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High Pressure PAPers
#1
Would anyone on the forum whose therapeutic pressure is around 20 cm H2O please let me know how you managed to reduce mask leakage to an acceptable level. I am getting very frustrated in this attempt. I am not new to VPAP but I went along for over a year thinking that I was reasonably leak free until I ran across this font of information (ApneaBoard.com) and learned what the data in the machine means.

I did find out the hard way that there was nothing that I could do to get the ffm that I had for a while to seal and the leaks were very irritating because they were directed right at my eyes. I went back to the nasal mask that I am still using and through some testing while awake found that I could completely seal off my mouth leaks with my tongue but when I did, I got a leak between my eyeball and my eye socket.

I just recently got the ruby red chin strap and I tried it last night but my leakage was not much better than with no chin strap. The leakage was 1.3 L/s versus my 1.4-1.7 L/s with no chin strap.

Any help or suggestions would be greatly appreciated.

Best Regards,

PaytonA
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#2
After 2+ years at a pressure of 17, I had my nose surgery done (throat surgery too), and that has helped a fair bit. No magic answers here, I used a nasa mask (this was years ago) and strapped it down tight. Perhaps one of the new FULL FACE masks (includes eyes) would help?

I did grab a new FFM, a 'Simplus',and at my current inhale pressure of 15-16 it is amazing, as is the 'Wisp' nasal mask. - Course, what works for one, may not work for a zombie.
*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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#3
I agree with Peter. When running high pressure there really is not way to prevent leaks other than having the mask tight. You may have to experiment with different masks in order to find one that you can live with having it tight. I guess that's why most of havw several, if not more, different masks some of which never get used.
To err is human, but to really mess things up, you need a computer.
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#4
(01-18-2014, 03:35 PM)Airstream Wrote: I agree with Peter. When running high pressure there really is not way to prevent leaks other than having the mask tight. You may have to experiment with different masks in order to find one that you can live with having it tight. I guess that's why most of havw several, if not more, different masks some of which never get used.

using mask liners could help with leaks.
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#5
(01-16-2014, 05:39 PM)Peter_C Wrote: Perhaps one of the new FULL FACE masks (includes eyes) would help?

Peter_C,

I agree with you on the whole face mask(covers the eyes too). I went to Supplier #1 and they will not sell the whole face mask without a prescription for it. Is this a legal requirement? I also got with my DME and they want a prescription to "investigate" different masks. Does anyone know of a supplier that does not require a prescription for this (as long as the Rx is not a legal requirement)?

Thanks

PaytonA
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#6
I would think if you have a script that says mask of your choice that would be good enough but I don't know what the DME's and/or suppliers think about that. There may be a regulation about a total face mask that I don't know about.
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#7
The mask liners suggested by me50 are a good idea. The most popular one I know of is not covered by insurance- at least mine.
Machines, masks, and humidifiers are classified as medical devices b the FDA. DME providers are required by this federal agency to sell only with a prescription.
Some people are able to buy from suppliers operating outside the law or assemble their own masks from parts purchased separately. Of course, you can always but from a private party (used).
To err is human, but to really mess things up, you need a computer.
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#8
I know you asked for opinions from folks who have pressures of 20 but here's mine.

My 95% is currently around 17cmH2O but I hit the max of 18 a lot. I use nasal pillows. My leaks dropped tremendously (Swift LT) when I started using the Nuance. I was afraid I would have to go to a nasal mask or something the higher my pressure gets but the Nuance seems to be just fine. The Breeze handled the leaks fine, too, but it is basically held in place by the frame and can't move very far.

A medication I was on caused me to gain weight and I am having trouble losing it now that the medication is gone. This is why I have been having to raise my pressure higher. I've been tempted to just max it to 20 and see where it goes but my bet is it will still sit around 17 for the 95%.
PaulaO2
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www.ApneaBoard.com


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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.




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#9
Scripts are required in the US for new masks. One of the vendors on the list will sell 'parts' - a mask with no headgear, and then buy the headgear alone without a script, but you pay more for it. If the script states 'patient choice' - then you can try any mask you want. If your sleep doc is a pain, time for a new sleep doc in my book FYI? Any DR can fill and sign the script, and most will (if for supplies only) if handed to them.
*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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#10
My pressures are 17/22. Were 20/25 (Bipap).

At first (at the higher pressures), I had gobs of trouble getting a seal. For a couple of months.

Also, my nose was ulcerated by the mask. A local DME helped me out, and my mask size recommended by the sleep lab was too small. (Resmed Mirage Quattro). No more ulceration.

But leaks still.

When putting on the mask, I had to wiggle it side to side and up and down to find the place it wanted to be on my face. This helped dramatically. Good placement is important.

I then tried two types of mask liners. Settled on the Remzzzs because they didn't leave residue on my mask. This didn't stop the leaks, but it stopped the farting noises and made the mask more comfortable.

Then slowly, the leaks went away. Probably had something to do with training myself to avoid transient leaking. Can't say what it is I did, but whatever it was, leaks of enough size to cause problems occur only rarely.

So

Correct mask of the right size (experiment)
Placement/tightness on face
Mask liners
Train yourself

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