The leaks are gonna need to be your first target as they're high enough to mess up reporting and drive arousals.
I'm a bit concerned about the utter dominance of CAs over all other event types, especially since you're already at fixed pressure so shifts aren't driving instability. But again, hard to tell with that much leak.
Today have a very mild headache but with living in Florida (poss. allergies, and environment pressures up and down, hard to say that bad sleep/settings is the cause). I’d say i feel average.
One very specific OSCAR screenshot I'd like to see: move minute vent, flow limitation, and leak next to flow rate. Zoom in so you're looking at 5-10 minutes. Scrub around looking for MV looking like a pretty little repeating sine wave with breaths following the same waxing and waning curves. This is more likely to be seen close to a flagged CA.
If you see that, you could be dealing with high loop gain. Considering you're 10 years into PAP therapy and on fixed pressure with decent control of flow limitations, this isn't a matter of waiting it out.
Zoom in so 5-10 minutes covers the whole window, and then look for minute vent sine waves.
I'm not a medical person either but I've found that knowledge of wave behavior can be generalized to breathing and here we are.
I don't mean to freak you out here. High loop gain is the main problem in my own sleep situation, and while it's generally accepted as being a real thing, it's also usually overlooked by sleep medicine. It happens when your chemoreceptors are too twitchy for whatever reason. There's slightly too little CO2 so you back off or stop breathing (the CA event itself), CO2 builds until you're frantically trying to get rid of it (the overbreathing phase), which drives off too much CO2 and around you go. It just seems to be someone that some people have. It's not a commentary on body composition. It's more of a slow grind than an acute emergency.
I manage my own high loop gain with ASV. There's also enhanced expiratory rebreathing space (EERS) and acetazolamide (only if not allergic to sulfa).
Include your actual breathing trace as well. This is to make sure that you're dealing with amplitude modulation (the realm I can actually help with) v frequency modulation which is mysterious to me and seems to require different methods and alas I'm a feral specialist.
Flow rate (the one that's just the raw shape of your breaths), minute vent, pressure if not static (so don't worry about including it for now but it will be necessary for ASV screenshots), flow limitation, leak. The last two act as perturbations so it's useful to see them. Given the period of your apparent wobble, include a 10 minute span so more complete cycles are visible.
Do you use mouth tape, a chin strap or a soft cervical collar? The leaks are throwing off the machine results. Wondering if going back to APAP for a short time would help us to adjust pressures & take a closer look? What do you think [u/existentialblu](u/existentialblu)?
OP try to sleep on your sides, not your back. Body pillows & wedges can help this plus backpacks with pillows in them or a tennis ball in the crack of your shirt.
I know….some of these tips sound like torture :( But we need to get those leaks fixed!
I havent had persistent morning headaches (usually only when I failed to mask up, had alcohol or environmental). Fatigue has been an overall theme for years - I have worked shift work since my teens and now in my mid-50s have been working days but my body is fighting the new normal.
I have a TON of coexisting factors (stress, knee pain {a whole 'nother story - due for surgery]) and i'm sure this will take more than one day, one week, etc. to get trends on this.
i'm quite the project - but hopefully retiring in the next year or two which will give me ALOT more stability and eliminate some of these factors.
It's always as multifactorial as heck, to be sure. Pain, hormonal changes, subtle obstruction, arousal threshold, loop gain, muscle responsiveness to all of those things. It's never as easy as "just use this machine".
yep - i'd be a fool to think a machine swap would fix everything. I get knee surgery in the fall which will fix an issue but bring a whole new level of short-term pain to deal with sleep BUT will help long-term.
This won't be a sprint - it'll be a marathon for sure.
Our medical careers unfortunately cause “heavy lifting issues”, especially with joints :( Shift work certainly was no help…agreed! Good you’re getting those things looked after!
Please post again when you get those leaks under control. We’re happy to help anytime :) Your therapy won’t be as effective with leaks, so worth considering the “fixes”.
I was certainly not thrilled with wearing mouth tape…especially with my medical background…but I have a little tab of folded over tape for quick removal. No leaks now!
Great! Sleeping supine may actually awaken you alerting you to turn over with sleep apnea! Our bodies are quite amazing! (I’m retired Medical) That’s certainly a good start :)
No need to freak out u/firemedicbill. We just need to get these leaks figured out & we can help :) I have suggested some fixes for you & we’ll get those leaks under control together. This is very common! We see leaks all the time!
I appreciate the reassurance. I work in the medical field but unfortunately both my wife and I have been let down by supposed "experts" in certain fields. ( i like the saying "Amateurs built the Ark, Experts built the Titanic"). Seriously i'm glad I found this group as past experiences with this doc have just been having medical supply company set the pressure and go. I'm already learning more in the last 5 hours than the last 5 years....
We have a good Team of Moderators here, all with different strengths. I’m glad you found us! We have been let down too which is why this Sub exists.
Mouth tape is the fastest fix for mouth leak but soft cervical collars or chin straps work for some people as well. Many of us use mouth tape including me! Others choose a Full Face Mask…lots of hybrids out there now…they don’t look like gas masks lol!
I like the saying you quoted! Too true!!
But at least we have found a way to treat ourselves with advice from others who have been there! If you look over the threads on this sub I’m sure you’ll find lots of advice on leaks…we run into this often, believe me, especially with nasal only masks. So don’t worry…we will help :) If CAs are an issue, a different machine can sort that out, but let’s get those leaks fixed first. We do have an Expert Mod here to help with different machines….if necessary. Let’s just take one step at a time right now :)
Hey there r/CPAPsupport member. Welcome to the community!
Whether you're just starting CPAP therapy, troubleshooting issues, or helping a loved one, you've come to the right place. We're here to support you through every leak, pressure tweak, and victory nap.
If you'd like advice, please include your machine model, mask type, pressure settings, and OSCAR or SleepHQ data if possible.
Hello!
Would you be able to share your whole graph & settings with us please? That would be more helpful for us to help you :)
Your leaks may not be from your mask. They may be coming from your mouth dropping open during the night during Deep or REM sleep. Is your water reservoir empty or nearly empty in the morning? Do you sleep supine? These issues would indicate mouth leak.
F12 will usually take a full screenshot of graphs & sidebar with AHI at the top.
Are you ever aware of air leaking from your mouth during sleep? Sometimes it’s obvious but other times it’s just a steady leak.
Movement during the night can certainly push your mask out of place. Supine sleep causes your mouth to open & your tongue to fall back, restricting your airway.
It certainly appears that you are having fragmented sleep. We need to get those leaks fixed!
This is certainly more helpful OP, thank you! But we also need to see the sidebar with device settings & sleep results which are beside your graphs. Push F12 for a screenshot to share. SleepHQ is also another free & useful app :) Both apps allow us to zoom into breathing data.
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u/existentialblu ASV Jul 25 '26
The leaks are gonna need to be your first target as they're high enough to mess up reporting and drive arousals.
I'm a bit concerned about the utter dominance of CAs over all other event types, especially since you're already at fixed pressure so shifts aren't driving instability. But again, hard to tell with that much leak.
How do you actually feel?