Not sure if I can help on that one. Leakage could be an issue causing events but remember that normal is less than 5. I still would try lower pressures and see if it helps.. Maybe the leakage is because the pressure is set too high.
If someone has had a proper sleep study then the pressure they are prescribed is the minimum required to keep them breathing properly. Lowering the pressure will almost certainly induce some level of obstruction - that's precisely why it's set as it is. It would be very unwise to adjust the pressure without consultation with a sleep physician. It may reduce mouth leak and it may make CPAP more comfortable, but it won't be properly controlling the OSA.
Totally concur. In another thread I asked DoctorDoug71 what type doctor he was and if he felt that a patient who disregarded any prescription he wrote would be wise to do so. Fiddling with a prescription after a study seems kind of counter intuitive as there is little point in a study if you are going to experiment with pressures on your own.
A large leak can reduce the sensitivity of the detection apparatus of the CPAP machine in some cases, so that may be why you have more events with the full face mask. However, there is a documented phenomenon in which people need a high pressure to eliminate obstruction when using a full face mask than when using nasal. One theory is that it is a "reverse MAS effect" with the pressure on the lower jaw from the bottom of the full face mask exacerbating airway collapse. Whatever the cause, I have seen it happen with my own eyes in some of my patients.
You could try taping your mouth shut with a nasal mask, at least for a few nights. If your residual AHI goes up then you were probably obstructing before with the nasal mask but the leak was stopping the machine from registering it. If your residual AHI is still low with the mouth taped shut then that would suggest your breathing is fine with the nasal mask the higher AHI with the full face is due to the reverse MAS effect. In the latter case you could keep using nasal is if it is more comfortable. A mouth leak is not necessarily a big issue in itself if CPAP is still effective.
I don't see how a home sleep study could determine the pressure needed. I had a lab study done several years ago which was a waste as I couldn't sleep long enough.
I've been trying to do this since March. I think my settings are 4-20 which might just be a machine "default range"?; it's ridiculous that I can't adjust my own settings. I can manage maybe two to four hours before I wake up choking and gasping - this seems to occur at pressures around 10-11. If I'm just relaxing or reading with my cpap, it's comfortable and soothing up to a pressure of 8 or 8.5 and I feel refreshed after a light afternoon nap. I had major abdominal surgery in the middle of my insurance compliance period and couldn't use the cpap at all - I was afraid the bloating from swallowing air might actually tear something and it was acutely painful - so I only used it when I was awake for the minimum to make compliance.
Using a nasal mask which doesn't work well if I don't have dentures in; they sent me some nasal pillows but they must have been made for an elephant as they don't fit at all (even the "small"). It took me six weeks to get them. I'm trying a full mask tonight that a friend had extra - I think it's a littl big but will give me an idea. I can't afford to buy different masks to try so I'm limited to three month trials (if I can actually get to talk to someone at the supplier).
Meanwhile I called my doc and asked that they do whatever it is they have to do to get the pressure lowered.
As a nurse and a cancer patient I'm pretty adept at navigating the system but this has been ridiculous. Without the cpap I sleep for twelve hours and find it difficult to drag myself out of bed and care for my ranch and horses. With the cpap I only sleep a couple of hours and find it difficult to drag myself out of bed, etc.
Patti in AZ
It's almost three in the afternoon and I'm trying to get enough caffeine, thyroid med and ALCAR on board to get enough energy to go feed my ponies. The full face mask lasted less than two hours. I have to check with my doc on Monday to see if he was able to get the lower pressure request going. It took me six weeks to get meaningful help from the ResMed CME folks before with lame excuses about being not well enough staffed. They seem to be very much in "blame the patient" mode. Sorry for the rant but I badly need this to work - I didn't survive three cancers and a couple of major surgeries a in the past two years to have my life shut down by a stupid machine and system that doesn't work. Did I mention I'm frustrated? And thank you forum folks for being here - at least I now know I'm not the only one : )
Patti in AZ