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Mask tension later on in the night...
#1
Hi everyone,

After being diagnosed in 2011... and failing to tolerate a CPAP back then, I'm giving it another shot (just had a 3rd sleep study done and my neurologist is pretty adamant about taking care of my sleep issues before we attack my other symptoms).

So... I dug out my machine... it's a ResMed S9 AutoSet (with heated hose and H5i humidifier) and the mask they fitted me with at the time was a Quattro FX. At the sleep study I just did last month, they fitted me with a ResMed AirFit F10. So... new mask... and the old mask had very little use so it should still be good.

I'm having a few problems tolerating it. I've been attempting to use it for 41 days. My 30 day average is 3.5 hours, and my average for the last week is 4 hours, 41 minutes. I did find my way into the clinicians settings. It had previously been set to a fixed pressure of 6.2. I changed the mode to auto (which was probably good as I often see the pressure is going above that) and I enabled the EPR and set it to 1. This has made it a little more tolerable.

Last night was actually my record, 7 hours, 10 minutes (pretty remarkable as I have a few years of sleep tracking data with the Sleep Cycle app and my average night is about 5.5 hours of sleep). It's not a straight through, peaceful sleep though. I wake up multiple times throughout the night to futz with the mask. It also takes me longer to get back to sleep.

The main problem I'm having is that after several hours of sleep, I wake up, and when I try to go back to sleep there's a leak at the bridge of the nose. Unfortunately there's no more room on the head gear to cinch it down anymore. I figured loosening the lower part of the head gear might help (as it wouldn't be pulling up on the nose) but it doesn't. My theory is that throughout the course of the night the head gear is stretching a bit, making for a looser fit. Sometimes switching to whatever mask I'm not wearing at the time helps.

My doc wrote a prescription for a new machine and a new mask fitting so I'm waiting for that appointment (it's tied up in insurance wars right now). Is there anything anyone can suggest trying once I do get to that appointment? (just in case, a nasal mask is unfortunately not an option as I have asthma/allergies and my nose isn't always clear). At the most recent sleep study fitting in January the tech tried different headgear sizes on me... I believe the medium was definitely too small.

Thanks Smile
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#2
I'm no fan of the ResMed Quattro FX or the F10. The designer of both masks should be:
[Image: beatdeadhorse5.gif]

I prefer the Mirage Quattro with the forehead brace and adjustable contact at the top of the mask.

As for what to do now -- perhaps a homemade mask liner?
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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#3
Thanks jM,

About 10 minutes after I posted the phone rang. I have an appointment on Friday for another fitting. I'll make sure the MQ is on the list for testing! Smile
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#4
While I've only used the F&P Simplus and really don't have anything to compare it to, several members here regard this mask very highly. I would suggest that you add it to your playlist.
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#5
(02-16-2016, 11:58 AM)shewhorn Wrote: The main problem I'm having is that after several hours of sleep, I wake up, and when I try to go back to sleep there's a leak at the bridge of the nose. Unfortunately there's no more room on the head gear to cinch it down anymore. I figured loosening the lower part of the head gear might help (as it wouldn't be pulling up on the nose) but it doesn't. My theory is that throughout the course of the night the head gear is stretching a bit, making for a looser fit. Sometimes switching to whatever mask I'm not wearing at the time helps.

I have worked with the Quatro - Full Face mask, with the funky forehead screw -
also with the AirFit 10 - Full Face mask.
The Quatro constantly leaks around the bridge of the nose. Only used it about 2-weeks before switching to the AirFit 10.
The AirFit 10 is a much smaller profile and also leaks around the bridge of the nose, but not as significantly.
All in all, a much nicer fit and mask.

Both masks, but especially the AirFit 10, will "re-seal" if you pull the mask away from your face and let it back down.

What is happening for me is that, being a side-sleeper, I typically not only toss and turn, but also wack the mask with the Pillow. This causes the mask to move and the soft-seal to "double-up" causing the leak.
At that point, you can not fix the problem by moving the mask or adjusting the straps because the seal simply stays doubled-up.
By pulling the mask off your face, the seal reverts to its correct shape, and you can replace it in the correct location - sans leak!

I actually use nasal pillows - the Swift FX - most of the time as the leak causes extreme condensation in the mask.
(I'm debating if the problem is the seal issue, or is fact that the inlet swivel itself pops loose; i.e. a manufacturing or design defect.)
This is not really a rain-out in normal description, but one caused by the fact that the leak causes a Venturi cooling effect in the mask itself so that the mask is condensing my exhaust breath, not the humidified air coming from my AirSense 10.

Bill Magill
Retired computing and networking professional
(ARPAnet, Unix and Mac OSX)
"People assume that time is a strict progression of cause to effect,
but actually — from a non-linear, non-subjective viewpoint —
it's more like a big ball of wibbly-wobbly... timey-wimey... stuff."
The Doctor
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#6
I also use the f10 and it seems to fit me better than the others mentioned. Tightening the top straps too much does not work. You should try to tighten them so as not to be uncomfortable' then tighten the lower straps. Try a little test. When you have a leak around the nose, try gently pressing the lower part of the mask against your chin. You might find that the upper leak stops. If that is the case then you can tighten the lower straps a little until the leaks stop. This has helped for me. Hope this helps for you.
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#7
Hi shewhorn,
WELCOME! to the forum.!
Better luck to you with CPAP the second time around.
I hope your appointment goes well Friday.
Much success to you.
trish6hundred
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#8
Thanks for the input everyone, much appreciated. Hopefully I'll find a mask with a better fit. I did try the F&P Simplus at the most recent sleep study but... I seem to remember it wasn't a great fit. That said... I was a little rushed in trying things out. Friday I'll have a lot more time to futz and fiddle.
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#9
Shewhorn,

I use the Mirage Quattro and have found it the best that I have tried so far for my particular needs. I also use the Simplus which I like almost as well as the Mirage Quattro. The only negative that I have with the Simplus is that, for me, it takes more futzing to keep the leaks down. The leaks that I am talking about here are the palpable leaks not the data. When the Simplus leaks for me it shoots a stream of air at my eye.

Best Regards,

PaytonA

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#10
Tried the MQ, and the S&P SP, both were quite leaky. I ended up with another Airfit F10 BUT... in a medium instead of a large which is what they fit me with (at the sleep study) last month. Looks like the large was... a bit large. If it does end up loosening in the night, I now have A LOT more strip available to cinch it down.
Thank you again to everyone for their input and advice, much appreciated! Smile
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