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Mask leak questions

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kd15 +0 points · 2 months ago Original Poster

I have high mask leak (about 30 l/min). The reason I have high mask leak is I am a hardcore side sleeper -- I literally cannot sleep in any other position, and never have been able to. When I'm on my side, the mask gets nudged around by the pillow, and voila! leak. My AHI is well under control, between 2.5 and 3. So my questions are, how concerned should I be about the leaking, given that my AHI remains under control, and is there a better mask for side sleepers. I'm currently using an Airfit N20, and while I dislike it, I disliked the nasal pillow thing I tried out in the RT's office even more, although if the air leak problem is serious enough, I'd be willing to suffer through trying out the thing. My major concern about the air leak is that it seems to me it would be hard to measure AHI with so much air blowing out of the mask, which makes my number kind of dicey to rely upon.

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Sierra +0 points · 2 months ago Sleep Innovater

ResMed considers the leak redline to be 24 L/min, so you are not really that much above this number. One of the concerns I have seen reported is that the machine response to events may be suppressed when the leak rate is above the 24 L/min limit, and at the end of the leak period, pressure may be too low and you could get a burst of events.

The N20 seems well constructed with good solid headgear. I would think if it is adjust correctly it should be quite stable for side sleeping. A couple of the things I have found helpful is using a satin pillow protector. It lets my head and headgear slide around on the pillow easier and keeps the pillow from dragging the mask out of place. Another thing that I believe helps is a pillow that does not push back. I started out with a memory foam pillow but found it liked to push back and push the mask out of place. I have since switched to a down alternative pillow from Costco. It is not super soft, but it kind of stays put when you compress it -- no push back.

Another issue is whether or not you are getting the leaks from the mask being dislodged, or if you are opening your mouth in the night allowing air to escape out. Symptoms are a dry mouth in the morning. If yous use SleepyHead a mouth leak usually starts suddenly and has a flat top on the leak rate curve. Mouth taping is one solution, and using a chin strap is another to stop mouth leaks. I find mouth taping to be much more comfortable than using a chin strap.

Hope that helps some,

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kd15 +0 points · 2 months ago Original Poster

Thanks for the reply.

I'm pretty sure the majority of it isn't from mouth breathing, because I've woken up a few times and the mask was entirely off my face, and I've knocked it around while awake just by rolling over a little in bed. One bump against the pillow, and the hissing starts. Also, I haven't had dry mouth issues yet.

In a coincidence, I'm already using Costco pillows.

Last night was pretty good, leak at 20 L/Min and my lowest AHI (1.7) to date, with me trying to stay on one side all night. If I can keep it around there, I'll call it a success.

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Sierra +0 points · 2 months ago Sleep Innovater

Everyone is always afraid of over tightening your mask straps. However, I find with a nasal mask tightening it up some can help keep it located on your face and over your nose.

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bonjour +0 points · 2 months ago Sleep Commentator

I'll add that the Phillips (DreamStation) large leak numbers are well above your leak rate.

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Sierra +0 points · 2 months ago Sleep Innovater

Yes for some reason the DreamStation machines include the purge flow of air out of the mask. In SleepyHead there are two curves for leak rate. I would ignore the higher one, as it is quite meaningless.

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SleepDent +0 points · 2 months ago Sleep Commentator

See my post: Help Is On The Way For People With Leaking Full Face Masks. Actually can be used for leaking any kind of masks. SleepDent

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sleeptech +0 points · 2 months ago Sleep Enthusiast

If you don't like the intranasal mask with the prongs that go up your nose, you could Look at the Respironics DreamWear in the under nose variant. It copes pretty well with side sleeping.

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kd15 +0 points · 2 months ago Original Poster

To update, I've had 2 more good nights of sleep with mask leak well under 24l/min. I even had my lowest AHI ever, at 1. I did nothing different that I'm aware of, it just stopped, although I have found the mask less uncomfortable in the last couple of days, so maybe I was picking at it in my sleep, and with the decrease in discomfort, stopped doing that. I'm still getting a little drowsy during the day, but I'm hoping with time that goes away. Thanks to everyone who replied with your advice and encouragement.

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