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the mask saga continues
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worn_out_in_lebanon Offline

Advisory Members

Posts: 270
Joined: Jan 2015

Machine: Resmed A10 Autoset
Mask Type: Full face mask
Mask Make & Model: F20 (newest Resmed ffm)
Humidifier: Included, ClimateLine tubing
CPAP Pressure: 13-15, EPR:0
CPAP Software: SleepyHead

Other Comments: I.T. Project Manager. Started CPAP therapy March 16, 2015. Untreated AHI 39.

Sex: Male
Location: TN

Post: #1
the mask saga continues
I started with a Resmed Quattro Air when I ordered all my stuff at one time online. After the first 3 nights it was obvious that mask wasn't going to work - killed the bridge of my nose and still leaked a lot. Later I trimmed a little of the inner silicone seal, at the top of the nose and that helped with the pain, but still didn't seal well.

So I ordered an Airfit P10 pillow. It arrived one week into the journey. And it worked great. For 3 weeks. Then I started mouth leaking. Not that my mouth was coming open. The air was just getting out anyway. Coming out of the corner. And making the back of my throat sore where the air was jetting past.

I ordered two more masks. A RespCare hybrid (mouth mask with nasal pillows on top). And a really comfortable looking foam seal Forma. I never did get the Forma to seal well, unless I tightened it really really tight. I didn't think this was okay to sleep with on a nightly basis.

The hybrid worked okay though. For a day or two. There was this really annoying chin flap on the bottom, which is supposed to take the place of a chin strap. A nice idea on paper I'm sure, but in practice it just pulled the mask down too low on my face, making the pillows not seal, and putting the top of the mask along my teeth instead of my gums. It came with medium and large cushions. I was using the large, so I experimented with the medium. I cut the chin flap off. It worked. So I cut the chin flap off the large. It worked even better.

I got bold after that and cut _all_ of the silicone inner seal out of the first mask - the Quattro Air. That exercise ruined that mask for good...

Went back to the hybrid. It was leaking. The left pillow kept loosing the seal. And I kept getting leaks in the two bottom left corners. Tightened it more than I thought I should, and it finally quit leaking in the corners. But the pillows were still leaking, later in the night. And the pressure (not the air but the mask itself) would push my chin back further during the night, changing the seal and making the jaw joint feel a little painful.

Now I'm getting desperate. It's been six weeks, and all I've done is trade out obstructive sleep apnea for leak sleep apnea. I'm still waking up probably dozens of times a night with leaks.

So I ordered two more masks last Friday -- with Saturday delivery. (this time I at least got return insurance) A blue ComfortGel and a cloth two piece Sleepweaver Anew. The ComfortGel sure looked and felt like it would work. But it never sealed in the two bottom corners. Loose and it wouldn't seal, tight and the corners would crinkle.

The cloth mask felt great - at low pressure. But it had a fatal flaw. In profile, I don't have a flat face, I have a round face. I need the bottom part of the mask to rotate in, to get a good seal. With two sets of straps, it looks like you can independently tighten the top and bottom. But... the bottom strap is attached to the mask with a wide plastic bit, that spreads the force across both the bottom _and_ the top half of the mask. When you tighten the bottom strap to seal bottom corner leaks, it mainly just pulls the dividing strip between the two mask halves harder against your upper gum. So both the new masks are going back...

I have to do something in the meantime. So back to the hybrid. And last night I finally figured out why the straps weren't evenly adjusted... My nose is a little off center (at the bottom, but not the top, which means besides the offset at the bottom, there is also a tilt from top to bottom). Since you insert the pillows first, the mouth mask is off center too (it's all connected and follows the tilt). With this new found info, I stopped trying to recenter the mouth mask (which had been pulling one pillow out...). I also just started adjusting the straps to what felt even, instead of trying to match strap lengths.

But it still leaks some. Especially if I try to lay on my side. And the exhaust vent is noisy. Especially if the elbow rotates up (which it tends to do with a Hose Buddy at the head of the bed). When the elbow gets in the exhaust stream, it's really loud.

So I figure I'll go back and try the P10 pillow again - maybe my mouth leak was temporary. But even more desperate because my sleep quality is going way down, and my sleep deficit is growing every day, so I can't take any chances. Next weapon in the arsenal - tape. Surgical tape. Two and a half inches wide, four inches long. Tested this at lunch time yesterday. It seals pretty dang good. So last night this is Plan A. (plan B is the hybrid again) Just for a test.

And it worked great for the first 3 hours. Then guess what - it starts leaking too! Yes, I am mouth leaking while sealed up with surgical tape. The air is escaping from one corner of my mouth, and getting out under the end of the tape. Looking at my Sleepyhead stats this morning, I dealt with that leak for another 3 hours before I finally gave up. So six hours on the P10, half good and half leaking.

