Side Sleeper needs mask help

[jagreen34]

that is why I'm asking for suggestions. I also have a beard so maybe that has something to do with it.

shave or use a nasal mask, it's exceedingly difficult to get a ffm to seal on a beard.

I came to this community because I thought you would be able to provide more insight but it appears it's about the same as I get from a respiratory technician. And I want to apologize that my frustration is coming through.

'
maybe next time, check your attitude at the door.

mask selection is a very personal thing, just because something works great for 100 people online doesn't mean you'll like it, you have to try various masks.

and not even mentioning your beard until half way down the thread???

Thank you. For someone coming in from outside it seems you should check your attitude as well. You have these things figured out. You are where you want to be in this part of the journey. Newbies to this board are not. No harm no foul. I will not be back.

[Rob K]

I have had the same experience. Not much help in choosing the right mask from the local supplier. Unfortunately I and the insurance company spent a lot trying to figure out something that will work. I'm still not quite there since I'm still having treatment problems 3 years later. I did find a mask that seems to work fairly decent.

I'm a mouth breather and I went through 4 or 5 full face masks and could not get any of them to seal with or without a beard. I keep it around 1/8", might grow out to 1/4" before I feel I'm getting too much leakage and need to trim. I toss and turn all night and sleep on my side a lot. I was getting large leaks when side sleeping so I was forced to sleep on my back with my head straight as much as possible. Very painful being in that position all night. Not sure if a cpap specific pillow would help with a full face mask or not. Never tried it.

Finally gave up on the full face mask when the store suggested trying a nasal mask with chin strap. Then it's critical to keep your humidity in check so you don't get stuffed up at night and can't breath.

Nasal pillows would be a good option for a side sleeper with a full beard. That's if you can get them to work for you. I tried a couple nasal pillow masks and they rubbed my nose raw from having to tighten them down pretty good and did not seal very well with all my tossing and turning. I wasn't able to strike a good balance between acceptable leak and being to tight.

Found that for me a nasal cushion that goes over my whole nose has worked the best and leaked the least amount. Keep in mind that I do keep my beard real short. I tried a Resperonics Wisp that sealed pretty well, but hurt my face too much. The one that seems to work the best for me so far is the ResMed Airfit N10. You can get it with different size cushions to fit your nose. I can sleep in all kinds of positions with it and it doesn't leak much. It is fairly comfortable, no mask is comfortable from my experience. The bottom of the cushion is too wide and blocks my nasal passages so I have to trim the bottom of the cushion each time I get a new one. Also have to wear a chin strap so I don't breath through my mouth. I run the tubing under the strap on the top of my head and behind my pillow, that way when I toss and turn from side to side I'm not laying my head on the hose every time. I can just turn and go back to sleep without having to rearrange the hose every time.

I've been through probably a dozen different masks in the last 2.5 years and still have not found one that works real well for me. The Airfit N10 has worked the best for me, but I still need to modify it out of the package.

My guess is the search never ends for a good mask. What works for one person likely won't work for another. Masks are a very personal thing. I wish you the best of luck in your search.

[amenite]

...

What should I try?

For side sleeping where nasal pillows are not an option I've had great success with the Mirage Micro nasal mask. If you found the full face version Mirage worked in the past I would give that one a try if you can get it with return insurance.

...
No harm no foul. I will not be back.

Unfortunate you won't be back to see my suggestion but I post anyway for the next bearded side sleeper that comes along ...

[LSAT]

If you are wanting to fix the leaks and try to use one of your FF masks we could try to offer suggestions. If you are wanting a different mask browse here and read the reviews. Some of the masks have free return insurance. So you can try one and return within 30 days
Finding a mask is very individual.

