APAP or CPAP?

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Permalink Reply by Marion@As I Live and Breathe on September 18, 2011 at 18:33

There are many reasons for leaks, so it's difficult to know where to start. Certainly your pressures could be rather high.

I personally would be inclined to question this with the consultant, and ask the reason for the high settings.

After all, if you are getting frequent leaks then your pressures will be affected, and you won't be getting what you need anyway. Just continually 'cranking up the volume' could defeat the object of the exercise.

This loss of pressure can be a problem for people who lie on their side in bed - the pillow can push the mask out of position and the ensuing leaks mean that the air pressure is not maintained.

Basic stuff is important, like checking your mask's straps and connections for wear - they do get loose, or perish, over time, and velcro fastenings won't hold securely anymore.

Getting a good seal of mask against skin is important - men can have problems with facial hair/beard growth which can prevent a good seal.

Type and shape of mask - especially if you don't have symetrical features (that's most of us!).

I have a blue gel mask that can be moulded gently by squeezing, to get a comfortable fit.

It's important to me as I have a very small head and face - I have a special little cap made to hold the mask in position as the usual straps are way too large and would never allow an air-tight seal. 

Chaps with beards sometimes go for the little nasal pillow things instead of a mask, but I don't know if they're suitable for all, and I believe someone here (Kath?) said she found them uncomfortable.

One cause of leaks, which sounds contrary to common sense, is tightening the straps too much.

Doctors (who don't have to live with these gadgets themselves) might advise you to tighten the straps if you get a leak. Sounds logical. But it can actually make things worse.

If you tighten one side of the mask it can make the other side lift off the skin, causing yet another leak.
And of course, tight straps will wear out quicker, therefore becoming looser sooner.

They will cause wear & tear to the mask so that it gets floppy or damaged, and thus cause more leaks,

In addition, tightly-fitting straps and mask can cause skin soreness, damage and even ulceration.

I had many years trying to cope with noisy leaks, painful, broken skin, and sleepless nights.

But the solution was simple and instant - I started using a Hose Lift gadget and I no longer have those problems.

The Hose Lift holds the weight of the hose so there is no drag on the mask or the tubing, and for me it has been a 'godsend'. I wouldn't try to sleep without it, and take it with me into hospital for my overnight sleep studies.

 Here are the Nippy3 readings for me and 3 other patients - Please bear in mind we are all small people.

Inspiration/Expiration

29/7  18/5   25/7   22/3

As you see they vary considerably, and depend, I assume, on each individual's personal medical condition.

(Includes scoliosis, asthma, Ehlers-Danlos Syndrome, Klipper-Feil Syndrome.)

Richard Mundy said:

I am an NIV patient and have used a ventilator every night for the last 6 years; the problem I have is that every year I go to the respiratory department and the consultant very kindly cranks up the pressure a little.  What started off at 28cms.H2O, high enough, you might think, has now reached 37cms.  This is ventilated, not CPAP, so the BREAS machine breathes for me, in effect.  Six years ago it was a NIPPY3 with a setting of 14 & 4 that really saved my life.

The problem I have is the leaks around the mask: the whistles, squeals and farts increase as the pressure is raised.  To combat this I have made my own remedy (of sorts) from surgical dressing, but these are a pain to make as each one only lasts for 3 or 4 nights.

If Marion or any other NIV patients are living with similar pressures, I would very much appreciate hearing their experiences of coping with leaks. The Remzzs face-mask liners are not up to the job, though I have emailed the makers to find out if they have a solution, but no reply.  Maybe Kath has more influence than me?

Please let me know.

 

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