- For many of you,
CPAP mask leaks are really, really annoying.
Not only do they reduce the effectiveness of CPAP therapy
but they can really disturb our sleep
and that of our partner's.
So what are some things we can do
to really improve the quality of our CPAP mask seal?
Well, stick around and I'll give you my top tips and advice.
(upbeat contemporary music)
Hey guys,
my name's Nick and welcome to my channel CPAP Reviews.
For those of you already subscribed,
thanks for your support, I really appreciate it,
and for those of you tuning in for the first time
this is my education channel on snoring and sleep apnea
and the products we use to treat the condition.
So, if you'd like to learn a little bit more,
please consider subscribing to the channel
and joining our growing community.
CPAP therapy to me
is all about balance.
It's about balancing the therapy, those pressure levels,
with comfort, how you sleep with the therapy
and it's about finding that happy medium
where your apnea is really well managed
but at the same time you can sleep comfortably
with the therapy.
There's absolutely no point, in my eyes,
having all the apnea really well controlled
yet at the same time that very therapy
is disturbing your sleep, waking you up out of sleep,
and you're just not enjoying going to sleep
with the therapy, all right?
It just doesn't make sense.
Having a really good mask seal
is a very integral part of finding that balance,
that happy medium and today
I'm gonna be discussing with you some great ways
in which you can really improve your mask seal
and your therapy.
So, firstly I think it's really important
that you understand how CPAP actually works
and why the mask seal is so important.
So, positive airway pressure works
when the pressure on the outside of our body
is higher than the pressure in our lungs
and it's this pressure differential
that actually forces air down into our lungs
and keeps are breathing nice and stable during the night
giving us a great sleep.
So the mask seal itself is really important
because without the mask sealing well
it's very difficult to create the pressure
required for this to happen, required for the therapy.
So if we have a mask that's sealing really well,
we're getting optimal pressure
and we're getting optimal therapy
whereas if we've got a leaky mask,
a lot of that pressure is escaping
and so there's gonna be less pressure where we need it
and this is gonna cause the therapy
to be less effective okay?
But it's also gonna cause a lot of other things
as I'm sure many of you are aware of.
It's gonna cause a lot more noise,
it's gonna cause a lot more discomfort
and disturbance during the night
with air leaks into your eyes and things and so forth.
So, it is really important that we get that mask seal
as good as it can possibly be.
So, what are some ways
in which we can improve our CPAP mask seal?
Well, the number one enemy of a good mask seal
is actually the pressure itself
and the higher the pressure goes
the harder it is for that mask to seal onto your face.
The pressure just wants to push that mask off the face,
it wants to escape through the seal.
So it's really important
that we get our pressure levels right
and get our pressure levels as low as possible
while still managing our sleep apnea,
and I say managing because that's what it really is.
It's about managing the therapy
with the comfort side of things.
So, how do we do this?
Well, you're gonna need to know two things
to be able to do this.
One is ya have to have access
to your pressure level settings.
We call them the clinical settings.
It's a bit of a hidden menu but I want you to go
and learn how to change the pressure settings
on your machine.
Google it, look at some of my videos,
but learn how to do it yourself 'cause it's really important
and it really will give you greater control
over your therapy and you'll thank me later.
Secondly, you need to have access to your data
on your machine and actually kinda know
a little bit about what you're looking for in your data,
sort of understand the data a little bit,
and I'm gonna teach you a little bit here.
I'm gonna break this up a little bit because I know
some of you are on fixed pressure CPAP machines
and some of you are on auto CPAP machines, APAP machines,
and it's a little bit different about how we do it.
So I'm gonna start with CPAP.
So, if you're on a CPAP machine,
what I want you to do tonight is just drop your pressure
by one level.
If you're on 10, bring it down to nine
and then over the next couple of days
I want you to monitor your sleep data
and you're gonna be looking at your apnea hypopnea index.
It'll probably say AHI in your data settings
and we wanna see that number ideally under five,
which means that your apnea is well managed
or around five is fine.
Like if it's 5.5, six, it's not a big deal, okay?
If it's going up eight, nine, 10, your pressure's too low,
you need to go up a little bit, all right?
But we're gonna be looking at the apnea hypopnea index
and if it's below five, in a couple of night's time
you're gonna drop it again to eight
and you can keep dropping that number down
as long as your apnea hypopnea index is below five.
Really simple, huh?
Now, if you're on an auto machine
it's a little bit different but it's quite similar.
We first wanna look at our data
and in particular we wanna look at three things.
The first one is going to be
our 90th or 95th percentile pressure level
and it'll be different
depending on what device you've got.
It'll either be 90 or 95.
The second is your average pressure
and then your third your apnea hypopnea index again.
And we're gonna use these values to guide us
where to set our pressure limits; our auto max,
which is our upper pressure limit, and our auto min,
which is our lower pressure limit
and then the machine will obviously use its algorithm
to determine where the pressure needs to be
within those limits
but the goal here is to reduce machine's ability
to really shoot up past that max limit
and cause those mask leaks.
So for that 10% of the night
when it is above the 90th percentile pressure
and causing those mask leaks,
we're gonna sacrifice that control,
that ultimate control for the comfort
and that's the balancing act there.
All right, so I'm gonna give you an example here
'cause I find examples work quite well with you guys
and I've looked at my data
and I've seen the 90th percentile is 10
and the average pressure is coming in at seven
and my apnea hypopnea index is four.
