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The war of the mask -- looking for advice from experienced warriors
#1
Following on from another discussion, I'm looking for advice on masks. First, I'll confess. [Stands up]. Hi everyone, my name is onsonby. And I'm a mask-ripper-offer-aholic. I'm just not good at being good at this stuff. Part of the problem is, even when I do wear the mask, I *feel* no better. In fact, I often feel worse. It's almost as if I'm faced with the following choice:

"Do you want to feel as if you slept OK (then don't wear the mask), or do you want to actually have slept OK (then wear the mask)? But pick only one."

That said, I'm not giving up. I accept I have to fix this. And I'm sure there's a way to get the "Pick only one" aspect of the above to be a thing of the past. So here are the relevant details.

I'm male, obese, light beard and moustache. Apnea is severe (AHI 80-90 or above). I have a slightly deviated septum, enough such that I often (but not always) mouth breathe. If not also congested in some other way, I can always create a clear nasal path in (usually) my left nostril by simply doing a very broad "smile" action action on the left side of my face. It is, of course, hard to maintain that while asleep!

I originally titrated with a nasal prong mask, but went for a nasal pillow for my first actual mask. However, the above septum problems were frequent enough that I found myself opening my mouth to breathe with the inevitable breaking of the air seal and me rediscovering my teenage ability to execute world class belches Cool.

I then tried a full face mask, and in fact it's the one I use now. However, it has two problems. The first is that it effectively eliminates any chance of me *ever* being able to nose breathe. The reason is that the mask pinches the top of my nose in *exactly* the spot to make it almost impossible for me to open my left nostril by grinning. The second problem is that mouth breathing almost always wakes me up with my mouth and throat dried to the point of choking.

I then switched to a hybrid, giving me mouth and nose breathing options but without constricting the bridge of my nose. But it just never worked, and I ripped it off regularly.

Finally I returned to my full face. What I've found is that with strategic strap use, I can get the mask and straps to maintain a leftward tension on my face and nose so that I can sometimes get my left nostril open, and that offers the best chance of a good night. The problem here is, the mask is then well off centre, and leaks open up around my eyes and on the now-poorly-positioned right side. I've tried a jel insert around the eye area, but it was worse than useless. Overall, clearly the mask and I are fighting each other. There must be a better way!

So, things I'm considering trying:
  1. a total face mask -- eyes and everything
  2. a custom built mask -- I've seen youtube stuff about a guy in Australia, partnering with some people in Dallas
  3. shaving off my beard of 20+ years (if it would help, but I actually don't think it's the problem)
  4. maybe even something in the septoplasty arena
Any thoughts?
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#2
I don't know about Resmed masks, but Respironics gel masks have a procedure in their manual whereby you can customize the mask by re-moulding the gel to fit your face. Basically it involves putting the gel part of the mask into boiling water, then dipping it briefly into cold water so you don't scald yourself but still have the gel soft and pliable. Then put the mask on and have the gel contour to your face.
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#3
(06-22-2013, 01:10 PM)RonWessels Wrote: I don't know about Resmed masks, but Respironics gel masks have a procedure in their manual whereby you can customize the mask by re-moulding the gel to fit your face. Basically it involves putting the gel part of the mask into boiling water, then dipping it briefly into cold water so you don't scald yourself but still have the gel soft and pliable. Then put the mask on and have the gel contour to your face.

I believe that most of the Respironics masks have been changed and don't offer that option anymore. In particular, the ComfortGel masks did that, but the newer ComfortGel Blue masks don't offer the boil and form options. The Blue version seems to fit better without the boiling step.

I don't think they still make the non-blue version, but some suppliers may still have stock of the non-blue cushions or masks.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#4
You sound like a full face mask candidate alright.
Bad news is you might need to shave the beard but you can keep the 'stache. Wink
For nose irritations get some of the small square bandiads and use them as chafe pads. You mask can still form a seal over those just fine.
The dry mouth-throat used to drive me bonkers. The only thing for that is more humidity and
try some Biotene mouth wash and/or Therabreath (mouth wetting mints).
First keep turning your humidity up till your dry mouth goes away.
If your humidifier is turned up full blast and you still have a dry mouth then you need a different humidifier.
Bad news here is that you may find (like me) that when the humidity is up high enough to fix the
dry mouth, you are going to feel like you are breathing warm steam.
You have to get used to high humidity and you'll get rid of the dry coughing fits and waking up with dry air passages.
I use the total face mask now and I hate it but it works great without leaking. I have to line the chin area with a paper towel because the mask gets full of water from condensate.
In conclusion: it's a mess but it does work and I can get some good rest with it but it took a lot of practice and
time to adapt to it all.

