Mask selection issues

[Szeth]

Been doing this for 6 months and, while I came into it optimistic, I'm so very much at the end of my rope for various reasons. Recently I've been having issues just getting myself to bed on time simply because I'm just tried of dealing with all of the issues.

One of the many issues I'd like some more targeted advice for is mask. When I first started I was given a full face mask. That was apparently a huge non starter for my brain. That was the worst week of my compliance statistics. 1-2 hours a night before having to tear it off. Have to itch something on my face? Stop machine, take off mask, itch, reseal, etc. Side/stomach sleeper and the mask was also jostling. One night I took melatonin to try and get over the hump and get used to it. I didn't remember waking up, but in the morning I saw the mask was off. Turns out I had ripped the mask off, without undoing the strap buckles. Mask was busted. Provider gave me a free  P10 that day.

P10 seemed promising. First week were or two fine. Then downhill. Sores in one nostril. I'd wake up and it felt like the nasal pillow was fusing to my skin. On and off I'd get these sores and then they'd heal and randomly wouldn't occur for a bit. I was using large pillow size. Reading around it seems some people have to deliberately stretch the headband so it isn't so tight, and then I decided the p10 wasn't for me. With everything else I had to deal with at that point, and my mood slowly but surely going from optimistic to defeated, last thing I wanted to deal with is figuring out the right amount to manually stretch a head strap.

I had other P10 issues that drove me away. Tube tangling for one. Hose buddy would have needed to be directly behind me to prevent this (stomach/side sleeper than rolls one way and another) plus no box spring or good mount mechanism for it. Also, side and stomach sleeping was still not ideal. The pillows would get moved around by the pillow.

I then got the N30i because it seemed to hit everything I needed. Tube mount on top of head with swivel, the nasal pillows seemed foolproof to seat and comfortable, and i always hated how the p10 would rest awkwardly above my lip.  Again things were good for 2-3 weeks and then...not

As I'm sure many of you are aware, the exhaust vent on the n30i is powerful and obnoxious. I need to make sure enough space in front of the vents is clear so it doesn't make noise hitting anything, and the top vent can't be close to a pillow or the wall for similar reasons. While my tangling problem is nearly gone, the tube does get caught on pillows or the corner of my bed. A ball shoved between the wall and bed corner seems to have solved that for now. The bottom exhaust vent though requires precise positioning which is maddening

Further I feel like I have to keep the straps a little on the tight side. Too loose and when my face hits the pillow it moves the mask and either causes a leak or the sensation of one. And my head has to now face a certain angle to keep the vent from becoming an issue again.

All this venting (pun very much intended) to say that I'm feeling pretty trapped by available masks. Ironic that my life would be easier if I wasn't a side and stomach sleeper. Too bad that didn't prevent me from needing this device. 

I cannot, and I truly mean cannot, do a full face mask. No amount of fiddling will get me comfy in one with my short beard and other brain induced issues. I'm open to other masks, or ways to solve the n30i  issues. I just need a mask that works with my sleep position and doesn't require a ton of work at night. It seems no mask is very good at staying put and comfy for a side and stomach sleeper.

I gotta solve this mask issue soon or I'm going to give up at the end of this year. I'm not really better off right now with the machine. I've stuck through it, my compliance rate over the last 5 moths is practically 100%. Only night I remember not wearing it was an overnight flight in economy (I don't sleep on planes anyways). Even when I had gnarly skin blisters from the P10 for 2 weeks I sucked it up every night. But I can't live like that 

Appreciate help. I cannot post Oscar charts for a week or so. Building up a consistent catalogue of them. My diagnosed AHI was 19. I have plenty of other issues to bemoan but I need to tackle one issue at a time and space it out for sanity's sake ( yours and mine )

Thanks

[Ockrocket]

I am a side sleeper. 

Mask is an Eson nose mask, I have a spare new Eson 2 in the wardrobe ready for when the current one reaches the end of its usable life.

My pillow is a "custom made" flat firm piece of foam cut specifically to fit in my suitcase for when I travel, by not letting my head sink in to the pillow it rarely dislodges the mask from my face.

I have recently started using a rubber band to thread the hose through to keep it above my head, previously I would wake up every time I rolled over to relocate the hose instead of only slightly stirring as I roll. (pain in shoulders, neck and back mean I toss and turn a hell of a lot) This has made my sleep less disturbed during the night.

The hose also arcs up to the bed head and then back down to where my DreamStation is located under the edge of the bed. (the DreamStation has an auto on/off feature, very handy)

It has taken me quite a long time to get it sorted, one step at a time with improvements along the way. 

The white "chin strap" is actually a tennis headband I'm trying as I seem to have started opening my mouth during sleep, this may be attributable to the fact I bumped my pressure up to 8 a little while back.. I had previously trained myself to not let air escape through my mouth even though I'm only using a nose mask. (sorry for the wrong way around photo) 

Only use mild soap to wash your mask, don't use any alcohol wipes or wash, make sure you rinse it thoroughly with clean water after washing it. 
I was originally washing mine in Dettol and using antibacterial alcohol wipes.. burned, stung, left red marks, and annoyed me like a b*tch.

