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[Equipment] Mask fitting
#1
Mask fitting
I've been using my AS10 for a few weeks now and this is my first experience with CPAP therapy although like many others, I probably should have started this YEARS ago. Unsure

Anyway, in the lab test they used a medium size nasal mask - I don't know what brand or model. When I got my equipment I was given an F&P Eson (nasal) in size large. I asked about the sizing but he said that the sizes vary by brand and that the large "looked exactly right" on me.

For the most part it is working well but I do get occasional leaks when it moves around as I am a very active sleeper! I also need to use a separate chin strap because otherwise I still tend to still snore and/or experience massive air leaks from my mouth. I initially tolerated the mask much better than the chin strap but I am getting used to the strap a little better now.

In an effort to ditch the chin strap (and have a backup mask for when I get a stuffed up nose) I decided to purchase a full face mask online. I'd have gone through the DME but I asked about a second full face mask when I got the nasal mask and he said I can't get a new one for 6 months or a year - I can't remember right now. Anyway, after perusing this board and other online resources, I chose the F&P Simplus FFM in size medium. I tried it for a couple of nights but it leaked worse than the nasal mask and I couldn't seem to do much about it. So I went back to the nasal and then after watching a YouTube video on the Simplus that mentioned sizing, I thought perhaps I was wrong to get the medium so I ordered a new mask cushion in size large based on the length from my nose bridge to just below the bottom of my mouth when slightly open. The large leaked considerably worse than the medium! I knew the large would never work at all within about 10 minutes.

Now I don't mind spending the money to get extra supplies on my own, but this is looking like a complete shot in the dark and I know from reading this forum that it often takes many different masks before a person finds the right one for them. I may at some point try a small or different FF mask altogether, but for now I'd like to get the nasal mask leaking less.

So here is the main point to my post:

Again, the nasal mask is a size large. It seems to fit "right" in that the top is at the bridge of my nose and the bottom is a little above my upper lip. Side movements don't generally cause leaks, but if I move it just a little bit up (say a 1/4" - 3/8"), air leaks at the top from both sides and blows into my eyes. If I move it just a little down, air leaks near the bottom even when it is still above my lip. Based on this, I *think* that a medium size nasal mask would fit better and not leak as easily. However, as I mentioned above, trying to change sizes didn't go so well on the FFM. Tightening the headgear helps but it needs to be pretty tight and causes pain by the morning.

Any thoughts on whether or not going down a size may help with my nasal mask leaks? How small is a small in the F&P Simplus? I would say I have average or typical facial proportions and I'm about 25 pounds overweight for my height of 6'. I do not have "chiseled" facial features but am more average.
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#2
RE: Mask fitting
Hi Tired,

First of all your DME did not give you appropriate answers on your mask. It is normal and expected that folks will need to try different masks starting up and replace them until they find one that works for them. Call them back and tell them you are aware of that fact and you would like to trade in your mask for something else.

Now, as to what else? I went down the road of nasal mask to full face much as you. Then I decided to try a pillows mask. "Oh, but you're a mouth breather!!! OH NO" they said. What I have learned is most of us are mouth breathers until we learn not to be. With the P10 pillows mask, a minimalistic chinstrap, and proper jaw placement at night I have been extremely successful with the P10. Many many others have as well.

So I would encourage you to tell your DME you want to try the P10, and a simple chinstrap. The idea of the chinstrap is to "encourage" the jaw to lay naturally forward, not to force anything. Encourage = good. Force = yucky. So it really doesn't have to suck up your whole head in order to do it's job.

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#3
RE: Mask fitting
The sizing between nasal masks and full face masks is kind of tricky. I had a F&P nasal mask and could not use a medium. Had to have a large (big nose). With my full face mask (Mirage Quattro) I do better with a small than a medium due to the distance from the bridge of my nose to the valley between my lower lip and my chin. I also tried a F&P Simplus and had better performance from the small than the medium even though their sizing said that I should use a medium.

Best Regards,

PaytonA

Admin Note:
PaytonA passed away in September 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#4
RE: Mask fitting
(03-03-2015, 01:17 PM)TiredToo Wrote: F&P Simplus FFM in size medium. I tried it for a couple of nights but it leaked worse than the nasal mask and I couldn't seem to do much about it. So I went back to the nasal and then after watching a YouTube video on the Simplus that mentioned sizing, I thought perhaps I was wrong to get the medium so I ordered a new mask cushion in size large based on the length from my nose bridge to just below the bottom of my mouth when slightly open. The large leaked considerably worse than the medium! I knew the large would never work at all within about 10 minutes.

F&P's Simplus mask comes with a cardboard gauge which enables you to determine which of the available 3 sizes is right for you. Generally speaking FFM's will tend to leak more than nasal masks but they still manage to administer therapy pressure. All masks should not extend up the nose as far as the narrowest part of the bridge, & should also reach down to the groove under the bottom lip for FFM's, (or just below the nose for NM's) otherwise air will leak into the eyes. Therefore, when choosing a mask size, these requirements should be kept in mind.
The problem a lot of patients have with nasal masks is therapy air exhausting orally which defeats the therapy, causes "dry mouth" & shows up on Sleepyhead as leaks. I have designed a device that will help if you are experiencing something like this. Stick with the FFM & good luck!

Also, I find the warmth from my face will tend to soften the membrane seal somewhat and leaks will cease after a little while. It helps to wiggle your facial muscles too. This causes the mask to settle down better.
[Image: signature.png]Keep on breathin'
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#5
RE: Mask fitting
Hi TiredToo,
WELCOME! to the forum.!
You might tell your DME that you are having trouble getting that mask to fit once you are asleep and let them know you want to try another one.
Hang in there for more responses to your post and much success to you with finding a mask that works for you and with your CPAP therapy
trish6hundred
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#6
RE: Mask fitting
Thanks everyone for your input! @Woozie, the Woozle looks interesting and I may give that a try at some point. I have lots of velcro lying around!

At some point I may try nasal pillows. I just ordered a small Simplus cushion and medium Eson cushion. I know I should just try to have the DME work with me on this but I'm afraid that they will give me a hard time on swapping out sizes and styles, especially since my AHIs average in the "technically treated" range. Unfortunately for me, I am a perfectionist and want to see my AHIs as close to 0 as possible though I may never achieve it. I had an AHI of 31.8 the first night of my study and SleepyHead shows an average of 4.2, varying from 1.39 to 9.67 over the past three weeks since I started cpap. I wouldn't say I feel 100% better but it is a noticeable difference.

While it may end up costing me a bit more money it is worth saving the time and hassle of going back and forth with the DME.

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