noticed that my leakage is not from my mouth spontaneously opening but the air inside my mouth seeping and bubbling out between small cracks in my lips...so what collar does this for you?? It sounds like it could be a more comfortable solution (if it works).
That's where the "tongue suck" technique comes in.
It takes time to make it into a habit that continues during sleep, but you can do it during the day to develop it.
Gently close your jaw, push your tongue into the roof of your mouth (tip against the back of the upper teeth), and apply a gentle suction.
That effectively "seals" the tongue and cheeks against the teeth and helps to prevent leakage.
Added benefit is keeping the mouth moist is very good for dental health.
The cervical collar is not a "prop"... it is merely a reminder or guide. I wear mine quite loose, as if I wear it tight enough to function as an actual brace, I feel strangled when sleeping (I hate wearing a tie and don't even like high-collared t-shirts... funny because I wore turtlenecks in the 70s). I *can* drop my chin toward my chest... the collar is simply a gentle reminder not to.
RE: large Leaks and AHI...correlation? - Allessio77 - 12-07-2017
For the mouth guards, are we talking double guards...the ones that mold to upper and lower teeth and are joined..how does that hold your mouth closed? Any specific recommends?