Resmed Mask leaks - relaxing jaw muscles?

[fixit9660]

Hello. I have a mask leakage problem which wakes me up. The leakage mainly occurs at the side of my mouth.
If I just remove the mask immediately, I can get back to sleep, and just suffer from broken sleep (bad enough for me). If I had to "switch the machine off, adjust your mask. Turn the machine back on and settle back down to sleep", I would be too awake and not be able to return to sleep. Once I'm woken past a certain threshold then I'm awake. I have to get up, get dressed and start my day, even if it's 0300hrs!!!
I have returned to my local NHS a couple of times and, overall I have tried about 6 different masks. The NHS have been EXCELLENT! I cannot fault their efforts, but I've been persistently trying the CPAP therapy since 6/3/2025 and have only had a couple of good nights where I wake up at the normal time still wearing the mask.
All of the other nights I have been woken by the mask leaking air, mainly around the area at the side of my mouth. I'm sure this is because, when I sleep, after a few hours my mouth/face muscles relax and my jaw drops down and back, away from the mask. I made my own chinstrap, which I integrated with the mask straps and it improved matters a lot. The NHS supplied me with a chinstrap which whilst better made, didn't improve matters. I need to have my jaw held shut upwards towards the top of my head. The NHS chinstrap tends to pull my jaw back and up, so when I relax it pulls my jaw backwards, and leakage occurs.
I also find that if I lie on my side, the pillow pushes the mask and my face skin sideways, causing leaks in other areas, despite trying all sorts of harness strap settings.
Does anyone else have this problem?
I'm beginning to think there's something odd about my skull/skin/musculatur construction

I'm using a ResMed AirSense 10 Autoset, and have had best results with my original AirFit F20 M mask, modified with my own chinstrap.

[Kelly @ Intus]

Good Morning,

Thank you for your post.

Can I kindly ask what other masks you have tried, just in case I can suggest an alternative to try.

Philips do sell a FitLife Full (Total) Face CPAP Mask, which we only suggest as a last resort mask if you cannot get a good seal with a full face mask.

Have you tried any CPAP pillows if you are a side sleeper? For example the CPAP Pillow 2.0 features cut-outs for your mask to sit in, minimising pressure and keeping your mask in place - https://www.cpap.co.uk/product/cpap-pillow-2-0-2/
Something like this may help you with a full face mask if you are a side sleeper.

Kelly

[fixit9660]

Good morning Kelly.

I'll try to list the masks but as I said it's been about 6 models:

My original/current, and ironically the best fit, is the AirFit F20 M.
I've just ditched the AirFit F40 M.
F&P Simplus Medium; pulled my jaw back harder making leakage even worse.
A model almost identical to theAirFit F20 M but with a memory foam seal, (an Air Touch F20 perhaps?). The memory foam crushed my nasal passages making it impossible to breathe through my nose.
There were a couple of others too but I can't remember them.

So far, the NHS have been very good trying to fix my leakage problem, but during the last visit they indicated they are running out of ideas.
I wonder if I need a M.A.D. (Mandibular Advancement Device), to keep my jaw in place during sleep as this seems to cause the main problem?

Looking at the Philips FitLife Full I don't think it will cure the problem of leakage from the corners of my mouth when my jaw relaxes back. All the masks fit well initially, it's the jaw movement that causes the main problem.

I sleep on both sides, and until a few years ago on my back. The Apnoea made back sleeping much worse, and I was hoping that the CPAP would allow me to return to sleeping on my back. I tried using a much harder pillow last night and it didn't cause mask movement/facial deformation leakage so I'll continue with that for now, but the CPAP Pillow 2.0 looks as though it might do the job. I'll definitely keep it in mind, thank you.

Last night, according to ResMed Stats (debatable accuracy) I got 4 hours 39 minutes usage, with leakage at 5 l/min and had 2.5 Events/hour. I don't remember when or why I took the mask off, just too much asleep, but those are the best stats I've had in a while. I was using both my own made chinstrap and the NHS chinstrap together.

I wish the ResMed stats had more detail available to the user. It gives overall leakage figures but not the times and volume of the leakage. Not helpful if you're trying to work out the reason.

Andrew.

[Kelly @ Intus]

Hi Andrew.

Thank you for coming back to me.

It seems you have already tried the majority of masks that I was going to suggest looking at.

I have spoken to our In House Clinical team, and they do not advise using a mandibular advancement device with a CPAP mask. They have suggested trying the Fit Life total face mask, as they have seen good success rates for those people who have used it as a last attempt when they have tried all the other mask styles.

Do you want to have a look into this mask and let me know if you try it?

Kelly

[fixit9660]

Hi Kelly.

Thank you for enquiring about the MAD and responding with the Clinical Teams advice. Did they say why? I've been offered a full face mask by the NHS but I'm saving it as a last resort.

Last night I resorted to my original mask, the AirFit F20 M, in conjunction with my homemade chinstrap and the NHS chinstrap. I woke sometime through the night feeling smothered but managed to get through it without removing the mask and woke at 0630hrs still wearing the mask. ResMed stats say I had 7 hours 22 minutes with leakage 6l/min!!!! 2.9 Events/hour. Maybe it was the combination of mask, chinstraps, hard pillow but as I've been trying to get this right for 2.5 months I've little confidence that it will be reliable. Time will tell I suppose, if I last that long. The sleep disruption is leaving me tired and irritable, and I've come close to quitting a few times.

