Amara View Full Face Mask

[Irfie]

Hello Everyone,

I am a fairly new CPAP user and at this moment my AHI is around 4.5-5.5. My concern is with the Amara View Full Face Mask, I use a medium cushion and it seems to be blocking my nostrils partially, even though my AHI is below 5 at times, i still feel myself struggling for air at times.

So i downloaded the Amara sizing guide and it seemed that i was just an entry to medium, do you think using a large cushion might help? Please advise if anyone of you have tried and are familiar with this.

I live in the United Arab Emirates and i am not lucky to have any DME support with CPAP and hence i rely on "try and error".

Any help with the Amara straps also would be appreciated as i feel that my mask is leaking but when i check dreammapper it says 100% mask fit.

[Sheriff Buford]

No worries. At the end of the day, we all use the trial and method when it comes to masks. It certainly is an adventure. Though I don't use the Amara view mask, it has sparked my interest and I may eventually try the mask. I was reading the other day that one of the advantages of the mask was that you use the same frame and head straps, but you can interchange the cushion sizes. Try the large cushion. It may or may not work for you. There are plenty folks here that use that mask that will help you on the straps and head gear concerns.

Sheriff

[Irfie]

Thanks alot for your reply Sheriff. Really appreciate that.

The mask by far is good, at first i was sore under my nose (columella) but now with time it is a bit ok. My lips are stretched and the separator on the cushion (nose and mouth) plastic causes a bit of issues at times. Its such an experiment that i have to keep it playing every night to find my sweet spot (which i did for a few days) but then again i lost it as i tempered with the straps as i felt it was getting loose.

Everything at this moment feels strange because i am new to this whole experience, but im being patient while im using my APAP, i clean the humidifier everyday and the cushion also and replace the distilled water daily.

Yet i feel, im not comfortable when sleeping, the mask is immediately painful when i take it off first thing in the morning but the pain/soreness goes off in about an hour of so. I wish i could find help here.

[Pugsy]

How long have you been using this mask? You say things went well for a while and then you felt the need to adjust the straps due to leaking and since then you have been having the problems. How long did you use it before things started to go awry?

No mask should cause pain or blisters or raw skin. If it does then it's either sized incorrectly or fitted incorrectly or simply not the right mask for that person's facial features.
A tired worn out cushion or headgear falls into the fitted incorrectly category.

Is it possible that the cushion or straps are just worn out and need to be replaced?

Also...you say that you feel like you are struggling for air sometimes...what are your pressure settings?
Did this happen from the very start of therapy or just recently with the changes in the mask from being initially good and now not so good?

I have used this mask and it doesn't need to be horribly tight to get and keep the seal. If you have it too tight it will cause pain and compress the cushion and that might impede the air flow.

If your pressures are relatively low that could maybe account for some of the feeling that the air flow is blocked.
Along with having the straps so tight that the cushion gets squished somewhat especially in the nose area.

I don't know that you need a different size...it may be that you just need a fresh cushion or headgear even.
The nice thing about this mask though ...if someone wants to try a different size cushion they only have to buy the different size cushion since the frame is universal sized. Makes it a little less expensive to try a different size.

[Okie bipap]

I tried the medium cushion when I first got the mask, but ended up using the large cushion. I have made liners for the mask from an old, well used tee shirt. After I use one, I throw it into a small mesh bag and place the bag in the laundry with our white clothes. My wife irons them flat and I reuse them many times. I have around 15 of them that I have been using for six months.

[Irfie]

Thanks Pugsy for your reply.

I have been using the mask from the past 4 months now and i have yet been battling with the perfect fit. The mask has good options to set, at sides it has 2 strips and on top of the head it has one. I would say that from day 1 i have been having issues with the mask and at first i had bad blisters which i thought was because of the silicon in the cushion, so i put a thin bandaid above my lip to give a soft contact between the silicon and my nose, but in sometime i realised that this was caused by over tightening the mask, so i played around a bit and finally i got my exact match which then i again changed because i felt i was losing air.

With your question that the cushion was worn out, i doubt it, because it is still new and i clean it with simple tap water and soclean wipes to sanitise it.

My pressure setting is at 9-19 and the optic-start at dream station starts my pressure at 11.5 which i don't think is a low pressure, now the only thing i think wrong is my cushion which i have ordered a large one to see how i cope with it.

