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Neck Pain with Full Face Headset
#1
Neck Pain with Full Face Headset
I am new to CPAP and am about 6 weeks in to my therapy. It has been a struggle for me from the beginning but I am determined to make things better. I have a Dream Station Auto and started off with a Dreamwear Nasal Cushion, which worked great in the beginning as long as my pressure was low. I went with the nasal mask because I always considered myself a nose breather while sleeping. My machine was set to 5-20 range in the beginning but my AHI was consistently in the 8-10 range with lots of OAs and CAs. To bring my numbers down, my doctor upped my range, first to 8-9, and finally to 8-12, which is what I use now. Adjusting the numbers has helped lower my AHI to the 3-5 range. Still not great but much better than it was. The problem is with the nasal mask. Although it is very comfortable to wear, apparently my mouth falls open when I am in deep sleep and wakes my wife up. She has actually recorded me with her camera when it happens, and yes, it's very loud.

I have tried various chin straps and cervical collars with the nasal mask, but nothing seems to stop the mouth leaks. So I have gravitated toward a full face mask as the obvious next attempt at a solution. My medical supplier only carries Respironics products, and I love the Dreamwear concept, so I went with the Dreamwear Full Face mask. In the beginning, it was horrible. I couldn't control the leaks, and breathing with my mouth caused severe dry mouth. With lots of research online, I was able to make adjustments to the straps to control the leaks, to the point of 100% mask fit. And my numbers have been stable with the mask also. I have learned to mostly keep my mouth closed and breath through my nose, so th dry mouth is getting better too. The best part is the mask is absolutely silent to my wife, so she can now sleep in peace. So I was finally to the point of thinking we had a compromise we could both live with. Then the pain set in.

The lower straps on the mask, which has 4 attachment points, presses against my neck muscle (sternocleidomastoid, to be specific), especially on the right side. I sleep on my side, mostly of the left side, so the pain is on the neck side that is up, not on the pillow. The pain has worsened a little each night, to the point now where it is almost too painful to sleep. I spent a lot of time this afternoon, adjusting the straps, trying to loosen the tension on the lower straps as much as possible to take pressure off the painful area, while maintaining a seal on the mask. I will report back tomorrow on if I have a better night with it tonight. I am hoping for any thoughts or advice on where I could go from here.

It seems all full face masks I have seen have this 4 point attachment style headset to anchor the mask properly, so I'm not sure changing masks would make a huge difference; still, I know the Dreamwear Full Face is known to be finicky for many, difficult to seal, so maybe a better sealing mask would allow me to keep the straps looser without leaks. I have been tempted by the Resmed F30i, because I love the hose attachment at the top of the head.

So that's my story. I feel like I'm almost to a workable solution for both me and my wife. I just need to figure out a way to lower the neck pain. Thanks for any input or insight.
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#2
RE: Neck Pain with Full Face Headset
That's not an uncommon problem. Supplier #31 might have a product to help. They produce mask liners and pads to cushion the headgear straps.
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#3
RE: Neck Pain with Full Face Headset
I have that exact same problem. The straps on my FFM are bruuuuuuuuuutal on my neck. I can't go a whole week straight of using a FFM. And I for sure can't even wear it on a night I already have a migraine.

This is why I keep going back to nasal masks.

I'm sorry I'm of no help to you.

I primarily use a nasal mask. If I wake up due to mouth breathing, I make the swap to my FFM for the rest of the night.

There had got to be a solution. I haven't found one yet. I've tried gorilla gluing other mask headgear/frames onto the FFM, but I can't get enough tension at the right angles to keep it on/sealed.
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#4
RE: Neck Pain with Full Face Headset
I have been on CPAP for 5 months and have tried various masks. When I first started with the Dreamwear full face, everything went well for a few weeks then I started getting a very sore neck and shoulder (just one side) I also had trouble with a good seal and my AHI crept up to 10+. So then I changed to Resmed Nasal mask (sometimes pillows) and although AHI is now below 1, I am having major leaks and wake a few times with a dry mouth so guess I am still mouth breathing. The sleep therapist thought that the AHI may not be accurate because of the large leaks (23 -35 l/min). She has sent me a Phillips chin strap ( I am unable to go to the shop because of the major lockdown restrictions here) so I am hoping it will work. I do find the single strap that goes around my head tends to move and the whole thing nearly comes off when I move around and even having it fairly tight doesn’t stop it moving. It really does seem getting the right mask and fit is a major issue for many. Is there only one out there who don’t have these problems?
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#5
RE: Neck Pain with Full Face Headset
Thanks DB, I may give those strap covers a try out of desperation. The pressure that is causing the pain is back where the lower strap just comes off of the stabilizing piece in back. Perhaps adding the cover will allow me to loosen the strap pressure some while still maintaining a seal.
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#6
RE: Neck Pain with Full Face Headset
Unfortunately, loosening the straps last night did not work. I woke up in as much pain or more. It is slowly progressing night after night. The loosened strap popped off because of the magnetic attachment and I only had 78% mask seal, so a big fail for the night.

