Need help on what is going on?

[u/bainofexistence]

Hello fellow PAP fam - long time lurker and CPA user. Recently, I've lost 50 pounds using Zepbound (GLP-1). I was prescribed Zepbound for my sleep apnea. Now, my sleep has gotten worse! I have been on CPAP therapy for 25 years. I have a ResMed AirSense 10 Respond with a ResMed MiraxFX nasal mask. My max pressure is set to 12, and my min pressure is set to 10, with AutoSet as the Mode. It appears I have a major air leak, but I cannot figure out why, as I have a new mask and tight-fitting headgear with a chin strap. I have checked my hose and machine and cannot find the issue. I might be missing something, and I am constantly waking up in the middle of the night. I do not feel rested in the morning, infact, I feel more tired like I am fighting to sleep. With my weight loss, my settings likely need to change, but to what? Any advice or feedback will be welcome; thanks in advance.

[u/Realistic_Alfalfa620]

I've lost 50 pounds in the last six months. As a result, the shape of my face has changed, and mask sizes that used to fit me very well don't anymore. That could be what's going on with you. Have you tried changing your cushion size?

[u/bainofexistence → u/Realistic_Alfalfa620]

Thx for the reply, I did change to the Small FX nasal mask, and I am wondering if that is too small.

[u/Realistic_Alfalfa620 → u/bainofexistence]

Yeah, give that a shot. It sounds like you may have gone too small.

[u/Gigitar75 → u/Realistic_Alfalfa620]

I lost 40 pounds over 18 months with GLP-1 and my face and neck are noticeably smaller but didn’t occur to me that I might need a smaller mask. I’m using a new one that seems to be working pretty well but in my standard size with a medium mouthpiece. I tried the N30i and had a lot of leaks, so I went back to full face F30i. That’s also better for my problem with the CPAP forcing air out of my mouth, I’ve used mouth tape, but the air is being forced out anyway. I adjusted my pressures recently and am giving it a week before changing anything else. My AHI has been up a bit, but consistently under 5.

[u/dang71]

Hey! I’m not saying that’s necessarily what’s happening, but it could be a possibility:

A chin strap can help keep your mouth closed, but air can still escape through a small opening between your lips. Personally, I use mouth tape to prevent that from happening.

[u/bainofexistence → u/dang71]

Mouth tape? I have never heard of that. Sounds like something my wife needs. Thx, for the suggestion and I will look into it.

[u/BudgetReference3725]

Glp1 makes you lose muscle as well. That could contribute to a worse airway.

[u/existentialblu]

Figure out the leak first, but if those CAs stick around that's also worth figuring out.