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Full Face Mask for petite face/ Air in Mouth
#11
RE: Full Face Mask for petite face/ Air in Mouth
Finding a properly fitting mask/cushion set-up for smaller heads is difficult--I know from experience.  I used the nasal cushion Wisp for 5 years and they had a smaller headgear and petite sized cushion.  I had to switch to a full face mask when mouth leaks like you described became too bothersome and my sleep doc recommended the AirTouch F20--he uses it.  The small size is almost too big but I have put up with it since it has almost completely eliminated mouth and mask leaks but has to be worn fairly tight due to the foam rather than silicon cushion.  I have the Resmed For Her smaller sized headgear.  I think I would look into the F & P Viteria mask as recommended if it is small enough and you can get headgear that fits.  I tried one F & P mask a few years ago and it didn't adjust for small heads/noses.  I wish you luck!
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#12
RE: Full Face Mask for petite face/ Air in Mouth
For your mouth filling up with air .....

It's all about the tongue position 

When not in use, tongue should rest on the roof of your mouth, a little back from your teeth.

Mask up, machine on, put your tongue in position and open your mouth.   Adjust as necessary until no air escapes your mouth.   

Practice this position during the day until it is second nature. 

If you wake up with your mouth filled with air, put the tongue in position and it disappears.

Sleeping on stomach or sides helps control this as well.
Sleep-well
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#13
RE: Full Face Mask for petite face/ Air in Mouth
In theory, cpapians explanation should work, but it didn't for me! After 4 years of successful use of a Wisp mask (nasal cushion) my leaks were not controllable. While awake I could not keep the air explosions out of my mouth. Taping mouth was not an option as I was afraid my ears would be damaged with the pressure. I finally gave up and went full face mask with great results.
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#14
RE: Full Face Mask for petite face/ Air in Mouth
[Commercial Link Removed] Search Amazon for: AirFit F10 / Quattro Air Full Face Cushion - Extra-Small - 62736


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#15
RE: Full Face Mask for petite face/ Air in Mouth
Thanks everyone for the ideas and replies. I did try keeping my tongue on the roof of my mouth, but the air just went around my tongue and into my cheeks, didn't work for me. Maybe if I keep practicing. Meanwhile, I talked to the "CPAP expert" guy at my pulmonary doctor's office, and he lowered the pressure a bit, which has enabled me to keep the tape on. It has worked and I've been sleeping much better now and getting used to the whole thing! Hubs is happy too because all is quiet. Bigwink

One thing though, is that after we changed the pressure I checked my levels on the Wellue ring app and noticed that I'm still dropping into the 70's once or twice most nights, even though apneas are down to normal levels. I'm thinking that means we'll need to raise the pressure and therefore, I'll need to go ffm, but doc is ordering a medical grade oximeter for a couple of nights so we can see what's going on first. 

So thanks again for the recommendations, all of this stuff is starting to make sense now. Thanks
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#16
RE: Full Face Mask for petite face/ Air in Mouth
OK yes that level of drop on the oxygen needs to be monitored. If it's below 89% for 6 minutes, you're a candidate for supplemental oxygen. Do keep an eye on that.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#17
RE: Full Face Mask for petite face/ Air in Mouth
I'm an old hand at the small size problem. One difference is that I put the nasal pads in and had an instant panic attack and so have done a full-face mask from the beginning.

I started with an F20. The "small" headgear is ludicrously large on me Rolleyes I actually cut the back strap so that I could lap it over and use a big safety pin to take out like 2 inches, and that got the straps off my ear. The first year-and-a-half I was on therapy I started with a size small cushion and then went to XS, but neither really fit right. I lost 130lbs and then it REALLY didn't fit right. I was having to crank it so tight that I got a bloody pressure sore on the bridge of my nose.