Thanks I am already adept at using Google for searches. I can return mine with 30 days too... that is why I'm asking for suggestions. I've also spent a good deal of my life watching videos about how to get rid of masks and it never works for me. I also have a beard so maybe that has something to do with it. It's okay I'll just continue to struggle with a random mask
I came to this community because I thought you would be able to provide more insight but it appears it's about the same as I get from a respiratory technician. And I want to apologize that my frustration is coming through. I found this whole process of finding a mouse that works extremely frustrating. And I found there are very few people that actually help.

You seem to have trouble communicating your thoughts.

[Physician]

Hello,

I've been a very faithful user of my cpap for almost 7 years. During that time I wore the Quattro FF FX for 4 years then had another sleep study after a tonsillectomy and switched to the Mirage Quattro for another 3 years. Over the last year and as my weight has gone up about 20 pounds I have been sleeping very poorly. I had another study in December and received a new machine. I was fitted for a new mask at the time. I have been wearing, if you can call it that, the Resmed Air Fit 10 FF mask since. My machine, which is new to me, says I am getting a fit of about 60% leaks on avg. I don't like this mask and want to try another. I have found that many times when going to a fitting I end up with less than helpful advice or choices.

What should I try?

Have you tried the Mirage FX? I love it, even after trying all available masks/pillows about six months ago. The only problem is that the cushion should be changed every 2-4 weeks to help prevent leaks. The peripheral contact part needs improvement. Can't imagine that a beard will interfere with the Mirage FX. I'm a left side sleeper. Untreated AHI was 70 and with the S9 and MirageFX, AHI = 0.0 .

[Okie bipap]

I had a beard for over 30 years and shaved it when I found out I was going to need to wear a mask while sleeping. When I had one of my sleep studies, I still had the mask, and they had a hard time getting the mask to seal. They finally used a mask liner which helped enough to finish the titration test. I decided I did not want to fight the massive leaks I had with a beard, so I shaved it off and have no regrets about it. My ahi has gone from 49 to under one and my maximum leak is usually less than 6.

[Jay D]

I have a beard and am a side sleeper. I'm new to a cpap, I've had it a week or so. I started with a nasal mask, but I found the face connection difficult. I then got the Phillips DreamWear, and it has been great. No leaks, so comfortable I can barely tell it's there.

My beard and mustache are not bushy, so if your hair is longer, your experience may differ.

[jtravel]

With a full beard it's going to be really hard to get a good FFM seal that does not leak when you sleep on your side.
Pillows or Nasal mask would work better for leaks with the beard but if your severely congested then they may not work for you.
I find pillows actually open my clogged nose up after a few mins with them on.
I would shave the beard and see how it goes.

[bonjour]

Mask Primer
Getting the right mask is one of the hardest parts of PAP therapy. This article is intended to help guide you through your choice of a mask.
First, all masks can and do handle all pressures associated with PAP therapy machines, this is from 3 to 20 (CPAP) or 25 (BiLevel/BiPAP) cmH2O.
Second, each of us has a different facial structure. This means that what works for me may or may not work for you, and what works for you may or may not work for me. You have to TRY the masks to see what works for you.
Third, You will have to try masks to see what works for you.

I’m going to call out one particular online vendor for 2 reasons. First they list masks by popularity within the mask type. This means that you can assume that the more popular masks work for more people. The second is that they offer “return insurance”, some free, some low cost, so that you can return a mask that does not work for you. That Vendor is CPAP.COM
Your DME is an excellent resource to try different masks. Use them for this purpose. Make an appointment for a mask fitting. Take your PAP to the fitting, it is best to do this under PAP pressure. If you are using a DME it is their job to help you use your PAP system for effective therapy. If the mask doesn’t fit or is extremely uncomfortable they are not doing their job.

