Nasal masks for large heads?

[cisbrane]

So, I'm having difficulty find masks that fit my head and face correctly. I have a larger head and I guess a wide face (eyes offset from nose a bit wider). Typically, One-size-fits-all hats never work for me. Also, I even have trouble finding glasses with wide enough nose bridges.  I would not say have a huge head though, but larger. I am over the one-size-fits-all barrier, but not as big as some other large heads. This puts me in an interesting spot between sizes, where the next size up can be too large.

I am looking for nasal masks that offer different size frames and headgear for larger heads.

I have tried the DreamWear Large Frame, which hit a lot of pluses, for example the sides are not close to my eyes, but also a minus in that the large is just slightly too big. I have trouble keeping the mask in place during the night. However, the Medium frame is way too tight and the edges are close to my eyes. In the end, This mask did not work for me due the nasal cushions not fitting my noise right, leading me to feel like I could not breath.

I tried a F&P Nasal Pillow mask, but it was really uncomfortable. The pillows were irritating, leaky. Also, the straps were on the corner of my eyes which was awful.

I had a ResMed N20, that was pretty good, but the head strap was too small and could never fit my head; it kept slipping off. Also, the frame itself wasn't quite wide enough... the edges were close  to my eyes, though not on top of them.

I could maybe try pillows again, but those F&P ones were horrible.

[Fats Drywaller]

Wisp is one that has headgear in size L, but you'll probably need to buy that separately. (Amazon search string "wisp headgear large", $20.) I don't know whether the retail package of the full mask is available in a variant that includes L rather than M headgear, but just in case, I guess it's worth searching for that to save the $20.

https://www.sleepapnea.com/products/masks/wisp

(sleepapnea.com is Philips Respironics)

I'm curious about which F&P nasal-pillows mask you tried and hated. What's the name of it?

[Gideon]

The headgear of most could be modified, cut with an extension piece sewn in.  But first hold a mask to your face with just your hand. if that doesn't work the mask is wrong for you.  I use P10 Pillows and a common issue with pillows is the pillows are too small.  Pillow masks should rest ON, not IN the nose.

Fred

[cisbrane]

It was the "Fisher & Paykel Brevida™ Nasal Pillow CPAP Mask with Headgear " that was uncomfortable. The Small was too small, and the M/L was very irritating. Also, my AHI went up a lot when using the mask... 10-15 from 0-1 (mostly Central events... problems I had when first starting therapy with the N20)

[Fats Drywaller]

It was the "Fisher & Paykel Brevida™ Nasal Pillow CPAP Mask with Headgear " that was uncomfortable. The Small was too small, and the M/L was very irritating.

Makes no sense to me. The Brevida's headgear is merely a single elastic strap with velcro adjusters on both sides, one size fits all, and I do mean all. Or did you have the early (semi-defective) version of it with snap-adjusters instead of velcro?

Old & new:


Lately I've been raving about how great the Brevida is, and I mean it. It's super-comfortable, and the headgear is so minimal, very much like the P10's, but better designed, with the velcro, which the P10 doesn't have, and a swiveling elbow at the frame/hose joint, which the P10 also doesn't have. But the main thing is no pain from the pillows. Maybe you were using the wrong size pillow nosepiece and never tried either of the other two sizes? If you did try all sizes of nosepiece, then I dunno what the problem was ... <shrug>.

[Fats Drywaller]

I use P10 Pillows and a common issue with pillows is the pillows are too small.  Pillow masks should rest ON, not IN the nose.

That applies to the P10 and others that use similar pillows, but not the Brevida. The Brevida's protuberances are supposed to be inside the nostrils, which is why they're very soft, pliable silicone rather than hard lumps.

[cisbrane]

So the F&P strap had enough room to go around my head, yes. But, it also slipped on my hair so easily and would not stay on. However, the real problem was the "angle of attack" so to speak of the face strap going from the nose piece to the head. Because apparently my eyes are offset wide(?), the straps would pass really close, or on top of the corner of my eyes, which is very irritating to me. It was the version that had the Velcro straps. Maybe I can get a picture of this later.

I used the small pillow first, but it was just keep leaking. So I moved to the M/L, but would wake up with a very irritated nose. Also, any tension on the hose would put weight on the nose pieces making it uncomfortable.

[Gideon]

any tension on the hose would put weight on the nose pieces making it uncomfortable.

Hose management, I use a velcro wrap around that clips to PJs or the pillow.  That prevents the weight of the hose from pulling the mask askew.

[Fats Drywaller]

Hmmm, interesting. I have a big head, and the Brevida fits me OK, with the strap going around the back of my head directly above my ears. I keep it pulled way down on the back of my head, so that there is (just as a side effect, not desired) slight pressure on the top of the ear. If it slips, then it's too loose and I tighten the velcro slightly. The nosepiece needs to be snug anyway, so a loose strap will cause both slippage and leaks.

If it still slips with the strap seemingly tight enough, then a scarf (do-rag) wrapped around the head before putting the mask on would be the thing, to give the strap something to grab.

I guess all this is just more evidence that with masks, what works for person A is not guaranteed to work for person B or C. And so it goes.

In any case, I'm not intending to imply that nasal-pillows types in general are right for everybody. There are still the various nasal masks to check out, and a few of those can be quite good. So far, I like the Wisp OK, although I haven't used it nearly as much as the Brevida, which is my fave.

[cisbrane]

Well, I was looking around, and I guess nasal cushions are only expected to last 1 month? I have noticed a significant quality loss already in my DreamWear cushion. I have had it for a month. I decided to order a replacement to see if that can get things ok again. Otherwise, the Wisp looks like the next mask I will try out as it appears to fix some other annoyances of the ResMed N20 in the pictures at least.