Then two hours on the hybrid, but got tired of sleeping on my back and wanted on my side but it kept leaking. So I did what I haven't done ever - I just turned the thing off and slept with no mask and no cpap. For another two hours. I was waking up with obstructions the second hour...

I remembered I bought a Sleep Gasket sometime during all this. So tonight I'm going to try the Forma again (the foam seal full face mask) with the sleep gasket, and see if I can get a seal without having to overighten the straps.

I'm realizing the problems (with a mask) are probably from my round profile and a "not square" chin/jawline. I need to be able to get a seal at the bottom of a mask, but tightening up the straps enough to seal at the bottom means I'm too tight everywhere else. A two part mask or hybrid would solve this, but the cloth two-part was defeated by the strap attachment. So I'm going to concentrate on making the hybrid work.

I may also give the Resmed hybrid a try. It has the dual wall pillows like their P10. (my current hybrid is a single wall and is easier to leak). It also has a quieter mesh vent. (my current hybrid has a noisy row of holes). But it costs double the other masks. And this mask saga is getting expensive. I _have_ to be able to sleep though.


Sorry for the length of this novel/rant/mask comparison. Smile
04-30-2015 09:59 AM
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accumack Offline

Members

Posts: 9
Joined: Apr 2015

Machine: Resmed airsense 10
Mask Type: Full face mask
Mask Make & Model: resmed mirage medium shallow
Humidifier: resmed
CPAP Pressure: 4-20
CPAP Software: SleepyHead

Other Comments: I just got my new airsense 10 yesterday and love it compared to my resumed s8

Sex: Male
Location: Temecula, California

Post: #2
RE: the mask saga continues
I have been using my current style of mask for 9 years and haven't found anything that works as well. I use a resmed ultra mirage FFM medium shallow I have a high bridge on my nose and a gotee and get a great seal. On the bridge of my nose I use cloth tape from the pharmacy to prevent the cushion from digging in at first I used a small bandage but the tape is cheaper and works fine.
04-30-2015 11:28 AM
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truetopath Offline

Preferred Members-2

Posts: 421
Joined: Feb 2015

Machine: PR system one 560p auto with a flex
Mask Type: Full face mask
Mask Make & Model: Resumed F10
Humidifier: PR system one
CPAP Pressure: 11
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Lake View, NY

Post: #3
RE: the mask saga continues
I pretty much mouth leak constantly with any nasal pillows, but never with a nasal mask. I know I'm weird. Right now my go to combo is the p10 with the ruby chin strap. Not a mouth leak to be found. I also have a round face, so I get what you're going through. Best of luck to you!
04-30-2015 04:24 PM
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DariaVader Offline
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Monitors

Posts: 1,820
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #4
RE: the mask saga continues
u must master the tongue seal.... pretend you have peanut butter on the roof of your mouth Big Grin and then go back to the P-10... as RG says, resistance is futile Bigwink

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
04-30-2015 04:46 PM
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AirSign Offline

Preferred Members

Posts: 85
Joined: Mar 2015

Machine: ResMed Airsense A10 for her
Mask Type: Nasal pillows
Mask Make & Model: Nuance / Airfit P10
Humidifier: Airsense A10
CPAP Pressure: 9-16, average under 14
CPAP Software: SleepyHead

Other Comments: Seasons here: Wintah, Mud, Road Repair, Wintah

Sex: Female
Location: Road Repair Season, New England

Post: #5
RE: the mask saga continues
Disappointed with my P10 resulting in high leaks, which seems to be keeping my AHI close to 8. One problem is that the pillow assembly rests on my upper lip, and this seems to pull it away from a good seal. Even with water soluble lubricant.
Have tried putting rolled up kleenex under it there, but of course it falls out during sleep. Will try using sports tape tonight to see if that stays in place.
Don't want to go back to FX because those pillows made my nose sore, even bleeding.
Side sleeping, including frequent turning, seems to be disturbing the pillow seal also.
Also using the same chin strap as always, for several years now. The white stretchy one, which has stopped the dry mouth problem.

Any further suggestions from the P10 club?
04-30-2015 05:08 PM
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worn_out_in_lebanon Offline

Advisory Members

Posts: 270
Joined: Jan 2015

Machine: Resmed A10 Autoset
Mask Type: Full face mask
Mask Make & Model: F20 (newest Resmed ffm)
Humidifier: Included, ClimateLine tubing
CPAP Pressure: 13-15, EPR:0
CPAP Software: SleepyHead

Other Comments: I.T. Project Manager. Started CPAP therapy March 16, 2015. Untreated AHI 39.

