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mask and TMJ
#1
Hi Everyone!

I've been using a CPAP for about a year and a half now. I'm still struggling. Most nights I average 3 or 4 hours with the mask on. Some nights I manage 5 or 6 hours and some only 2 or 3. I was shocked that my dr was happy with my numbers, so I keep struggling on.

I'm currently using the F&P Eson nasal mask, but have developed jaw problems. I've had TMJ disorder problems as far back as I can remember, so chose a nasal mask over a full face mask in attempt to not put pressure on my lower jaw. However, although this is a nasal mask, the straps come right across my jaw joint, below my ears. I'm a side sleeper, so I have to tighten the mask pretty tight to keep a good seal. When I tighten them up, I think it's putting significant pressure on my jaw joint.

The last week, I haven't been able to open my mouth more than 2 fingers wide and have been in constant pain. I saw a dentist who specializes in TMJ, and my jaw is so messed up right now with muscle spasm and locked that we're working on relaxing it with hot compresses, massage, nsaids and muscle relaxers, and a soft food only diet. I go back in 2 weeks and hopefully it will be improved enough that we can get impressions for either a bite plate or a sleep apnea mouth piece. My sleep specialist thinks my sleep apnea is too severe for a mouth device to help (50 events per hour), but I'm thinking if it could even help lower my pressure some, then I might not need to tighten the straps so much.

Anyway, my question is for mask recommendations that will hold a seal for a side sleeper without putting any pressure on my jaw. I've tried the Air Fit P10 nasal pillows, but couldn't keep a good seal and woke up feeling horrible every time I used it, even when I wore it the whole night, so that one is out.
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#2
Well, I was going to recommend the P10 because of it's simplistic or minimal strap design because of your TMJ, but see you have tried it.  Perhaps you didn't give it enough time.

Also, no mask should be tightened down so much as to cause discomfort or pain.  

May I suggest you start looking at photos of different masks and visualize where the straps would hit your face and jaw.  The Dreamware may be an option.  Good luck in your search.
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#3
Two other possible mask solutions are the Rio or Brevida. Unlike the P10, both have adjustable straps. And yes, do not over tighten.
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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. 
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#4
I am an active, side-sleeping Eson user.  It sounds like you have the straps waaaay too tight.  That actually makes it harder to stop leaks. They need to be justly slightly tighter than what is needed to keep it falling off of you face.  My straps slide all over my face at night and my leak level is very low.  The mask should inflate and seal the edges to your face from the inside.  If you have it too tight, it can't inflate.  

Keep the top straps very loose, you should be able to put a finger between the plastic piece and your forehead.  The just adjust the bottom straps to keep the mask from lifting off of your face.  Do this lying down and with your machine at maximum pressure.  Adjust it in very small steps, like 1/8" on each side at a time.

If you are not already, you should start sleeping on the edge of the pillow with the mask touching the pillow as little as possible. A buckwheat pillow makes this very easy.
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#5
I love the Dreamwear. I'm cautious about my jaw, as it is sensitive to getting messed up (due to having had braces, etc). The Dreamwear doesn't mess with my jaw at all.

I've had jaw trouble with the 1 FFM I've tried (Amara View). I actually decently like the Amara View, except it pushes my lower jaw back and presses in on my mouth/teeth area. Someone else on this board mentioned he has similar jaw issues with FFMs, so that reassured me that I'm doing the right thing sticking with the Dreamwear that works well for me.

P.S. If you do try the Dreamwear, I'd encourage you to try the various sizes... and likely size down from how you measure on their template thingy. I measure as a Large or Medium Wide cushion, but those both leak on me when I roll to my side; the Medium cushion fits me well, and doesn't shift when I roll or nudge against my pillow.
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#6
The Airfit F20 has slightly firm arms which curve around the face to the mask. They don't seem to dig into my face. I'm wondering if that might help - sort of a bracing effect around the jaw, so there aren't point pressures.
                                                                                                                                                                                  
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