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Cautionary tale- improper mask fit, long
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zimlich Offline

Preferred Members-2

Posts: 392
Joined: Feb 2012

Machine: Respironics PR System One BiPap Auto SV Advanced
Mask Type: Nasal mask
Mask Make & Model: ResMed gel Nasal Mask
Humidifier: System One
CPAP Pressure: 8-20 ASV, 8 EPAP,PS 12
CPAP Software: Not using software

Other Comments: I use the Quattro FFM when necessary

Sex: Female
Location: Norfolk, VA

Post: #1
Cautionary tale- improper mask fit, long
This won't apply to everybody, may not apply to anybody and is a generalization. It's my experience.

I was told I'm a mouth breather in my first sleep study in 2008. My experience bears this out. Frequently I go to bed with a stuffed up nose. I can't even move enough air to trigger my auto on. When first diagnosed I used the Quattro FFM mask, but the hard plastic in the frame caused the skin on the bridge of my nose to break down badly. Nothing helped; the comfort pads only caused leaks. I was still putting pressure on the sore and it got so bad I reluctantly took three weeks off to let it heal. In one night with the Quattro it started to break down again. I tried many different masks and was unsuccessful with all of them, perhaps with what I know now about mask fitting some would have been satisfactory. I finally settled on the Respironics FitLife Total Face Mask. It took some work and the use of silicone sealant (Macks ear plugs) at times to make it work, but I really liked the mask. The past eight months I began to have problems with the mask- it would ride up to my mouth during the night. At my dental appointment six months ago I did not notice any dental changes. During the past month I became aware that my bottom teeth had been pushed back and the front teeth seriously crowded. My profile had changed, I now have a slightly recessed chin. At my dental check up this week I talked to the dentist and he referred me to an orthodontist. My appointment is next week. A month ago I changed to a nasal mask when my nose is clear and the Quattro FX when it is blocked and I can't trigger the auto on. I have no trouble with leaks and fit with either mask. The gel on the nasal mask does not bother the bridge of my nose. The FX is a dream mask!
I have advocated the use of silicone sealant to improve the fit and stop leaks from a mask- in the past Macks (silcone earplugs you roll into a string and place around the mask where it fits the face), more recently the sealant scuba divers use. Now with my experience with "smashed face syndrome" I've reconsidered. I believe (generally) there is no substitute for a proper fitting mask ( Pad-a-Cheek and Quietus lines are fine). When I got the FX a month ago the tech at the DME helped me with fit. I finally learned how to fit the mask comfortably and allow the cushion to fill with air to form a seal. YouTube videos helped. I was then able to properly adjust the nasal mask. I have very little problem with leaks. Since I am prone to tooth movement I will take both masks to the orthodontist for evaluation- I do not want to worsen the problem. My teeth and mandible have shifted back 1/4 inch mainly (I figure) in the past eight months when I began to have trouble with mask fit. I know many people are successful with nasal pillows; I don't like them. When I use the nasal mask I use a chin strap. My leakage is minimal. I have called the interface the achillies heel of CPAP treatment. I know successsful fit can be difficult. I was in the dark for five years, my own fault. One of the big mistakes I made, in spite of knowing better, with leaks I would tighten the mask down instead of reseating. It took me several nights to get the fit right on the two masks I am now wearing. This is going to be an expensive mistake. I relate this experience for the few people who it may affect. I'm sure some people can use a sealant and not encounter problems.
Mary
(This post was last modified: 02-22-2013 10:50 AM by zimlich.)
02-22-2013 10:43 AM
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SuperSleeper Offline

Administrators

Posts: 9,973
Joined: Feb 2012

Machine: PR System One REMstar Auto (DS560)
Mask Type: Nasal pillows
Mask Make & Model: ResMed Mirage Swift II
Humidifier: none
CPAP Pressure: 12.5 - 18.5 cmH20 (auto range)
CPAP Software: SleepyHead

Other Comments: Have diabetes Type II

Sex: Male
Location: Illinois, USA

Post: #2
RE: Cautionary tale- improper mask fit, long
Good info, Mary. Thanks! Coffee

SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

02-22-2013 10:30 PM
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Moriarty Offline

Advisory Members

Posts: 270
Joined: Jul 2012

Machine: Respironics REMStar 50 Series Auto
Mask Type: Nasal pillows
Mask Make & Model: Fisher & Pakel Pilairo Q
Humidifier: Respironics System One
CPAP Pressure: 8.5-20 (average 9.4)
CPAP Software: SleepyHead

Other Comments: Image above is my CPAP machine...

Sex: Male
Location: Toowoomba - Qld - Australia

Post: #3
RE: Cautionary tale- improper mask fit, long
Good information there Mary,

The real take-away message here is you point about not overtightening the mask to stop leaks.


I started CPAP with a Mirage FX Hybrid mask Even taking care not to go too tight I noticed issues with jaw joint pain and my bite..

I now use a Pilairo nasal pillow mask and have greater cumfort and lower AHI.

I hope your issues are not too hard to resolve.
(This post was last modified: 02-23-2013 05:47 PM by Moriarty.)
02-23-2013 04:58 AM
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zimlich Offline

Preferred Members-2

Posts: 392
Joined: Feb 2012

Machine: Respironics PR System One BiPap Auto SV Advanced
Mask Type: Nasal mask
Mask Make & Model: ResMed gel Nasal Mask
Humidifier: System One
CPAP Pressure: 8-20 ASV, 8 EPAP,PS 12
CPAP Software: Not using software

Other Comments: I use the Quattro FFM when necessary

Sex: Female
Location: Norfolk, VA

Post: #4
RE: Cautionary tale- improper mask fit, long
Thanks, Moriarty.
I'll post an account of the damages after I see the orthodontist Wednesday.
02-23-2013 08:15 AM
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zimlich Offline

Preferred Members-2

Posts: 392
Joined: Feb 2012

Machine: Respironics PR System One BiPap Auto SV Advanced
Mask Type: Nasal mask
Mask Make & Model: ResMed gel Nasal Mask
Humidifier: System One
CPAP Pressure: 8-20 ASV, 8 EPAP,PS 12
CPAP Software: Not using software

Other Comments: I use the Quattro FFM when necessary

Sex: Female
Location: Norfolk, VA

Post: #5
RE: Cautionary tale- improper mask fit, long
I saw the orthodontist yesterday. I have two options, a retainer to prevent any more movement in my teeth and the option I chose. The other option was full braces and having one tooth pulled to make room for my teeth to move back into place. Since my bite is good and I hate the idea of pulling a perfectly good tooth I chose to go with the retainer for $200 to $400. He said my quattro fx should not cause further problems and the retainer is like insurance.
02-28-2013 10:31 AM
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iSnooze Offline
Apnea Board Proofreader
Advisory Members

Posts: 239
Joined: Feb 2012

Machine: Respironics PR System One C-Flex+
Mask Type: Nasal mask
Mask Make & Model: Resmed Mirage Micro
Humidifier: System One Heated Humidifier
CPAP Pressure: 11
CPAP Software: SleepyHead

Other Comments: also use a Comfort Gel Full Mask by Respironics

Sex: Female
Location: Indiana

Post: #6
RE: Cautionary tale- improper mask fit, long
Thanks, Zimlich, for the detailed account. I knew that masks were not always easy to sleep with but I had not thought about the impact they could have over time if improperly fitted. I'm glad to hear that you have a solution to stop further changes with your teeth.
02-28-2013 06:58 PM
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