It is good to see you having a good experience with this mask, could you please share your tips and tricks and possible challenges and how to tackle them since you have had a good experience with this mask, my experience by far has not been good nor it has been bad, i would say its on and off, on days i couldn't wait to get on my cpap because i loved the mask but now a days it is a torture to sleep with the mask, i used natipot to clear any sinuses before sleeping to help ease the congestion if i have any, but it seems the same way.

@Okie bipap - Thank you so much for your reply, just a question, did you try or go through the sizing guide before choosing your cushion? Or was it a trail and error? i used the sizing guide and it looks that i am a Medium, but the problem with the sizing guide is that it only measures the length of your nose and not the width, the tip of my nose gets a bit sore with medium, and can you please share how have you made liners for the mask? Are you having a reaction with the silicon and hence you made a liner? There are some companies like silent night which make liners, so do you think i should try liners for more comfort? I am generally tolerant over change but when the change feels a bit uncomfortable thats when i start looking for solutions to help me better understand my equipment.

Thank you all for your replies and your time to write in, i appreciate your replies and your willingness to help me, thank you again.

[Pugsy]

Well...when I say that I have used this mask it is not to say that I use it now or that it is my primary mask.
It is the only full face mask that I have been able to keep on all night though. My primary mask is a nasal pillow mask. I did try the Amara View for about 10 nights just to see what it was like. The fact that I used it for 10 nights is saying something for me. It was last fall though when I tried it and I don't remember if I did anything special but I know I didn't have it tight at all. That's just not my style with any mask. I wear them all really loose and have minimal to none leak issues. I did keep the Amara just in case I ever needed a full face mask for some reason or other but in over 6 years on cpap therapy I have never had a night where I couldn't use my nasal pillows...not even when I have had a bad cold. I always have been able to get the nose clear enough to breathe and the humidity actually helps clear up any congestion.

So I am not someone who can offer much in the way of tricks on getting it fitted and comfortable. It isn't my main mask and it won't ever be. I prefer as little on my face and head as possible so I go with the minimal nasal pillow mask..see the link in my profile to what I use.

How come you are using a full face mask? Unless you have some serious nasal congestion that forces you to mouth breathe there's no reason to not at least try one of the nasal masks...so much less area to have to try to deal with in an effort to get and keep a seal.

[Okie bipap]

If the tip of your nose is getting sore, you have the wrong size cushion. I made the liners to help control the leaks. I also use a cervical collar when sleeping which helps me keep my head up. I sleep on an adjustable bed with my feet and head raised. I bought the bed five years ago because I was having a lot of back pain due to my arthritis.

[Irfie]

@Pugsy - I am using a full face mask because i am a mouth breather, why i breathe by my mouth during my sleep is because i have a slight deviation, which the doctors here said that it should be ok and not cause issues, but at times during especially pollen months i suffer with congestion and sinuses and hence i use full face mask to help me with this, i could try a nasal pillow with a chin strap but im a bit worried about it that i might choke myself.

@Okie bipap - Yes i think its tricky to try sizes as when you go by the sizing guide it kinda confirms you into buying a smaller one (i believe 90% of us are stuck with a M unless your nose to too big), but anyway, i have ordered a large cushion to see how i cope with it.

Alright so after some battle with my mask, last night i tried something new, simply cut off my facial hair and to my surprise it was doing a bit of a difference, its amazing how tiny things affect your interaction with the mask, even though i felt there was a leak to my surprise my machine showed a 100% mask fit with no leaks, so guess im good to go with it being extra loose, but still i need to find a perfect fit with the Amara view. I will update you all when i try the large cushion in about 2-3 weeks.

[PoolQ]

I use that mask and love it. Takes some getting used to though:
1. it is very sensitive to adjusting the straps, 1/8 inch at a time
2. that little strip of silicon by the breathing hole is supposed to sit flat against your upper limp and not flat under your nose
3. after I put the mask on and start the air, I pull the mask slightly away from my face and let the cushion inflate and set the mask back in place
4. It likes to be kind of lose, this will vary with the upper limit of your air setting. It can be adjust tight, but you don't want to totally squish the cushion and have the hard plastic pushing against your face
5. once you lay down the straps don't need to be so tight, so adjust it for that
6. I put the tip of my nose in first and then rotate the chin in place, others do it opposite
7. the front of the nose cup should just cover the end of your nose
8. the mask seals around the nose by inflating inward and not by being pushed up against the bottom of your nose
9. I can actually drop my chin out from under the mask, yawn and put my chin back
10. really helps to have a hose hanger to keep the hose from pulling the mask sideways

[Pugsy]

Facial hair makes using any full face mask a challenge.
Not impossible but certainly more challenging.
I don't remember that you mentioned the facial hair in your first post.

A deviated septum doesn't mean a person can't use nasal pillows...just saying because I know people that are doing it and being successful with minimal mouth breathing going on. A lot depends on how much deviation and can a person move enough air to be comfortable without adding in the mouth breathing. If a person simply can't feel like they get enough air through the nose with mouth closed (like during the day when you can control it) then that's one thing and a FFM will need to be used but if a person doesn't need to mouth breathe during the day then there's a chance that the nasal pillows will work and might not even need a chin strap.
OH...those chin straps...more for gentle support than clamping the mouth shut...they aren't vises.

I mention this just in case down the road you want to maybe try a nasal pillow mask...they work well with facial hair too.

[Irfie]

@PoolQ - Thank you so much for the tips, yes this is what i have tried last night and it was so much better. I mean the problem is remains that the silicon nose/mouth divider slides up towards my nose. But yeah, thanks for posting the tip, your idea of sliding in the nose and letting the cushion inflate, it did help, but again i am curious to try the large size and see how that would work out for me.

@Pugsy - Im sorry for not being totally descriptive about myself, but yeah, i don't have that long of a facial hair, i guess it was about 2-3 weeks old, so yeah taking the facial hair off helped. About nasal pillow? hmm, you had my curiosity earlier and now you have my attention (lol Django unchained) And you think it might help with me over the full face mask? Why do you think so that the nasal pillow is better than the full face mask? I mean the full face mask gives me an AHI of below 5 already and i think if I'm scoring below 5 it should be good (comparing to my without cpap score of 81). I mean i am interesting in trying out the nasal pillow but then again as i said i am limited with medical supplies (only CPAP supplies) here in Dubai and usually order all my things from US without a return policy (obviously) so I'm not lucky like you guys who could try a mask for about 30 days and return it back if it doesn't suit you. Yet, I'm interested to thinking why i should switch when I'm having a below 5 AHI. Maybe the comfort and leak rates improve?

[Pugsy]

Why consider trying nasal pillow mask...simple...comfort and easier to get the leaks better managed and you can have as much facial hair as you want and it doesn't affect leak.
Look at the tiny area on your nostrils that the nasal pillows will touch and need to seal...now look at the amount of real estate a full face mask covers...it's easier to seal the smaller area.
I don't do it for AHI at all...I do it for ease of seal and comfort.
Just a thought for you to consider.

A while back we had a forum member who I had to just about twist his arm to get him to try a nasal pillow mask because he also had a deviated septum and thought he was just going to HAVE to use a full face mask. I finally got him to try it and he loved it. I am trying to remember his forum ID because he did a nice little write up about his success...and if I can find it I will post it here.
Oh...sometimes people can use less pressure and get the same results AHI wise when going from full face to nasal pillow. I can't promise it will happen for you but it is fairly common for people to discover that they can get by with less pressure.

I am not against full face masks...I know that they are needed and people do well with them but I just think people should try other masks if they are interested in them and there's even a small chance that it might work.
I have always thought that "I want to" is good enough reason to try anything and while it may not always work out as we hoped....at least we learned from the endeavor.

Let me see if I can find that guy's thread...I think I just remembered his forum ID name.

[Pugsy]

It was Perrybucsdad
see what he says here...next to the last post on the page
viewtopic/p663440/Mouth-Breathers.html#p663440

and here...last post on page one
viewtopic.php?f=1&t=73308&p=673720#p673720

He was needing pressures over 15 with a FFM and fighting leaks all the time and once I got his arm twisted enough to try a nasal pillow mask he never went back to a FFM...and his pressure needs dropped by 2 or 3 cm which made things a little more comfortable in terms of breathing.

I wish I had a spare nasal pillow mask and I would just send it to you to try but the only spare I have is the "for Her" P10 and that headgear might be too small for a guy.
I have some new unused Swift FX nasal pillows but I don't have the headgear or short hose. Maybe I can find someone who no longer wants their Swift FX stuff and I can add a new nasal pillow to it.
Would you try it if I twisted your arm that way? For free? If you hate it..send it back to me.
Shipping internationally won't be horribly expensive because they weigh next to nothing and will fit in a small box.

[Irfie]

Are you seriously wiling to help THAT much? This is very good and I'm impressed with your efforts, seriously, no one ever on the forum i have seen who would go out of their way to help out with what you just did

Now that you have posted this just makes me emotional and want to give it a shot, but in return id like to do you are favour too Which i might tell you over PM.