Sex: Male
Location: TN

Post: #6
RE: the mask saga continues
(04-30-2015 04:46 PM)DariaVader Wrote:  u must master the tongue seal.... pretend you have peanut butter on the roof of your mouth Big Grin and then go back to the P-10... as RG says, resistance is futile Bigwink

I have definitely tried.

Actually it worked for a couple of weeks, but then it quit working and I can't seem to get it back. I will continue to try again from time to time, because when it works, it's great.

It will hold for a few hours, but then it starts breaking loose. It wakes me up, I move my tongue maybe a millimeter and it holds again, 5-10 minutes later it breaks the seal again, and then I'm like this the rest of the night, waking up every few minutes. It's like before cpap, except my heart isn't pounding....

I need to check my leak rates for the times I thought it was working. It may have been leaking a bunch even then but just not waking me up. I know I have big leak rates now, 30-50, and almost continuously, for hours at a time, when it starts leaking. I get one or two good hours in the beginning, but the rest of the night is leaking and waking.
04-30-2015 05:11 PM
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worn_out_in_lebanon Offline

Advisory Members

Posts: 270
Joined: Jan 2015

Machine: Resmed A10 Autoset
Mask Type: Full face mask
Mask Make & Model: F20 (newest Resmed ffm)
Humidifier: Included, ClimateLine tubing
CPAP Pressure: 13-15, EPR:0
CPAP Software: SleepyHead

Other Comments: I.T. Project Manager. Started CPAP therapy March 16, 2015. Untreated AHI 39.

Sex: Male
Location: TN

Post: #7
RE: the mask saga continues
(04-30-2015 05:08 PM)AirSign Wrote:  One problem is that the pillow assembly rests on my upper lip, and this seems to pull it away from a good seal.

Any further suggestions from the P10 club?

Just curious, do you have an upturned nose, or more flat on the bottom? If it's upturned, you probably need the strap low in the back to line the pillows up. But if it's flat, you probably need the strap high on the back of your head. If I had to guess, based on your comment about the cushion resting on your lip, you may have the strap too low. (or a small nose without much room for the cushion)

I get the best seal when the strap is up high, pulling the pillow up in line with my nostril. This puts the pressure pretty much only against my nose and almost no pressure on my lip.
04-30-2015 05:16 PM
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DariaVader Offline
Apnea Board Facebook Editor
Monitors

Posts: 1,820
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #8
RE: the mask saga continues
what about a boil and bite? maybe even set it with lower jaw slightly forward. (or get a mouth piece made by a dentist) and attack apnea from a double strike vantage?

seems like a cheap boil and bite mouthguard would actually serve as a pretty good sealer. For the rest, since you have described a rounded or receded chin, this is exactly the circumstance that might benefit from the mouth appliances, although you might need both pap and the appliance.

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
04-30-2015 05:22 PM
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worn_out_in_lebanon Offline

Advisory Members

Posts: 270
Joined: Jan 2015

Machine: Resmed A10 Autoset
Mask Type: Full face mask
Mask Make & Model: F20 (newest Resmed ffm)
Humidifier: Included, ClimateLine tubing
CPAP Pressure: 13-15, EPR:0
CPAP Software: SleepyHead

Other Comments: I.T. Project Manager. Started CPAP therapy March 16, 2015. Untreated AHI 39.

Sex: Male
Location: TN

Post: #9
RE: the mask saga continues
(04-30-2015 05:22 PM)DariaVader Wrote:  what about a boil and bite? maybe even set it with lower jaw slightly forward. (or get a mouth piece made by a dentist) and attack apnea from a double strike vantage?

seems like a cheap boil and bite mouthguard would actually serve as a pretty good sealer. For the rest, since you have described a rounded or receded chin, this is exactly the circumstance that might benefit from the mouth appliances, although you might need both pap and the appliance.

Great point. I have a boil and bite sitting on the counter actually... Haven't had the motivation to set it up yet, and include it in the mix.

Plus I wear a dental retainer at night. Have been doing that for 30 years. If I go without it for more than a week or two, my top teeth start shifting again. After two or three weeks, I can barely get the retainer back on again.

If the appliance worked, and I started using it every night, then I'd have to decide what to do about the retainer... Unless the appliance would replace the function of the retainer.
04-30-2015 05:30 PM
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DariaVader Offline
Apnea Board Facebook Editor
Monitors

Posts: 1,820
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #10
RE: the mask saga continues
I would think you could effectively combine retainer and bite therapy and get a device that will also help your mouth seal - you might be best served to have a dentist make it, but its spendy, and rarely covered by insurance. on the other hand, "spendy" is still under 1k and quite possibly very worth it.

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
04-30-2015 05:35 PM
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