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Need mask help at 18 pressure
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Xrayrose Offline

Members

Posts: 6
Joined: Feb 2016

Machine: Resmed S9 Elkte
Mask Type: Nasal mask
Mask Make & Model: Respironics 1X
Humidifier: Unsure
CPAP Pressure: 18
CPAP Software: Not using software

Other Comments:

Sex: Female
Location:

Post: #1
Need mask help at 18 pressure
Hi, I'm new here but not to CPAP therapy. My pressure was bumped up to 18 - 2 years ago approx. I rotate between nose cone, hybrid with pillows, nose and mouth and now the oracle. I have to tape my mouth shut so I tried the oracle. I bought foam nose plugs and swimmers nose plugs - both types were launched across the room during my sleep. The nose/mouth mask leaks sooooo loudly I awake tired because the noise wakes me every few minutes. The full nose works the best but within a few uses I am forming super sores way up in my nasal cavity. I put the saline gel on my nostrils, and use saline spray prior to use. I have the heat which I am told also controls humidity all the way up yet my air to nose or mouth is intolerably dry. My teeth ache all day and are hot and cold sensitive from the dryness of the mouth mask. My DDS gave me some discs that stick to your teeth for patients with dry mouth but they dislodge and I'm afraid I'll choke on them. CPAP is crutial for my health, weight and happiness but I am at the point of giving up. I have no routine, every night I have to refit and hope I'll get a bit of rest. I'm hoping some smart person with a high pressure has resolved some of these issues and can offer some help and...how do I know the moist air is ever getting to me? I'm dry while still awake with it on for 5 mins? Any help at all is welcome.
02-07-2016 08:47 PM
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Ghost1958 Offline

Advisory Members

Posts: 957
Joined: Aug 2014

Machine: PRS1 Series Sixty Auto Aflex
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: PRS1 with Heated Hose
CPAP Pressure: 10.5 min 16 max
CPAP Software: SleepyHead EncoreBasic

Other Comments: Moderate to Severe SA Obstructive. Rapid O2 desat off the machine.

Sex: Male
Location: KY

Post: #2
RE: Need mask help at 18 pressure
Is recommend a Simplus ffm frim the sound of your troubles. It will handle high pressure and not tear up your nose.

Failing that go with a Fitlife total face.
02-07-2016 09:26 PM
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Terry Offline

Advisory Members

Posts: 553
Joined: May 2014

Machine: Philips Respironics RemStar Auto with A-Flex (560P)
Mask Type: Nasal pillows
Mask Make & Model: P/R Nuance & Pap Cap
Humidifier: Integrated
CPAP Pressure: Auto
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #3
RE: Need mask help at 18 pressure
As ghost said, you're going to need some flavor of Full Face Mask.

There are several different manufacturers and you might need to try a few before you get the right fit.

If you like nasal pillow masks, you can try the Resmed Mirage Liberty which has nasal pillows and a "mouth part" and will stop mouth leaks.

The only problem is (at least for me) is that it doesn't fit all that well and tends to leak. However if it fits you, it might work well.

I've had a more reliable seal with the Simplus, but when I can make it work, less dry mouth with the Liberty.
(This post was last modified: 02-07-2016 09:38 PM by Terry.)
02-07-2016 09:36 PM
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trish6hundred Offline

Advisory Members

Posts: 6,436
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #4
RE: Need mask help at 18 pressure
Hi Xrayrose,
WELCOME! to the forum.!
Masks are trial and error, you just have to keep trying ’till you find one thatworks for you, don’t give up.
Hang in there for more suggestions and much success to you as you continue your CPAP therapy.

trish6hundred
02-07-2016 10:10 PM
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Xrayrose Offline

Members

Posts: 6
Joined: Feb 2016

Machine: Resmed S9 Elkte
Mask Type: Nasal mask
Mask Make & Model: Respironics 1X
Humidifier: Unsure
CPAP Pressure: 18
CPAP Software: Not using software

Other Comments:

Sex: Female
Location:

Post: #5
RE: Need mask help at 18 pressure
(02-07-2016 10:10 PM)trish6hundred Wrote:  Hi Xrayrose,
WELCOME! to the forum.!
Masks are trial and error, you just have to keep trying ’till you find one thatworks for you, don’t give up.
Hang in there for more suggestions and much success to you as you continue your CPAP therapy.

Thank you all for pulling me out of my pity party. I will redouble my efforts to find the right fit. The docs and techs are so disconnected from the issues patients face it astounds me. I watch video demos of new masks and its a joke; they have it blowing at 5 and are sitting up - well of course it doesn't leak lol
02-07-2016 11:09 PM
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DeepBreathing Offline
Wiki Editor
Moderators

Posts: 2,295
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #6
RE: Need mask help at 18 pressure
Hi XrayRose, welcome to Apnea Board. I agree with Ghost that the Simplus is a good mask for high pressures. However, I also agree with Trish that getting the right mask is very much a matter of trying them out to find the one that's right for you.

Without knowing your background, could I suggest an alternative approach? A constant pressure of 18 is pretty high and almost certain to cause problems. Are you in a position to try an autoset machine? These tend to operate at a lower average pressure and only build up to the maximum in response to apneas etc. You might find that its a more comfortable and effective form of treatment than the Elite constant pressure machine. You can track your progress using SleepyHead software to work out optimal settings for yourself.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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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.
02-07-2016 11:42 PM
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cpdaniel Offline

Preferred Members

Posts: 61
Joined: Nov 2015

Machine: Resmed AirCurve 10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P SimPlus
Humidifier: Built-in
CPAP Pressure: IPAP: 9-17, PS: 4
CPAP Software: ResScan SleepyHead

Other Comments: Untreated AHI: 58. Undiagnosed years: 20+

Sex: Male
Location: Central California, USA

Post: #7
RE: Need mask help at 18 pressure
(02-07-2016 11:09 PM)Xrayrose Wrote:  Thank you all for pulling me out of my pity party. I will redouble my efforts to find the right fit. The docs and techs are so disconnected from the issues patients face it astounds me. I watch video demos of new masks and its a joke; they have it blowing at 5 and are sitting up - well of course it doesn't leak lol

Three thoughts:

1. I use the F&P Simplus - my pressure tops out at 19.6 and I'm able to keep the leaks well enough controlled with that mask.

2. According to a recent thread on this forum, the Airsense 10 line of machines from Resmed generates more humidity than the S9s do. That's what I'm using and I've never had an issue with dry mouth since I started using it (unlike PRS1 and S9 machines I had previously).

3. At that pressure, you might want to talk to your Dr. about a bi-level machine, like the Aircurve 10 VAuto. My Dr. let me do two in-home trials with borrowed machines - one an S9 APAP and the other a PRS1 BiPAP and choose whichever one was more comfortable - the bi-level was far more comfortable at the higher pressures - no question.
(This post was last modified: 02-07-2016 11:45 PM by cpdaniel.)
02-07-2016 11:43 PM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,065
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #8
RE: Need mask help at 18 pressure
My 95% goes between 18 and 20. I rotate between the Nuance nasal pillows and the Simplus. Both do rather well at the higher pressures. But then I am on an autoPAP, which I think is much better option for those of us who require such high pressures.

If you can afford it, look into getting an autoPAP on your own. You are using the S9 Elite so going to the S9 Autoset would be easy to do. You can use the Elite as a backup. You would only need the blower unit which really cuts down on costs! Check out Supplier #2 in the Supplier's List (link at top of every page). Even if you don't see a listing for one without the humidifier, contact them.

I can almost guarantee that with the autoPAP, a lot of your mask issues will be worked out. Or at least narrowed down.

And please, no more mouth taping. There are safer alternatives.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


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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.
02-08-2016 12:22 AM
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Xrayrose Offline

Members

Posts: 6
Joined: Feb 2016

Machine: Resmed S9 Elkte
Mask Type: Nasal mask
Mask Make & Model: Respironics 1X
Humidifier: Unsure
CPAP Pressure: 18
CPAP Software: Not using software

Other Comments:

Sex: Female
Location:

Post: #9
RE: Need mask help at 18 pressure
(02-07-2016 11:42 PM)DeepBreathing Wrote:  Hi XrayRose, welcome to Apnea Board. I agree with Ghost that the Simplus is a good mask for high pressures. However, I also agree with Trish that getting the right mask is very much a matter of trying them out to find the one that's right for you.

Without knowing your background, could I suggest an alternative approach? A constant pressure of 18 is pretty high and almost certain to cause problems. Are you in a position to try an autoset machine? These tend to operate at a lower average pressure and only build up to the maximum in response to apneas etc. You might find that its a more comfortable and effective form of treatment than the Elite constant pressure machine. You can track your progress using SleepyHead software to work out optimal settings for yourself.

Thank you - that's sounds like a viable alternative. I believe all my issues started when the pressure was turned up - having it vary during the night sounds like a better alternative.

I'll work on getting an order for a new machine.

I appreciate your input
02-08-2016 03:40 AM
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Dawei Offline

Preferred Members-2

Posts: 342
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Other
Mask Make & Model: Respironics "FitLife"
Humidifier: H5i
CPAP Pressure: 10-20
CPAP Software: ResScan SleepyHead

Other Comments: Began CPAP in 2006; spent the first 6 years with a "brick"

Sex: Male
Location: Western North Carolina

Post: #10
RE: Need mask help at 18 pressure
Rose, if you find out with an APAP that you really need higher pressure to keep your AHI under control, you may find the answer in a FitLife total face mask, as mentioned by an earlier poster in this thread. I've been using one for at least a couple years now. I first tried it after a FFM's nose bridge damage was too much to continue. Contrary to what some folks believe, the FitLife isn't at all claustrophobic. Matter of fact, it provides full range of vision (unlike a FFM). To keep it well sealed on my face, I've been using a bead of silicone (ear plug silicone) on the sealing surface of the mask, a tip I learned about here on the forum. My pressure varies from about 17 up to 19, and my leakage rate is usually under good control. There are nights when it will spike higher than desired, but these are quite brief periods, since the green smiley face on the machine greets me in the a.m.

David
02-08-2016 04:56 PM
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