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A mouthbreather's game changer enabling use of the P10
A crude prototype of my mouth breathing side sleeper's solution (as is used with nasal pillows now) is pictured. Leaks are mostly zero now and  I can now use the lighter and friendlier P10 pillows. I sleep in peace after struggling with my leaking, sleep-disturbing FFMs--though my 95 % leaks and AHIs were not that bad. The real breakthrough was finding (locally at an independent orthopedics store) the Gel-E Roll (GER) bandage Silipos makes ( https://silipos.com/collections/sheaths/...gel-e-roll ... if a link to a manufacturer is permitted here). I got burned with a high price for the 4 inch by 48 inch roll, excited and in a hurry as I was to try that mouth sealing element after trying others. It is effective and easy to use--maybe even as both a lip sealer and as a very light duty chin strap for some people (if it were to encircle: to cover the mouth, pass below the ears and go around the neck.

But aside from feeling as though I wore a WWII gas mask, all too often the Airfit FFM F10 Medium (Large was too large) rode up to the nose bridge while asleep, would leak and the bottom of the cushion sometimes--like the Amara View--crowded my lower lip unless the chin strap was fairly tight. The more pleasant Amara View was great half the time, but I could not get a seal at all sometimes and could never consistently seal the creases at the sides of the nose.  (I had read and did benefit from applying many of the excellent instructions on the Board as I progressed doing tongue training, strap adjustments, cushion inflating, floating of masks and trying two kinds of the recommended medical taping.) 

MOUTH SEALER AND RETAINER: The approx. 4 x 4 1/2 inch lip sealing element shown below is larger than necessary and was simply cut off the GER; it is applied to and clings gently to a clean and usually clean shaven face. It adheres easily and stays in place by itself until its pressure-applying retainer "apron" is affixed.  I place its top edge about 1/4 inch below the lowest point of the nostril opening (where I do use a thin film of Lansinoh, as is applied to the pillows, too). The GER is skin friendly, therapeutic, comfortable, easy to work with, and flexible, but elastic in only one direction--parallel to the 48 inch length. I pull the skin of my aging-creases to smooth and flatten the skin being covered once I have the GER element in the right spot. (Removing nightly taping I found necessary would really stretch and wrinkle skin.) 

Next that tan colored GER retainer: It is like grandma's old from-waist-down apron that tied behind her back. I put its top edge about 1/8 inch below the top edge of the GER, thinking it best to shingle the two overlapping layers to reduce  protrusions below the pillow mask frame, which would push it outward. The top edge of the "apron" just clears the bottom of the ear lobes for easy fastening of the Velcro just back of the ear (right side for me, a right hander) and on the neck. I happen to have some worn out compression stockings from which I used the top 3 or 4 inches to make the wider/deeper than necessary GER retainer. The upper end of the elastic socking (about 1 1/4 inch) is doubled as it came from the factory. So, when stretched, more pressure is applied to the upper lip, but enough is applied to the lower as well. One thing not clear in the photo: the loop Velcro strap is long, the hook Velcro anchor point is short; most of the top edge of the apron is free of Velcro and elastic (the Velcro is present and affixed only at each end of the apron).

CHIN STRAP--a must for me: The one shown below partly overlays and probably helps the elastic retainer apron and the skin-friendly tackiness of the GER seal and hold the 4 x 4 sealing square in place.
I wore out one chin strap, fashioned another fair one from a baseball cap, and tried a number of other vendors' different chin straps, for the FFM's. But I have found the one below, the AG Deluxe II, most comfortable and effective. When it came by mail I thought it waaay too wide, but it is soft,  it distributes strap pressure (not furrowing the scalp) and it is most comfortable (and it is easy to mount well, just before donning the P10). The chin strap is dismounted easily by pushing the main strap forward below and behind the chin. 

Just one Velcro hooks-end of the back strap needs to be detached for mounting. (It was touchy adjusting the wide D II strap as it just barely touched the F10, before getting the P10). This was because I always set the top of the main strap as far forward as possible to avoid rearward pressure on my jaw at the chin. I marked the center of the strap for viewing that in a mirror and accomplishing accurate mounting (that mark being kept centered on my chin which is, at first, partly and lightly cupped by the strap).  I then work the top part of the main strap over the top of my head to the place where the rear strap can be hooked (after forehead strap slack is taken up). That rear strap passes just below the bulge at the back of the skull. When all done for bed, the upper P10 strap rests on top of the chin strap and the lower P10 strap rides below the rear strap of the chin strap. The upper P10 strap has enough traction on chin strapping to retain any final fine adjustments to reduce upward pressure of the pillows on the nares.  

