Mask fit

When I have a good mask Fit, I do not feel air flow (seems to create a vacuum) and I wake up feeling dizzy and oxygen deprived. When my CPAP mask fit is poor and there is heavy leakage I feel air coming through and sleep better. Can someone please explain this dynamic? Thank you. Susan

Hi Susan, I'm brand new to this site, and you're the first person I am talking to! Last year I had a second sleep study and found out I had to switch from CPAP to BiPap. I had no trouble switching, but after a few weeks I was still having too many apnea episodes, so my Sleep doc increased the pressure. Most nights my mask leaked horribly, but unless the noise woke me up, I slept OK. One night the mask fit perfectly well with no leaking, but the pressure made me feel as if my lungs would explode!! I got chest pressure which lasted through the following day, too, and had to use my supplemental oxygen to feel better. I said all that to say that maybe the pressure is set too high for you to tolerate when the mask isn't leaking. Tell your doctor how you felt when your mask did not leak. When I told my doctor he decreased the pressure.

Hi Susan. StraighforwardSilver makes a good point about talking to your doctor. Some patients experience "air hunger" when their starting or ramp pressure is set too low, and a slight increase in the pressure can help resolve that problem. For others, the force of higher pressures causes difficulty exhaling. In this case, a change in treatment might work. Sometimes this means a change from a fixed pressure to an automatically adjusting pressure, a change from CPAP to BiPAP, or a change in a machine setting that temporarily decreases pressure during exhalation. Some machines use the term EPR or flex for this feature (CFlex, Aflex). I encourage you to talk to your sleep physician or equipment provider to see if there are any suggestions or adjustments that might help. Best wishes!

I can only concur with the above comments about seeing your sleep doctor.

In regards to DanM's comments, the EPR function (as it is called on a resMed machine) is worth a go. I found it created a differential which avoids that feeling that there is no aiflow. Being able to use your APAP/CPAP/BiPAP is just as much about being comfortable.

Your doctor will be able to sort out whether you need more pressure or less but you will get the best out of the treatment if you are comfortable.

If you are allowed to try one, then you might give APAP a go. It is likely to give you that feeling of differential and be higher when you need it and lower when you don't