What I'm gonna do is straight away
I'm gonna go into my clinical settings
and I'm gonna set my auto max
at the 90th percentile at 10, okay?
I've capped it at 10, the machine can't go higher than 10.
I'm gonna use my average pressure, which came in at seven,
as just a guide where to put my lower limit.
You can just leave your lower limit at the base at four
but I find that you're gonna get better results
with your apnea hypopnea index if the lower limit
is a little bit closer to your average.
Just for fun, I'm gonna have a little ramp period
just while I'm getting off to sleep,
while I'm gettin' comfortable in my bed,
watching a bit of YouTube I'm gonna get comfortable
and have the starting pressure at four
with a little ramp period going up to six for 30 minutes
just while I get off to sleep.
So those settings explained, machine starts at four,
gradually it builds up to six
while I'm getting off to sleep.
Once it hits six and that 30 minutes is finished,
it's gonna go between six and 10, which is my cap,
depending on what's required,
depending on whether or not I'm snoring,
depending on whether I'm having a sleep apnea
and so forth, okay?
So that's sort of how it works,
but that's a great little example there
of how you can set your machine up correctly
so that it's working at its lowest level
while still controlling your sleep apnea.
And then what I'm gonna do is
I'm gonna monitor my therapy over the next few days,
check out my apnea hypopnea index,
and if it's still below five you know what I'm gonna do?
I'm gonna bring that cap from 10 down to 9.5 or nine
and I'm gonna keep monitoring my apnea hypopnea index
and I can keep bringing that level down
as long as my apnea hypopnea index is well managed, okay?
And that's sort of how you do it.
But if you can do this,
if you can really sort of fine tune your therapy levels
it's gonna go a long way to improving your mask seal
and ultimately the comfort of your therapy
and how well you sleep with your therapy
and how quiet your machine is.
It's not gonna disturb your partner,
it's not gonna wake you up with dry eyes,
all this sort of stuff, okay?
So get it right.
Number two cleaning and replacing your equipment, all right?
So all the oils and sweat that are gonna build up
in your silicon cushion and so forth,
they reduce the mask's ability to seal, okay?
It's much easier for the air to escape
if your mask isn't clean
and obviously it's not gonna smell as good and so forth okay
and be as hygienic for you.
So just get into a habit.
Get yourself a pack of mask wipes
and just wipe down the mask in the morning,
it'll take you three seconds.
Or, if you don't have mask wipes just warm soapy water,
just get the oil and the sweat off the cushion.
Your gear will last longer, it'll smell better,
it'll be much better for you,
but you'll get a much better seal as well.
And then obviously you need to replace your gear
from time to time.
I know it's expensive.
Ultimately, you're gonna be much better off for it.
Your mask is gonna seal a whole lot better, okay?
So just don't have your mask cushion for two years
and just expect it to seal well.
You need to put a bit of money in fitting it correctly
and running a mask seal test.
Just spend a bit of time making sure
that your mask straps are nice and even,
that they have the right amount of tension on them
to hold that mask in place.
Many of you will go to bed and fit your mask
at the lowest pressure level
and then obviously when you fall asleep
and that pressure level increases, yeah sure
it was sealing well in the beginning
but as the pressure goes up it might not seal as well.
So most machines these days can run a mask seal test
and the machine will run through a variety of pressures
to make sure the mask is sealing well.
So if you can run through that in the beginning
you know that when you fall asleep
and the pressure gets a little bit higher
the mask is still gonna seal really well.
And lastly obviously you might have to change up the mask.
Different masks are gonna suit different faces and so forth
and I've got a little list here
of just sort of my mask from experience
that I've found do seal really well.
They might not have all the features of different masks
and things like that,
but when it comes to the actual seal of the mask
these are some top ones to have a look at
if you are struggling.
So I did a video.
This is a full face mask to start with.
I did a video not long ago on one of my favorites,
the ResMed Mirage Quattro.
Very old school now but (clicks tongue)
spot-on seal.
ResMed Quattro Air and the ResMed F10.
The F20 is still good
but I don't find it seals quite as well as the older ones,
the Quattro Air, the F10, and the Mirage Quattro.
And from Fisher and Paykel the Simplus and Vitera
is also a fantastic mask.
Very similar seal, that RollFit
and the RollFit XT seal on the Vitera and the Simplus,
excellent seals.
Standard nasal, you're going to be wanting to go
Fisher and Paykel Eson or an Eson two
or a ResMed N20 or AirTouch N20,
both excellent sealing nasal masks, standard nasal masks.
And then for the pillow mask
you can't go past one of my all-time favorites
which is the P10 mask.
But what you might wanna do if you do have a P10
or you're looking at getting a P10
is getting a strap from the N30.
You can buy the strap by itself and replace it
'cause the P10 doesn't have any adjustments
but the N30 strap, you can get that strap,
it's got an adjustment on it,
you can make it tighter and looser,
which works an absolute treat.
And then you've got the DreamWear gel or the P30I
which are those top-of-the-head, hollowed tube masks
that have the pillow sections.
If you're gonna use the top-of-the-head
that have sort of the nasal cushion parts,
they're probably not gonna be quite as good
in the sealing aspect.
Alrighty guys, I'll leave it at that.
Thanks for watching, I really appreciate it,
and if you found it somewhat useful
I'd really love the thumbs up.
And if you've got some tips or advice
make sure you put 'em in the comments section
so that others can learn from your experiences.
I hope you're all well.
Take care and I'll see you again next time, cheers.