Cheers & good luck!


"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#5
(06-22-2013, 11:53 AM)onsonby Wrote: [*]a total face mask -- eyes and everything

Yeah, no. You REALLY don't want your eyes inside the mask. There's a good reason you've never seen a mask like this. A quick test: have someone gently blow on your eye while you are sleeping. If you don't immediately wake up, check to see if you are dead.


(06-22-2013, 11:53 AM)onsonby Wrote: [*]shaving off my beard of 20+ years (if it would help, but I actually don't think it's the problem)

Beards are terrible. Scientific fact. Even if it doesn't help with the mask, do this anyway. Smile


(06-22-2013, 11:53 AM)onsonby Wrote: [*]maybe even something in the septoplasty arena

I've considered this for my deviated septum (and also soft palate at the same time) but the surgery is reportedly incredibly painful (recovery-wise) and not guaranteed to do anything for you. I'm also slightly bitter because the "doctor" that set my broken nose in the first place is the clown that caused the DS. Hooray for medicine.

Good luck with your quest. I'd suggest a mask_strap to you that has helped me tremendously, but I'm pretty new and I'm sure someone would yell at me for pimping a product. I'll try to find a thread with someone talking about it.
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#6
I am a newby who had a war with masks to start with- not as many challenges as you have though. I went done the path of the chin strap and the cloth nasal mask- sleepweaver advance. The first night I wore it I slept over 8 hours straight where as I would usually rip off the mask after 4 hours. I needed to fiddle with leaks for a little while, mask tends to leak with pressures below 6 or 7, but now doing really well (AHI consistently less than 1). Considering the Sleepweaver Elan as I like to have the hose come from above my head, however have yet to order.

Good luck in your search for the mask that will work for you. [/php]
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#7
I am on my 4th full face mask...so far I can tell it's going to be no different than all the others.

(goatee & mustache here as well) tho I did trim the goatee shorter than I would like..seemed to help with high leak rate a bit...

masks tried so far
1:quattro
2: hybrid
3: flexfit 431
4: comfort gel (not comfort gel blue-dont know if the blue is better or not)

Sometimes when I first started bipap therapy with the masks 3 years ago..I would get claustrophobic and pull my mask off...as time went on..this lessened to the point I can't remember the last time I did it...so hang in there
I don't believe anything I hear and only half of what I see
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#8
quote: onsonby
"Yeah, no. You REALLY don't want your eyes inside the mask. There's a good reason you've never seen a mask like this. A quick test: have someone gently blow on your eye while you are sleeping. If you don't immediately wake up, check to see if you are dead. "



Actually the total face mask does not direct any airflow across the eyes.
It only comes into your snout when you inhale.
The real thing is that it is prone to fogging up.
I only use it because it works for me. I have issues with pressure building up behind my eyeballs causing a lot of irritation, swelling and blurring of vision.
(pressure from behind the eyeball causes it to shorten and throws things out of focus just like a camera) (eye is a biological camera in fact)
wearing a total mask keeps pressure equal behind AND in front of the eyeball.

So it's big & heavy, it fogs up, and it's stuffy...but I get relief from eye issues
AND lower CA events.

And that's the fair dinkum.

Big Grin
"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#9
(06-25-2013, 09:55 AM)Shastzi Wrote: Actually the total face mask does not direct any airflow across the eyes.

Learn something every day. I didn't know that even existed. I can only imagine the complications of anything but sleeping on your back with that one though...
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#10
(06-24-2013, 02:22 PM)APNEA_Sam Wrote:
(06-22-2013, 11:53 AM)onsonby Wrote: [*]a total face mask -- eyes and everything

Yeah, no. You REALLY don't want your eyes inside the mask. There's a good reason you've never seen a mask like this. A quick test: have someone gently blow on your eye while you are sleeping. If you don't immediately wake up, check to see if you are dead.

The total face mask can also a be lifesaver for those who have problems with air coming out of their nasolacrimal duct into their eye. Also, some people find it solves their problems with sealing or pressure on the nose.

I agree, it's probably way down on the list of things to try.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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