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Intro and request for advice
#11
Thanks for the reply. I have been doing pretty much exactly what you suggested, which the exception of the Lanolin. I've tried the M and L pillows. My head is big enough the the P10 can provide a snug fit.

I have been using Sleephead, which is how I learned about the leaks. Looks like I'm not allowed to post images yet. I'm averaging around 20-30% of the time above the leak threshold.

My AHI averages about 2.5.

(02-23-2015, 08:26 PM)retired_guy Wrote: I'd suggest you give the P10's another chance.

Put on the chinstrap first, but make sure you don't use it too tightly. If you use it too tightly, then you'll end up clinching your jaw and during the night your lips will part as you are grimace in pain, causing a leak. The chinstrap should simply "encourage" the jaw to stay forward, not force anything. You should still be able to open your mouth and even talk if you need too.

Now put on the P10's, but use one size larger pillow than you think you should need to use. So for instance if you think you need a medium, use a large. The straps should fit snugly on your head, but not so snug as to suck your nose into your brains. If the straps are too loose, you can cut them, then put them back together using a safety pin in order to get a tighter fit. If they are too tight, you should be able to stretch them then put them on.

Finally, you can apply a bit of HPA Lanolin to your nostrils before you put on the P10. That will allow for a better seal as well. HPA Lanolin is available in the baby department at your local drugstore.

and finally, finally.... Get us some results from Sleepyhead so we can see just exactly what sort of ahi and leak experience you are having.

Oh... and by the way: It is true as Mongo says, that everyone is different. Except for me. I'm not different. I'm the same.


Thanks, I will have to check that out.

(02-23-2015, 10:26 PM)OpalRose Wrote:
(02-23-2015, 08:41 PM)TyroneShoes Wrote: One thing my DME tech DID NOT tell me, is that if you "size" the pillows without the blower on, you will likely settle for the one that "feels right". But when the blower is on, it inflates the pillows against the nose making them tighter, which means you may have the mask too tight, and you may be using a size that is too small. Check the fit with the blower on, laying down.

If you are someone who (not assuming that you are) subconsciously digs your face into the pillow when asleep, that can certainly affect the mask fit. There is a device that was mentioned here (someone else please supply the name if you can) that is a pillow mask attached to a mouth guard, with a mechanical adjustment. The dental device part can be helpful in jaw placement, but having it attached firmly to the pillow mask keeps that from moving as well, so it may be just the ticket for those who have leak issues related to head movement during slehep.

I believe it is called the TAP PAP mask.

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#12
If the Eson gave you leak problems its probably the wrong size or you wore it to tight. Its a very very lose fitting mask. Ridiculously loose actually. If the upper support is touching your forehead its to tight. And will leak since the roll fit cushion cant flex to seal as you move around or inflate properly.

Its also the only nasal mask Ive tried that when I bury my head into the pillow, which I do, cant help it, it has enough flex to maintain a seal. I even pulled left side bottom strap loose a couple of nights ago and still didnt get into large leak territory or have enough leak to notice it until I woke up in the morning.

As far as chin straps A respironics premium strap is about the best ive tried as far a stopping mouth leaking.
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#13
Update: after I found that the full face mask wasn't going to work I went back to the DME. I traded for a hybrid mask - the Mirage Liberty. The idea was that if I needed to wear a chin strap with a nasal mask I might as well try a hybrid. The problem with the hybrid, which is the same problem I had with the FFM is that it is too wide and so when I sleep on my side it gets pushed out of place which causes a leak. I also found that the piece that the hose attaches to is slightly smaller than usual. The first night the hose fell off so I was sleeping without any pressure for about an hour.

So now I am back to the nasal mask with the chin strap which is really uncomfortable. My DME is out of ideas at this point. I know everyone says "keep trying" but I don't understand why my leak rate is so much higher than most and why my experiences with these masks is so much different. I guess I could try the TAP PAP mask as suggested earlier.

Also, I now have a number of basically new masks that I no longer need.
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#14
The mask probably came with an adapter to fit the hose. All fittings are standardized at 22 mm. The adapter can be stuck in a hose and otherwise misplaced, so look carefully. Please review this fitting guide to be sure you are using the mask properly: http://www.resmed.com/us/dam/documents/p...er_eng.pdf

This template should be used to verify you were issued the right size. http://www.resmed.com/int/assets/documen...ow_eng.pdf

It sounds like you might be using too large of a size, and if so, it simply won't work.
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#15
Update: I got another mask - the Mirage (hybrid). That that might be a good option but I can't seem to keep it from leaking. Went back to the pillows since that is more comfortable. Still having a lot of leaks, but at least I can sleep.
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#16
Hi Seabird, sorry you're still having leak issues with your cadre' of masks.

When you say you're having leaks: Can you tell us what your leak numbers really are? Maybe it's not as bad as your thinking it is. Or maybe it's worse?

Also, when using the pillows mask, where are you experiencing a leak? Are you sure it isn't mouth leaks?



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#17
Hi, well we thought it was mouth leaks, but the chin strap hasn't reduced the number of leaks. I'm above the leak threshold about 20% of the time. Here is last night: [Image: nuVpxqw.png][Image: MHbEWaN.png]

(03-20-2015, 01:47 PM)retired_guy Wrote: Hi Seabird, sorry you're still having leak issues with your cadre' of masks.

When you say you're having leaks: Can you tell us what your leak numbers really are? Maybe it's not as bad as your thinking it is. Or maybe it's worse?

Also, when using the pillows mask, where are you experiencing a leak? Are you sure it isn't mouth leaks?

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#18
Well your numbers are good.. And except for a couple of periods during the night the leakage isn't really awful. But it does need some cleaning up.

What it looks like to me, especially the time period from around 2:45 until a CA aroused you around 3:20ish, is that you were really nicely asleep, and your jaw fell back. We try to keep that from happening with the chinstrap, but in your case I'm thinking either the chinstrap is not actually encouraging the jaw to stay forward or it is, until it isn't. When you go to bed tonight make a special point of positioning the chinstrap a little further forward and see if it doesn't take the jaw with it.

Also practice using the tongue on the roof of your mouth when you sleep to help block the airway. When you get really good at that, you can actually open your mouth for a short time and not lose pressure.
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#19
Thanks, I'll give it a shot. My doctor is happy with my AHI but I'm still tired throughout the day.

(03-20-2015, 10:22 PM)retired_guy Wrote: Well your numbers are good.. And except for a couple of periods during the night the leakage isn't really awful. But it does need some cleaning up.

What it looks like to me, especially the time period from around 2:45 until a CA aroused you around 3:20ish, is that you were really nicely asleep, and your jaw fell back. We try to keep that from happening with the chinstrap, but in your case I'm thinking either the chinstrap is not actually encouraging the jaw to stay forward or it is, until it isn't. When you go to bed tonight make a special point of positioning the chinstrap a little further forward and see if it doesn't take the jaw with it.

Also practice using the tongue on the roof of your mouth when you sleep to help block the airway. When you get really good at that, you can actually open your mouth for a short time and not lose pressure.

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#20
If the chin straps aren't working for you, you could try a boil and bite mouthguard. I sometimes use one of the cheap boxing ones with the plug for the air holes in the front of it.
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