My insurance changed and my first DME went out of network, so I picked a new one and "test drove" the DME by going in and having the RT try to fit me for a mask. The RT was kind of an idiot, but we DID find that the Amara View worked pretty well for me. (You know, you would think that when you have something called sleep apnea, the "professionals" would have at least figured out that you are, ya know, asleep when you use the mask! So carefully putting the mask on you and lining it up exactly and then telling you to remain perfectly still is not a practical plan.) But this was Lincare, which I quickly realized was simply about having a phone rep call you and send out supplies and bill insurance without any sort of human contact. The Amara doesn't touch the bridge of the nose at all so no more bloody sores, but I kind of flailed around on whether I was a medium or small with that, and it's not really the question that can be figured out over the phone!

The Amara View is NOT a good mask for anyone whose face is not an average size -- in this mask the size is strictly about how far your nose sticks out from your face, and all of the sizes are exactly the same height and width. I was part of a mask study which I later realized was comparing the Amara View with the not-yet-released Dreamwear. When the Dreamwear came out I asked for it, at which point came to the limits of the call-center-mail-order model of cpap supplies that is Lincare. So I made an appointment at a Lincare office (different city from the first Lincare I used, which was in a work town and I know longer worked there.) I arrived at my appointed time and it was clear that they had no idea that I was coming, but the RT did happen to have a Dreamwear mask and she fit me with it, and I took it with me. Apparently Lincare really is incapable of providing any sort of in-person cpap help and the only people that you interact with are minimum-wage call center employees. And they never submitted the mask to my insurance and never sent me a bill because they didn't seem to have any procedures for this in-person encounter! I still have a pile of unneeded Amara View mask supplies still sealed in their packages, and I figured I was done with Lincare. But bottom line is that small face is probably not going to work well with the Amara View.

Next stop on my journey was a small-chain (3 stores I think) DME in the town of a new job. (I'm a girl scout leader, and a leader in another troop works in the office there, and so I was willing to trust them.) I mentioned that I have lots of flow limitations and the machine will ramp the pressure up to whatever I set the max at, but 1) that doesn't stop the FLs, and 2) if I set the max down and don't let it go to where it wants to go, I don't have more events. The RT was aghast that I dared to touch the settings (I was 4 years into therapy at this point, and wasn't intimidated.) She said, "Are you a respiratory therapist?!?" I replied that, no, I'm not a respiratory therapist, but I do understand tuning and forcing data, and I lost 130lbs and kept it off via close control of data, and what's your superpower? Anyway, I was able to get my dreamwear masks from them.

Then in Fall 2019 I was part of another mask study, this one comparing the Dreamwear to the -- at the time still pretty new -- F30. This is ResMed's version of the minimal-contact mask like the Amara View & Dreamwear. It has a much more forgiving fit for us small-face people that either of those two masks, but at the time I decided that I like the hose connection at the top of the headgear rather than hanging off the end of your nose like every mask other than the dreamwear.

I'm not sure about the details of your small size, but what is important for me (and after 6-1/2 years of cpap therapy I am only now understanding this) is that the size is not only a mask-fit challenge. My sleep-disordered breathing is a result of my small size -- the airway just isn't big enough to allow me to breathe through my nose when I'm asleep. As long as I'm awake I can breathe just fine with mouth closed, but the instant I get drowsy my nose closes up and my mouth has to open or I can't breathe. There is no way I can sleep in a nasal mask.

The stuff that I've been working on very recently has made me realize that I need the F30 mask -- it's the only one that will stay sealed if I change position. One of the challenges of the big weight loss is that my face kind of "falls away" from the mask depending upon what position I'm in. And then it does the "mask trombone" thing! (Daughter is a trombone player, and everyone in my family are physicists. They can explain why a leaky mask is a trombone not a piccolo...) So I think that you should ask for an F30 mask. Oh, and that mask is also sized strictly on how far your nose sticks out from your face. The reason that it's more forgiving is that the cushion is a lot bigger, so narrow face or wide face it still works.

Ok, sorry, that was a whole novel! but, anyway, takeaway is don't get an f20 mask, get an f30! If you can't make the F30 work, then the dreamwear might be a good next step.
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#18
RE: Full Face Mask for petite face/ Air in Mouth
The Resmed f10 makes an extra small set up. I posted a direct link to it but received a warning from the admins
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#19
RE: Full Face Mask for petite face/ Air in Mouth
It's best to tell others to search for the item in question without a direct link. It preserves our educational forum status.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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