How much mask leakage is ok?

I think if your ahi number remains low then the leak is acceptable. If not then contact your Dr.

Everyone is a little different. If you want a definitive answer ask your sleep specialist.

AuntThoo, I’m 10 months down the road with my bipap machine. I’ve had 4 masks, three unique, and one in two sizes, and I’ve yet to find a mask that doesn’t leak, but some are better than others. It helps to pull them tight to the face, but while effective, this is not that comfortable. As for leakage, I’m sure it has some relationship to AHI, but I can still see my AHI spike at times even when my mask fit is 100%. I also see AHIs of 1 to 3 when my mask fit is low, like 38%. Guess what i’m trying to say is I can’t see a discernable pattern between leakage and AHI but there must be a correlation.


@shuggeman - what are your pressure settings?

I’m on a bipap, machine, so it blows at a 12 for inhale, and an 8 for exhale.

@shuggeman - What types of masks have you used? Not brands, but types. (Nasal (nasal only); Nasal Pillows (nasal only); or Full Face (oro/nasal).

Nasal pillow (for a short time), and full face.

Welcome to the forum Aunt Thoo. As the others have said, everyone is different. I can be excellent on leakage and out of the park on events, then turn around and they will flip. If you are concerned I would recommend that you talk to your sleep folks. I was concerned about my events and my doc told me not to be, even though I seem to average in the 13 range or so. Here’s hoping you get the sleep you need!


Look into getting a chin strap. After being all over the lot with many kinds of masks, etc. finally had a tech suggest using a chin strap. 9 out of 10 days my leaks are now ZERO! AHI is much, much better - used to be between 15 and 35 or 40. Now almost always under 5 or 6. Sometimes even 1 or 2. Can’t believe that I went for over a year and a half before this was suggested. PS I use max pressure - 20. Good luck!


Welcome to our community @dtmaguire ! And thanks for sharing!!


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Ideally the lowest possible of course but the rule of thumb is a max leak of less than 3 times the pressure setting. For example, a cpap pressure of 12 on would not want the leak higher than 36. Now this is speaking to a total leak not the unintentional leak. Of course any leak could potentially cause adverse events and every one is different. I have seen people with large leaks that didn’t seem to cause a large number of events or a higher AHI and I have seen some with event a small leak lead to a great increase in their AHI. I would keep a diary about how you felt each morning and then when the CME company downloads you data for the next doc appointment. Depending on the company and/or model of cpap one could try to correlate ones sleep to the data received from ones machine. Just ideas anyway

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Good suggestion, @Tom11980

Thank you for sharing!!

Just my personal perspective, but leakage to me, causes a constant breeze by my face and the more breeze, the more likely it is to disturb my sleep. So no, leakeage is not okay…

How bad the leaks are depends on if it’s preventing proper therapy and your CPAP machine. Current ResMed 10 Series machines call large leaks over 24 L/min as an example. If I look on my reporting tool (I use OSCAR data from the Apnea Board) for leaks over 5% of the sleep session, I’m making mask adjustments. I have to control leaks under a low tolerance because I’m on an ASV BTW.

If the leak gets out of control, your machine can’t keep up and provide proper apnea event control. If myself, I’d be working to control leaks by changing cushion size or adjusting. Don’t clamp down the mask too tight or leaks can actually be worse. Try looser rather than tight. If it’s tight enough to hurt it’s wrong, then you’ll need to try to change masks, swap in a new cushion, or size.

Have you tried resmed airfit F20. Mine never leaks

If the leakages cause apneas, then it’s a problem. If the leakages wake you up, then it’s a problem. If not, then I don’t think you have to worry about it. I use a chin strap to reducing my leakages. It doesn’t work perfectly, but without it I have a terrible problem with leakages and now I don’t. (I recommend the Knightsbridge Dual Band chin strap. Don’t bother with the cheap neoprene ones. The Dual Band lifts your jaw vertically. The neoprene ones push your jaw into your jaw joint. Very different designs.) I tried cervical collar to help keep my mouth closed, but the ones that worked to keep my mouth closed gave me a neck ache. Another thing you could try is a mouth tape …

Good luck!

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I’ve heard that Knightsbridge cap is a good product and it’s on my wishlist.

Do you mean the one popular for horse riding? Not being sarcastic, just would like to see a Knightsbridge you speak of, @SarcasticDave94

Sorry about that, I must have been a bit distracted to reply with that half thought of a post.

Knightsbridge has a product called dual band chin strap. Here’s the website: Knightsbridge.

The product is a cloth cap you put on before the mask. This cap has 2 Velcro straps that goes under your chin to gently pull up without making the jaw move in or out.

FWIW on Apnea Board we have a few that’s tried the Knightsbridge strap cap and have some successes with lowering mouth leaks. I myself have it on the wish list for the near future.

I have been going through a lot of this. I’ve been on CPAP since May 2019. At first I had a few rough nights getting used to the CPAP and air leaks but then all was well and I was sleeping through the night and felt great.

Over the last two months or so I’ve been seeing more air leaks and I have to make the mask so tight that it hurts and then I walk around with the red mask lines all over my face all day - to the point people have asked if I’m okay. I’m also waking up with extreme dry mouth that some days my teeth hurt - I’m a horrible mouth breather! I use the full face mask.

I’ve tried to work with my doctors office and the company providing my equipment to no avail - I can’t afford to keep taking time off work to go back to “trying something else.” And of course when I’m in the office everything is completely fine.

I’ve replaced my mask with several different options and sizes to no avail - including different head straps.

I’ve tried 3 different chin straps and none hold my mouth closed - I guess I have a strong jaw. I’ve seen the mouth tape but because sometimes I can’t breathe through my nose the thought of those freak me out. Plus the straps all seemed to interfere with my mask.

I’ve looked into mask pads but from what I’m reading they seem to just quiet the air leak noise, not actually stopping the air leaks.

I am completely at my wits end!

If anyone has suggestions for things that worked for air leaks and for morning dry mouth I’m all ears!!

Thanks in advance :frowning: