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Question on masks that will handle higher pressures like 27
#1
I have recently had to switch from an APAP with settings of 20/10 to a BiPAP with settings of 27/21 (as originally prescribed). I couldn't tolerate the baseline pressure of 21 and have reduced it to 17 with consultation with my doc. At 21 it was filling me with air to the point of waking up in pain with a very distended gut. I am using a Fisher & Paykel Simplus mask. The cushion is so soft that I have had it "blow out" and begin leaking to the point that I had to take it off and start all over again. Does anyone have any experience with any masks that you can recommend which will help me tolerate the higher pressures without "blowing out"? Any recommendations would be most appreciated.
Thank you!
Nanook683
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#2
Welcome

That's going to be tough one. There are several people who run around 20 cm-H2O -- but, 27 is the highest pressure I've seen on the forum.
By design, the sealing surface of the mask is soft and flexible as it is supposed to float on the face. There is usually a stiffer layer behind it to give it form.

First make sure your face is free of oil; and the mask seal is clean. That helps it "stick."

You might try the ResMed Mirage Quattro. I find the forehead brace and micrometer adjustment of the contact at the nasal bridge to be helpful; bit, I am still not near your pressure.

Let's see if some others have some ideas.
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
I am more than 10 below your pressure but I am also a Simplus user. I have found that the Simplus works great worn loosely at lower pressures. At higher pressures, I had to really tighten down the straps, top as well as the usual bottom) to prevent the sides from blowing out. I am not sure that it can be tightened enough to handle your pressure. The other thing is that I have oily skin and often need to get up about 4AM and wash my face with soap again and wipe off the mask for it to seal properly.
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#4
I have been told that there are people using the PR Fitlife mask at a pressure of 40 cm/H2O.
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#5
Yes, I was going to recommend the FitLife. It can handle the higher pressures. My Simplus and Nuance can handle my pressures of up to 20 although I have to use liners with the Simplus. The Nuance does much better. Not sure how it would do at 27, though.

As far as the bloating goes, no mask is going to help with that. Try raising the head of your bed. Either put something under the feet of the headboard, something under the mattress, or something under your pillow. You need to raise yourself up to assist gravity in keeping the air out of there and getting it back out.
PaulaO2
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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.




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#6
Plus one for Fitlife. I think.a Simplus would also if you tighten it down.

Dreamwear was designed to handle 30 cm.
Being a nasal cushion the more pressure there is the tighter it seals.
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#7
(08-23-2016, 09:52 AM)nanook683 Wrote: Does anyone have any experience with any masks that you can recommend which will help me tolerate the higher pressures without "blowing out"? Any recommendations would be most appreciated.
Thank you!
Nanook683

I'm at 20 / 12; My Dr specifically switched me from what I had been using (ResMed P 10's) to Phillips Respironiscs DreamWear under the nose nasal mask.

My sleep tech explained to me he was in on the "beta" test of the mask, and it was shared with him that mask had been designed to handle up to 30 cmH20.

I do know the mask Ive been switched to seems to easily handle the 20 cmH2O as long as I don't do stupid things in my sleep.... as I tend to do.

I've started using an astringent on my upper lip and my nose as well as the actual mask after washing it and it seems to help it "adhere" to my skin better...

I'm still experimenting to see what's going to work best.. but this mask seems to be meeting my needs for the most part.

Not an ad, not an endorsement, just my personal experience.

Good luck
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#8
I'd also suggest trying the Respironics FitLife mask. I've been using it for three plus years now and still like it. My pressure gets up to 19 point something now and then. I see that it's described as being made for CPAP and BiPap applications (e.g. higher pressures). The sealing surface is nice and flexible like FFMs, but its construction as well as the face plate is super durable. Earlier, I had a leaking across the forehead problem. So, I tried a suggestion from a board member and began placing a pencil-sized bead of silicone (made from silicone ear plugs) across the top sealing surface of the mask which did stop that leak problem. Recently, I tried using the mask straight, without the added piece of silicone and to my surprise, no leaking at the top or anywhere. I don't know if my face/forehead shape changed or why, but now I just put it on. I'd suggest trying the "large" size of the three sizes offered.
David
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#9
Hi nanook683,
WELCOME! to the forum.!
Good luck to you as you continue your CPAP therapy and finding a mask that will work for you at higher pressure.
trish6hundred
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#10
My pressure is only 17, but I find leaks difficult with some masks even at that pressure. Currently, I'm going back and forth between the Airfit F10 and Amara View full face masks. The View seems to seal better (once you've played around with it a bit to get a good seal), but I've noticed my AHI seems to average a bit higher with it (in the 2 range, so still not bad). The Airfit seems to seal fairly well as long as the cushion isn't too old.

My recommendation is like one of the other posters. Wash your face to remove oils before going to bed. This not only helps seal better, but increases the longevity of the cushion since your skin's oils aren't breaking it down.

Secondly, higher pressures require frequent cushion replacement. I find I need a new one at least every 30 days or I get leaks. Forget about trying to get extra life out of them. I even sometimes buy one before that (which is painful because insurance won't cover it).

And, despite what your DME says, the cushion can't just "float on your face" when you're at a higher pressure. You've got to tie it down.
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