Andrew,

[Kelly @ Intus]

Good Morning,

Thank you for your reply.

In their experience, the mandibular advancement device should be used alone rather than with a mask.

Over 7 hours of CPAP therapy is amazing. Leakage of 6 litres/min is great. Anything under 24 /min is the target for a good seal. An AHI score of 2.9 is awesome. The target AHI with a CPAP machine is 5 or under and you are achieving this.

See how you get on with your combination, and if that does not help, then consider the CPAP pillow 2.0 or a total face mask.

Please do let me know how you get on.

Kelly

[fixit9660]

Good morning Kelly.

Thanks for the response.

Last night of 20/05 – 21/05 2025, Stats say almost 6 hours, with leakage 1 l/min!!!! but 6.7 Events/hour? Better leakage but worse Events???
I woke at 0330hrs, I don’t know why but I felt it wasn’t CPAP-related, and couldn’t get back to sleep so I got up. I'll report back in a week to say if it's reliable or not.

Andrew.

[Kelly @ Intus]

Good Afternoon,

Thanks for the update.

An AHI of 6.7 is still good. Please do let me know how you get on over the next week or so.

Kelly

[fixit9660]

Hi Kelly.

Well the last 10 days have been something of an odd ride; I've experienced the longest run of long nights treatment interspersed with some really bad ones:

Night of 21/05 – 22/05 2025. Stats say 6 hours 7 minutes with leakage 7 l/min!!!! 3.7 Events/hour. I woke at 0430hrs wilth a mask with saliva running out of it. Couldn’t get back to sleep so I got up.
Night of 22/05 – 23/05 2025. Stats say 7 hours 18 minutes with ZERO leakage!!!! 5.7 Events/hour. I woke at normally at 0610hrs.
Night of 23/05 – 24/05 2025. Stats say 4 hours 49 minutes with 20 l/min leakage!!!! 4.9 Events/hour. I woke early with mask leakage and saliva.
Night of 24/05 – 25/05 2025. Stats say 6 hours 22 minutes with 24 l/min leakage!!!! 4.7 Events/hour. I woke early again with mask leakage and saliva. I don’t feel rested.
Night of 25/05 – 26/05 2025. Stats say 2 hours 17 minutes with 2 l/min leakage!!!! 2.6 Events/hour. I woke at 0315hrs with mask leakage and saliva. Took mask off. Tried to restart but felt Smothered again, couldn’t breathe, so took it off. Wide awake then so I got up at 0330hrs!!!!!
Night of 26/05 – 27/05 2025. So tired as a result of last night. Long afternoon nap (hours). No CPAP, I needed a good nights sleep to catch up. Also suffering another snotty nose - query Hay Fever or Atorvaststin. Leaving off Statins until 6/6/2025 under suggestion from doctor.
Night of 27/05 – 28/05 2025. No CPAP tonight - still suffering another congested nose.
Night of 28/05 – 29/05 2025. Still slightly congested but tried anyway. Stats say 7 hours 15 minutes, 14 l/min leakage and 5.9 Events/hour.
Night of 29/05 – 30/05 2025. Still slightly congested but tried anyway. Stats say 4 hours 16 minutes, ZERO leakage and 4.2 Events/hour.
Night of 30/05 – 31/05 2025. Still slightly congested but tried anyway. Stats say 6 hours 3 minutes, 11 l/min leakage and 2.4 Events/hour. Feeling really tired this morning!!!

The deduction from this seems to be:
Leakage bears no relation to Events.
Long treatment doesn't mean long sleep / waking refreshed.
It's still not reliable depsite being exactly the same equipment and configuration every night.

I wish I could get more detailed stats info from ResMed to determine and understand when during the night each of the things occur.

Andrew.

[Kelly @ Intus]

Hi Andrew

How are you viewing you CPAP therapy data from your Airsense10 machine?

What stats are you looking for specifically?

Kelly

[fixit9660]

Hi Kelly

I'm viewing the Stats via the ResMed website myAir web.

I'd like to see the time that events occur, for instance Leakage; does it occur continuously throughout the night, in several isolated groups, or all at once at the end of the sleep period?

Thanks,

Andrew.

[Kelly @ Intus]

Hi Andrew,

Can you email me at [email protected] and mark the email FAO Kelly and ask for the airsense10 download instructions for SleepHQ.

I can't upload them here, but I can send them from our main email address. This allows you to create a free account on sleepyHQ.com and upload your data from the SD card. This may just give you abite more information.

Kelly

[fixit9660]

Hi Kelly,

Thank you for the SleepHQ info. That is EXACTLY what I was looking for!!! I can see detailed Leakage Times vs Amount. There's a lot of other Historical info to go through too but now I can at least do it.

I hope when the 13 day Pro Trial ends I will continue to see the same nightly data, that's all I'll really need.

Thanks again,

Andrew.

[Kelly @ Intus]

Hi Andrew,

Excellent news. I am glad it helped.

I use the free account version and can see customers data when they send us the link so this works for me. It might be worth seeing what you can view on the standard free account Vs the pro.

Kelly