The soft fabric enclosing the elastic strands tends to fuzz up when Velcro hook material is pulled away from the strap, as you can see. Accordingly, I sewed some brown-colored Velcro loop material on, just above my ears for anchoring the hook ends of the forehead and back-of-head straps (having lengthened the latter for my large head as is marked by wild sewing). Once the main and forehead straps are adjusted, those three Velcro attachments need not be  separated except, probably, for laundering.

As you can see, I am not licensed to drive a sewing machine or to use imgur. But the three devices work well and are crude patterns for a vsn 2.0, to be sewn by someone competent. The sealing element is the key. A variety of chin straps will no doubt work fine, as will various alternative designs of retainers. A lot depends on individual differences and needs. After the fact I found online suppliers of GER with much better prices than I paid in my hurry.

Meanwhile, I'm sleepn betta with nasal pillows, looking to learn more and still experimenting . Many thanks to all for great questions and advice on the Board.

[Image: 7JBzyWsh.jpg]
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Hi 2SleepBetta,
It’s great to hear that you found a solution for your mask.
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Can you post a picture of you wearing this? I really want to write that I can't wrap my head around what you are writing - but you might think I was poking fun at your rap. Seriously though. I like nasal pillows and I think I might have started mouth breathing after almost 3 years of CPAP usage. So I an very interested in what you are doing. But I can't figure it out from your post. I read it several times too.

Thanks 2SleepBetta
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(03-27-2017, 08:19 PM)aconcepts Wrote: Can you post a picture of you wearing this? I really want to write that I can't wrap my head around what you are writing - but you might think I was poking fun at your rap. Seriously though. I like nasal pillows and I think I might have started mouth breathing after almost 3 years of CPAP usage. So I an very interested in what you are doing. But I can't figure it out from your post. I read it several times too.

Thanks 2SleepBetta

Thanks aconcepts. Remember this is a first cut at a long term solution to my need for both a chin strap and a lip sealer if I'm to use the P10 as I wished--and am happy now that I have been using it for some time. My motivating experiences are summarized above.

Many will say there is excessive skin and scalp coverage. There's a lot, but pressure (per square inch of strap) is reduced and that fact and good sealing,  the P10 headstrap help and comfort features, er, tapelessly seal the deal for me for now. As is evident, I need to learn better Imgur practices and I hope never to fool with a sewing machine again after making this crude retainer and chin strap modifications.


[url=http://i.imgur.com/mc5niYNt.jpg][Image: mc5niYNt.jpg]
[url=http://i.imgur.com/j0l8nL5t.jpg][Image: j0l8nL5t.jpg]
[url=http://i.imgur.com/K6uszjFt.jpg][Image: K6uszjFt.jpg]
[url=http://i.imgur.com/zAewGQTt.jpg][Image: zAewGQTt.jpg]

[url=http://i.imgur.com/1X3pSaXt.jpg][Image: 1X3pSaXt.jpg]
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Thanks for the reply 2SB - what is the orange piece for?
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(03-29-2017, 07:52 AM)aconcepts Wrote: Thanks for the reply 2SB - what is the orange piece for?

To protect his identity. Secret agents have to remain incognito, you know. Too-funny

Great job, 2SB!
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Congrats on finding a solution that works for you. But personally, I would have concerns about sealing off the mouth completely like that when using the Airfit P10. After all, it doesn't have an anti asphyxiation valve built in. If you had a power outage and were sleeping very deeply, very likely you would wake up before suffocating and take the gear off, but I'm not sure if personally I would want to take that chance. That looks like much more than a light taping to keep the lips closed.
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Paranoia? Didn't want my pic online.
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Thanks for the red flag. Isn't there such a valve that could be coupled into the air hose? If not, then its a challenge to see what can be done to create one.
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Maybe a different fabric would work. I use a wide lady's stretchy head band over my lips in the same manner you are using the mouth portion of your device. I also use a Ruby chin strap which, as you said, does leave a mark on my scalp. Since I have started using the chinstrap/ head band combination my leak rate has consistently been below 24cm. I'll have to try your chin strap mod.

Have you seen the Ultimate Chin Strap? If not it may be worth looking at. A simple web search will find it. It looks interesting, although it is a little pricey.
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