May have to go back to the nasal mask because the pain from the straps on the FFM is just too much. Don't know how to control the mouth breathing though. Very frustrated here...
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#7
RE: Neck Pain with Full Face Headset
After more morning research, I have a plan for tonight. Going to return to my Dreamwear Nasal Cushion but going to add mouth tape to see how that works. I've been hesitant to try this, one because I have a beard and mustache and wasn't sure the tape would hold, and because it just seems a little scary and weird. But at this point, it's the only thing I can come up with that I haven't tried to make the more comfortable Nasal Cushion mask work for me, so it's worth a shot. Testing with the tape this morning, it seems to hold well, even with my facial hair. I'll report back tomorrow.
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#8
RE: Neck Pain with Full Face Headset
(04-22-2020, 09:47 PM)wdarner Wrote: The lower straps on the mask, which has 4 attachment points, presses against my neck muscle (sternocleidomastoid, to be specific), especially on the right side. I sleep on my side, mostly of the left side, so the pain is on the neck side that is up, not on the pillow. The pain has worsened a little each night, to the point now where it is almost too painful to sleep. I spent a lot of time this afternoon, adjusting the straps, trying to loosen the tension on the lower straps as much as possible to take pressure off the painful area, while maintaining a seal on the mask. I will report back tomorrow on if I have a better night with it tonight. I am hoping for any thoughts or advice on where I could go from here.

It seems all full face masks I have seen have this 4 point attachment style headset to anchor the mask properly, so I'm not sure changing masks would make a huge difference; still, I know the Dreamwear Full Face is known to be finicky for many, difficult to seal, so maybe a better sealing mask would allow me to keep the straps looser without leaks. I have been tempted by the Resmed F30i, because I love the hose attachment at the top of the head.

So that's my story. I feel like I'm almost to a workable solution for both me and my wife. I just need to figure out a way to lower the neck pain. Thanks for any input or insight.

I have had a hard time with this same Dreamwear Full Face Strap attachment point below the skull pain and headache. It was suggested to me to try a sponge between my neck and the strap which did alleviate the problem within a few nights. The standard sponge is a good fit and allows for some above and below so the bottom straps have something to press down on in addition to the neck being cushioned. You will need to readjust top and bottom straps to compensate for the added bulk but it does have some give and I still get a decent mask seal. When the sponge gets dry you can wet it and squeeze out the excess water. I haven't had the pain in a couple weeks and this has allowed me to seek a better solution. Next I'll be looking at 1/4" inch gel padding similar to what you may find in shoes for a material that doesn't lose its shape like the plain old sponge does.
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#9
RE: Neck Pain with Full Face Headset
Totally sympathize.

I love the DreamWear FFM, the headgear is stronger and less stretchy than the Resmed F30i, which is my next most successful mask.

I have almost zero leak with the DreamWear mask. If you are getting progressively sore neck muscles could this be a repetitive stress type injury, do you think? The Dreamwear mask seals better than the Resmed F30i because of the harder plastic bits inside, the only reason I mention this is that after a week or so I notice some pressure points around my nose area and then swap back the Resmed F30i for a while. I also swap between the different cushion sizes, I find that avoids pressure points building up.

I often wake with sore neck muscles below the occiput just about where the lower straps meet the rest of the headgear but in my case I think that is just positional, with my neck turned opposite to the direction of my body.

Unfortunately with my skinny neck the soft cervical collar overlaps at the base of the skull, also contributing to some pressure against the pillow: time to take the scissors to the neck collar...

I also notice that when side sleeping I think I subconsciously sort of hold my head up so the full weight does not rest on the pillow: could that contribute your own sternocleidomastoid muscle pain? You mentioned you sleep mostly left side down and the right is more sore than the left?

I must say I like the idea of inserting some foam or memory foam. Or maybe fashioning some sort of wrap around sleeve to that area?

Not giving you a solution to your problem I am afraid, just throwing around some ideas, and letting you know you are not alone and many of us have to resort to some sort of DIY fixes.

Best of luck with the mouth taping, would love to hear how you get on with that!
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#10
RE: Neck Pain with Full Face Headset
I have used the Dreamwear, Resmed F30 & the newer Resmed F30i and if you like the Dreamwear with the hoses carrying the air up both sides you may like the improved Resmed F30i. The problem I had was like the Dreamwear, because I also was a side sleeper and my head would block the air tubes going up the side and that made the other side noisier. I went back to the Resmed F30 as it hade regular straps. One of the problems with both the F30 and the F30i is the cushion only comes in small and medium cushions and although I wouldn't say I had a big head (my wife might not agree) when I toss and turn the cushion slips  up the over my lower lip presenting noise and leaks. The cushion on the F30i is improved from the F30.

My best advice to you is to make certain if you try the Resmed F30's make certain they can be exchanged, as I have spent a small fortune trying to find the best mask for me. I now have a DME that actually focuses on customer service, and they work very well on exchanges.
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