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My Bumpy CPap Journey
#1
Angry 
Started off with a pillow mask the end of November. I loved how small it was. I wasn't getting enough air and never slept with it.  Switched to a nasal pillow and felt relieved with more air and was able to sleep with the C-Pap for the first time.  Then I started getting air in my cheeks and extremely dry mouth.  Therapist said I must be breathing through my mouth.  Excessive leaks well over 24 into the 50's and 60's on my reports.  I tried a silicone full face mask (just over the nose and mouth, not up to the bridge of my nose) Finally got very good reports but leaking into my eyes and around my jaw - no matter how tight the straps were set. My face felt all mushed.  I got another full face mask to try up to the bridge of my nose and it was leaking all night and getting a [Image: angry.gif] sad face for my leak rate.  Just woke up at 2 AM and took it off and here I am looking for advice. Feeling very disappointed.  Ive gone into this with a very positive attitude but can't seem to find a good fit.  I asked a few people I happened to see at the store and asked them their experience and they said they got used to the 1st mask they tried.
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#2
I would try either a chin strap or soft cervical collar with either the nasal mask or pillow mask. The most likely reason you felt air starved with the nasal mask was too small a pillow. Most people end up with a larger size pillow than what appears to fit them. You already have a nasal mask that was working for you until the mouth leaks started so it may be best to use it until you get the mouth leaks under control. If you decide to go with the pillow mask I would suggest starting with the large pillow and working down as needed.

There are several styles of chin straps available. I use a Ruby style chin strap with good results.

The Tongue Suck Technique for preventing mouth breathing works as well.
  • Place your tongue behind your front teeth on the roof of your mouth
  • Let your tongue fill the space between the upper molars
  • Gently suck to form a light vacuum
You can practice it during the day to help get used to it.
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#3
I also get air leaking up the side of my nose and blowing into my eyes. An easy way to overcome this is to use a mask liner - do a search for Remzz or Pad-a-cheek. Alternatively, you can use DB's patented nose-leak seal: Take a piece of soft fabric (eg flannelette) 15cm x 9 cm and fold it so you end up with a strip 15 x 3 cm and 3 layers thick. Drape this over the bridge of your nose with the ends hanging down on your cheeks. Now carefully place the mask so that the fabric sits between the silicon and your skin (easier to do than describe). This will give you a nice tight seal without needing to do up the straps too tight. I've been using this for years - works for me.
DeepBreathing
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#4
Go back to your nasal MASK ( the one that covers your whole nose, not the pillow one ) and wear it as LOOSE as possible, with just enough tension to hold the mask lightly against your skin.

The nose mask is designed to "inflate" slightly to create the seal against your face once the CPAP machine is turned on and blowing air in to the mask.

It will take a little toying with until you work out just the right adjustment for you, but it can be done. 

I use a Fisher & Paykel Eson nose mask, I had all sorts of problems with it not sealing until someone on here suggested I loosen it off, as opposed to the pulling it tighter and tighter that I had been doing. 

To overcome the mouth breathing the tongue suck method is worth practicing, but another way is to hold half a mouthful of water in your mouth and try breathing through your nose.. most likely you will find you can actually do this, so just practice holding it for an extended period of time and it will become habit for when you use your CPAP.

For what it is worth, getting your CPAP adjusted with mask/pressure/humidity is a process that can take quite some months, so hang in there.

On my first night I said I was going to throw the machine out the window and smash it ( not wise given it cost me well over $1,500 out of my own pocket.. and would have meant I wouldn't keep my professional driving licence ).. after the first week I thought I'd never sleep in comfort ever again.. after the first 3 months I was coping most nights.. now that I'm 18 months or so in to it I can fall asleep almost instantly, and I don't stress if I have the occassional night with slight leaks or the odd elevated AHI.
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#5
If you use Nasal Pillows or Nasal mask and get a dry mouth air is escaping through your mouth through the night. It starts off fine while you fall asleep, but if you go onto your back (especially) air will try its best to take the route of least resistance and escape via your mouth. It might start off so as you would not really notice, but as your mouth dries out it gets harder to stop it leaking this way and even if you lay wakened it can become very hard to stop it leaking. Keep a bottle of water next to the bed so as you can take a mouthful to moisten your mouth. Even with a chin strap this can still happen, it starts like a dripping tap and even trying to stop it while awake can be difficult, a sip of water is all that is needed sometimes.
At low pressures, some people will just breathe through their mouths, when this happens your mouth will dry very quickly.
The real answer is to use a Full-faced mask, but some people do not like these as they can feel very claustrophobic so unnless they need to use one they will use Nasal or Pillows.

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#6
Read the Mask Primer.
Modern masks are designed to inflate and fit loosely on your face.  Forget the straps and lightly hold the mask on your face with your hand.  Move it around until it works.  Now loosely put the straps on to match what your hand was doing.  Also find and watch the manufactures video on fitting your mask.   

Fred
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#7
About an hour ago in someone else's post I wrote up a little experiment I did to teach myself how to get rid of mouth leaks. It worked out great!

Occasionally, I get the air blowing in my eyes. It comes from two sources:
1) The exhale valve is near an elbow on the mask. Sometimes the elbow is upside down. I rotate it so the air is redirected away from my face.
2) Sometimes the problem is near the bridge of my nose. I do a mask off, shut the machine of (so it's not recording AHI), and reposition the mask until I'm satisfied. Then I turn the machine back on.

If you have a Resmed, you can also use the "Run Mask Fit" option. It quickly zooms the pressure up to the max. That way, you can tell if there's likely to be a leak in the middle of the night. Fix it the leaks before you exit that option.

--------

I once slept with an Airfit F20 pretty much lying on top of my face. I didn't even attach the headgear. No leaks.

However, there were nights that were very leaky. My (idiot) Sleep Center said that was because I had to completely crank the mask down. Per Resmed, you're not supposed to do that at all.

However, I do have an F10 now, and I do have to quite crank it down. Otherwise it farts. Hate that.
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#8
I have an air fit F20 trying to get used to it is that possible coming from a mirage fx nasnasal
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