Fitting a Mask
First a strategy,
· Try a LOT of masks on, under pressure, preferably lying down in a sleeping position.
· Frequently, not always, a mouth breather will shift to nasal breathing under PAP pressure, so don’t be afraid to try the less intrusive nasal pillows, prongs, and masks.
· Try multiple sizes of the same mask, Your facial structure may require a different size
· Try masks in this order (or choose your own order)
· Nasal Pillows / Nasal Prongs (most people prefer Pillows, are you “most” people)
· Nasal Mask with a forehead structure
· Nasal Mask without a forehead structure
· Full Face Masks with a forehead structure
· Full Face Masks without a forehead structure
Finally some specific masks because they have a uniqueness to them. This does not mean these masks are better or worse than other masks, only that the uniqueness may or may not work for you.
· FFM – Amara View because the nose seal is unique
· FFM – SleepWeaver this is a “Cloth” Mask (there is more than one)
· Nasal – SleepWeaver this is a “Cloth” Mask (there is more than one)
· Hybrid Masks – Basically a FFM with Nasal Pillows
· Oral Masks – All pressure is delivered thru a mouthpiece that sits behind the lips and in front of the teeth.
· Complete Face Mask – covers mouth, nose, and eyes
How to Fit a mask, some general guidelines.
· There is on-line help for almost any mask. Search for fitting xxx mask.
· Most modern masks are meant to be worn loosely and the seal is designed to gently balloon from the PAP pressure to form the seal.
· In Bed, place the mask on your face with all the straps loose. You are gently holding it with your hand.
· Lying down in a normal sleeping position, slowly and gently pull the straps only to the point where the mask feels comfortable and all leaks stop
· I like to manually gently position a mask while under pressure until the mask feels comfortable and the leaks are stopped, then gently tighten the straps to hold the mask in that position.


Mask Types
Nasal Pillows
Nasal pillows rest under the nose covering the nasal openings and sealing against them. This mask style is among the least intrusive of all masks. Typically they easily seal and have very low mask leak rates. The main disadvantage of this style is with the light touch if you are a very active sleeper the headgear can shift and cause a mask leak. Generally these masks are for non-mouth breathers. There are ways (chin strap, cervical collar, tape) to eliminate mouth breathing and allow you to use this type of mask.
Brands are different. The headgear can be anywhere from bulky to minimal, and they will fit differently. The only way to tell what works for you is to try them.
Size matters. Try the different sizes, I have trouble with the small and the medium here, the large works for me. This may differ depending on brands
Some users do not like anything touching their nose. I’d try a pillow to see if this is an issue for you. Don’t assume.



Nasal Mask
These masks cover the nose from the upper lip to the bridge of the nose. The volume of these goes from minimum, just barely covering the nose with minimal volume otherwise to considerably bigger. Most have a hard mask mount up to the forehead, but a few do not. These tend to have mask leaks a bit larger than the Nasal Pillows or Nasal Prongs. This is because they have more area to seal. With this type of mask it is important to try them because of the difference facial structures. You have to find what works for you. Again these are mostly for non-mouth breathers. There are ways (chin strap, cervical collar, tape) to eliminate mouth breathing and allow you to use this type of mask.
Brands are different. The headgear can be anywhere from minimal to bulky and they will fit differently. The only way to tell what works for you is to try.
Size matters. Try the different sizes. This may differ depending on brands

Full Face Mask (FFM)
The primary purpose of the Full Face Mask is to eliminate the need to correct for mouth breathing. The FFM covers the nose in a manner similar to a Nasal Mask but the lower seal is below the lips so it surrounds the entire mouth and nose. This is the traditional method of solving mouth breathing. These masks are bigger than most other masks and because of their size have more area to seal. Generally the bigger the mask the higher the mask leak will be.
Brands are different. The headgear can be anywhere from minimal to bulky and they will fit differently. The only way to tell what works for you is to try.
Size matters. Try the different sizes. This may differ depending on brands
One specific FFM I will call out is the Amara View. I’m not saying that this mask is better than any other mask. This mask seals differently than other full face masks so it is one to try if you are having trouble finding one that fits and works for you.
OK, one more. The “Total” Face Mask. This mask covers the entire face including the eyes and is occasionally used when other choices are not working.