Keep at it, the answers are out there.

[Dormeo]

Couple of questions. About the hose buddy: what is underneath your mattress? What kind of pillow(s) under your head do you use? Have you ever tried Lansinoh for nasal soreness? (It is made for nursing mothers who experience sore nipples, so it is in the baby section of the drug store.) A lot of people, including me, find it very helpful. And if you use a TINY bit before you put a nasal pillow mask on, it has a slightly adhesive effect.

[Szeth]

Thanks for the replies, glad I didn't scare anyone off with my big brain dump. Been rolling this around in my head for 2 months now

My mattress is a foam mattress so nothing under it but a metal frame. Frame has metal "slats" I guess but nothing that I think the hose buddy could really hook onto. Feels great for me and my spouse to sleep on, and it's apparently naturally "resistant" so to speak to dust mites. Pillow is also a foam pillow.

I haven't used lansinoh yet. I had read about it during my final two weeks of pain with the p10, but ultimately it seemed the internet had me believing the issue was mainly the strap being too tight. I'll see about getting some lansinoh and try it out.

Gotta say when I read your (ockrocket) description of the rubber method I figured I'd probably not like it. But seeing the picture it's quite elegant in a diy way that I can get behind. I'll see if I can rig that up for a try. I don't have a headboard, we never really saw the point. Spouse might get one eventually but no current plans.

I've been using wipes provided by the store I got my last mask from to clean it semi-regularly (every other day or so). 


I spend probably 45 min every night the last 2 months or so just getting comfortable to fall asleep. Thanks for your advice, hopefully something here helps me. I've been running on just above E for most of the last two months.

[Dormeo]

You could almost certainly sandwich the base of a Hose Buddy between your mattress and your metal frame. There's a triangle-shaped, flat piece that slides in there; you'll see what I mean if you look at a picture.

And for what it's worth, when I travel I use the Arden collapsible hose stand. I slip it between the mattress and whatever is below it, placing it at the side of my pillow rather than the top. It kind of leans over some, and it's somewhat flexible. It does a surprisingly good job of suspending the hose while still giving me room to roam.

There's a velcro loop on the top-of-head strap on my Aloha mask, but it doesn't do diddly to keep the hose in place. I use paper medical tape to keep the short hose fixed where I want it to be. It's an interesting substance: sticky, but easy to remove cleanly. Also cheap! But the rubber band idea looks great.

[Ockrocket]

The rubber band I use is compliments of Australia Post, they are the ones the posties use around bundles of letters.. I managed to buy a bag of 1000 from a post office about 3 years ago. 

It is threaded through the plastic piece the two top head straps loop through, and then back through itself so it has an eye loop for the hose to pass through on the top of my head.
The rubber band has the stretch to not snag or cut the hose if I roll over awkwardly.

[MitchS]

If the HoseBuddy doesn't work, there are hose hangers that attach to the wall with Command hooks. They have retractable reels. The cord hooks to your hose and the reel suspends the hose above your head.

Sore nostrils can be caused by too small a nasal cushion. Most people do best with a larger cushion than the sizing charts indicate. Lansinoh is great to use for sore nostrils. It only needs to be applied to the affected areas. The least amount you can get on your finger will treat both nostrils, so a tube of Lansinoh will last a very long time. 

Best of luck with getting your issues resolved. It can be hard to get everything working with CPAP treatment, but it is worth the effort in the long run. 

Regards,
Mitch

[RMSko]

I'm using the DreamWear nasal mask and I really like it a lot. It's soft (gel) and also has the tubing connected at the top. It's the least obtrusive mask I'm aware of and for me I'm always getting either a 100% or 99% mask fit, i.e., virtually no leakage.

Although you don't want a full face mask, the interesting thing about the DreamWear line is that you can freely substitute their three cushions (nasal, nasal pillow and full face) all with using the same frame. The DreamWear Full Face mask is also much less obtrusive than other full face masks so you could give it a shot and see how that goes, but you would really only need to do that if you are a mouth breather.

[RMSko]

One word of caution. I have been using the DreamWear nasal mask and switched to the full face mask and the switch led to disastrous results. My AHI with the nasal mask was around 6 and had a 100% mask fit and when I used the full face mask it shot up to an AHI of 45 and my mask fit was only 48%. I'm sure a lot of the problem was the mask fit, but the bottom line is that sometimes a nasal mask is the best option and a full face mask can actually make the situation worse.

[booksfan]

Have you looked at the Bleep? It is very comfortable as it attaches to the OUTside of the nostrils with adhesive and has no headgear. I, too, was unable to use the P10 because of soreness (and the headgear), even though my husband swears it is the best mask ever. But the Bleep works really well for me. I do use a hose buddy to route it, but you could attach something to the wall. I am a restless stomach/side sleeper, so the system I use really helps with my tossing and turning.

Good luck on your search!