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Tightening mask question -- How tight?
#1
Tightening mask question -- How tight?
I am just curious -- what is the reason why people recommend a "looser" fit with masks to let them inflate?  The reason why I ask is that from the beginning, my DME has recommended I tighten it pretty well to make sure leaks don't happen.  And I've had good luck with this with the Amara View.  Too loose (letting the mask inflate)  would result in a lot of leaks when I moved around.

I don't have a ton of red marks when I wake up.  My AHI (as recorded by my machine) is anywhere from 0.5 -1.0.  And I think it's working well.

Is it "OK" that my mask is fairly tight?  Or is there a therapeutic reason to try to loosen it as much as I can?
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#2
RE: Tightening mask question -- How tight?
I don't see why not. If it's working well for you, then great!

From my personal experience, when I tighten the Amara View it causes my jaw to get pushed back when I sleep, and the hard plastic on the sides pushes in to my teeth. So I can imagine this could cause me jaw/teeth problems over time. But this could be just how the Amara View fits my face structure.
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#3
RE: Tightening mask question -- How tight?
It sounds like there's no problem with what your doing but you may find the mask primer interesting. http://www.apneaboard.com/wiki/index.php...ask_Primer
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Mask Primer
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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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#4
RE: Tightening mask question -- How tight?
Seems to me that each person would have to adjust the straps to the tension that works best for them. Glad you are having luck with the Amara View. No matter what I did I could not get the mask to stop leaking. I even tried a small cushion thinking that the medium was too big, even though medium is what the sizing guide indicated. Such a shame as I really liked having a more minimal mask like this one.
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#5
RE: Tightening mask question -- How tight?
Hi SimbaLion,
WELCOME! to the forum.!
Do what works best for you. I couldn’t get the Amara View to work because, no matter what I did, I had leaks around my eyes.
Good luck to you with CPAP therapy, hang in there for more responses to your post.
trish6hundred
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#6
RE: Tightening mask question -- How tight?
(05-07-2017, 12:42 PM)SimbaLion Wrote: I am just curious -- what is the reason why people recommend a "looser" fit with masks to let them inflate?  The reason why I ask is that from the beginning, my DME has recommended I tighten it pretty well to make sure leaks don't happen.  And I've had good luck with this with the Amara View.  Too loose (letting the mask inflate)  would result in a lot of leaks when I moved around.... 
Is it "OK" that my mask is fairly tight?  Or is there a therapeutic reason to try to loosen it as much as I can?

I recommend trying a "mask liner."  This is a donut-shaped piece of cloth which is is placed between the face and the mask.  The mask liners come in various sizes and materials.  I use RemZzz brand, but I am careful to avoid stretching out the material. Lately i have found that using two at a time helps reduce leaking even more (allowing looser straps) and helps each liner last longer.  I suppose making my own liners out of thicker cloth would likely be better for me, but I've never taken the time.

Although RemZzz recommends using a new liner every night, two liners worn as a pair will last me at least two weeks if I am very careful to not pull on or stretch out the liner(s).  A "30 day supply" will last me longer than 6 months. Also, The liners can be washed (in the washing machine, as long as they are placed in a mesh laundry bag to make sure they are not lost in the machine) and ironed, making them pretty much good as new again.

I suggest it is always best to do whatever we can to minimize how tight the straps need to be.  When the straps are too tight they tend to cut off blood circulation to the scalp, which may gradually lead to long term problems.

Also, full face masks (FFM), total face masks (TFM) and hybrid mask types all tend to pull back on the teeth and lower jaw, which not only may gradually result in crowded/crooked teeth but also (in some users) may aggravate Temporomandibular Joint (TMJ) problems which may become serious and result in constant pain and may require very expensive and even somewhat dangerous surgery, because TMJ surgery can cause paralysis in parts of our face.

Take care,
--- Vaughn
The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies.  Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#7
RE: Tightening mask question -- How tight?
Have you a research citation for that statement?
                                                                                                                          
Note: I'm an epidemiologist, not a medical provider. 
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#8
RE: Tightening mask question -- How tight?
(05-07-2017, 06:31 PM)Beej Wrote: Have you a research citation for that statement?

Hi Beej,

I haven't seen studies which catalog the various problems which may be caused by overly tight straps, but my pressures normally hover between 21 to 25 cmH2O every night, and I've experienced problems from having the straps too tight.

My comments were based on personal experience, comments from others posted on this forum throughout the years I've been a member, and general knowledge about TMJ surgery which was considered for my daughter but was decided against after researching the risks.

Take care,
--- Vaughn
The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies.  Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#9
RE: Tightening mask question -- How tight?
The first masks I was introduced to had a round seal. Think of it as a tube of forgoing around the mask. These were small medium and large and were considered to fit everybody. At the time I was an EMT and when these masks were used it was literally to save someone's life. The only way to deal them was to press them fairly hard onto a face.

Modern cpap masks seal differently. Look in the Mask Primer, put a pic of a modern mask seal in there.

The Mirage Activa is very good for activev sleepers and really needs a very loose fit. Try that mask. It was my mask of choice for years.
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#10
RE: Tightening mask question -- How tight?
(05-07-2017, 06:31 PM)Beej Wrote: Have you a research citation for that statement?

I got a manual for the P10 mask, and it says CPAP masks may cause TMJ problems.
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