Mouth Breathing
Mouth Breathing is when you open your mouth and the air pressure from your PAP is venting out your mouth typically showing on your charts as a large leak which can substantially negate the effectiveness of your therapy. It is generally not good. The solution varies depending on the person
How to manage Mouth Breathing, not in any particular order. Realize that ALL of these solutions fail for some people. Nothing will work for everyone
FFM – Full Face Mask. This is a very traditional solution to mouth breathing and it is generally effective.
Practice nose breathing with your tongue at the roof of your mouth with the tip behind your top teeth. This helps close the path to the mouth which can stop mouth breathing.
Chin Strap. A chin strap is to manage mouth leaks from a variety of causes. Most result from the jaw dropping or opening either partially or wider. The chin strap is to gently keep the jaw closed. If you have to crank it shut to make it work this is not the correct solution. This is the “standard” solution for users who desire to keep their non-FFM or are adverse to using a Full Face Mask. Note that your jaw is strong enough to open against a chinstrap if it wants to.
Cervical collar. A Cervical Collar may also be used to keep the jaw from dropping. This is a non-traditional solution suggested by PAP users. These come in a variety of sizes and can be found in many pharmacies. The purpose of a cervical collar is to immobilize the head and neck when neck, back or spinal cord trauma is suspected. This is NOT the purpose here, look for a looser fit, all we want is to prevent the jaw from dropping, kind of a reminder, to prevent mouth breathing.
Mouth Guard. The concept here is a closed mouth guard to keep the air from leaking out.
Taping. The purpose of taping is to seal the lips and prevent mouth leaks / mouth breathing. It is not to stop the mouth from opening. This method is the most controversial. The fear some have is that you will not be able to quickly remove the tape and you may suffocate. Try to use as little tape as possible. I make sure that I can easily open my mouth, when taped, if I need to. I have a very full mustache and beard, almost Santa Clause like (little kids have mistakenly identified me as Santa). Try placing the tape on the lips, it doesn’t have to go over the mouth, I tape so you can see the shape of my lips.

[bonjour]

Oh and a ffm with a beard?

It took a bit of trying but for me an Amara View worked, and quite well I may add.

It seals real close to the lips for me and directly under the nose.
And I have a real bushy beard.

Keep looking.

My favorite though is p10 pillows with tape on my lips.

[yaconsult]

Nice post, Bonjour - you saved me the trouble! LOL

Look at the masks for the type you want to try on our sponsor's site - for example, here are the full face masks: https://www.cpap.com/cpap-masks/full-face-cpap-mask.php. They are listed in order of popularity by default, so the most popular masks are toward the top. Now notice the icons on the list for which masks have free shipping and/or free return insurance. This is a huge, huge benefit of buying from cpap.com. Instead of being stuck with a mask that doesn't work for you, you can try some of the most popular masks and return them and get a refund if they don't work for you.

Like Bonjour, I have found that the AirFit P10 nasal pillows work best for me - even at my high pressures of 13-20. Like him, I also use a simple strip of 3M Micropore tape along my lips to keep me from blowing air out of my mouth. This combination works great for me and my AHI is always under 1 and I get great sleep.

[englandsf]

Don't give up on nasal pillows because of congestion. Run with no humidity and/or try a month long program of daily nasal rinses (pressure wash not netipot). Look into Flonase type sprays once a day too. I had the same issue and now am VERY happy with my P10. The Amara View I use for back up is a mask I cannot imagine working with a beard.

[bonjour]

The Amara View I use for back up is a mask I cannot imagine working with a beard.

The Amara View avoids the real dense portions of my beard, I use a medium where I usually use a large. No problem with the beard (for me) with this mask.

[Katlee39]

I use the Amara View

Sent from my SM-N910T3 using Tapatalk

[RogerSC]

Well, the OP isn't posting, but I'm guessing that they're reading none the less *smile*. You never know, though.

I have a beard as well (and am a side sleeper), and have tried FFM's and not been able to reduce leaks enough to make it work, even with a liner. