questions re: leaking air

I use the nasal pillow AirfitP10 with the Resmed Airsense10. When I'm sleeping on my back everything is clearly working as it should. But I have problems with my leakage when I go on my side, as shown both by my scores in the morning and the sounds I get from the CPAP. I tend to be woken up by the change in sound and the sensations I get. The mask doesn't fall off and I'm not having a problem with the head gear.

I'd appreciate any feedback about reducing the leakage. I'm fairly new to the CPAP. My overall AHI score was mild (a little above 13) but when I was on my back at certain times of night, dreaming, my scores were severe.

Also, my apnea scores with the CPAP tend to be low. If that's the case, how much of a problem is leakage (except for the fact that I get woken up, which is not helpful)?

Thank you so much - great site and forum!

Whether it is a problem or not depends on how bad the leaks are. If you go by the green happy face on the AirSense 10 machine you can be mislead. I have found that it takes a really bad leak before the red grumpy face shows. The best way to find out how much your mask is leaking is to copy your data from the AirSense to your computer and view the results in SleepyHead. It tells you what the leakage is all through the night, and when it exceeds the leak redline. When it goes over the leak redline ResMed claims that apnea detection is impaired, and as a result it does not increase pressure in response to potential apnea events it is not sure about. Then when the leak ends, the pressure is low and you can get a series of apnea events. So how the leaks affects things kind of depends on how bad they are. The other issue with a P10 is that one can open their mouth in the night and that can be a fairly large leak too. Again you can kind of tell that in SleepyHead.

In general with the P10 mask I try to sleep with my face on the outside of the pillow so the mask hangs over the edge of the pillow a bit. I think this prevents it from dislodging and leaking. I also use a fairly soft pillow with a down alternative fill. My feeling is that the down alternative does not push back like a foam or memory foam pillow. It gives a bit so as to not dislodge the mask.

But, your best bet is to download SleepyHead so you can see what is really happening. See this snips from SleepyHead. Both were with the P10 mask. In general I am happy when leaks stay below the 24 L/min leak redline. The graph gets grayed out when you go over.

Bad Night

Good Night

Thank you so much. Where do I get Sleepy Head? Is it an app? downloadable?

I've a few times had that red circle but that was for something really big and weird (I tried a new mask and didn't have things right at all, and the machine just shut down eventually). I do see the leak data but I don't exactly know what to make of it. I have had problems with my mouth opening. I tried taping the past two nights and had much better scores. But I'm interested in learning more of the details. Thanks for your help.

Unless your leak is massive, it doesn't have to be a problem. If it is not bothering you and your AHI is still nice and low then you don't need to worry about it. If the leak is so big that the machine cannot tell if you are breathing, the data downloaded from the machine should tell you. I'm not familiar with Sleepyhead but I expect it would do the same.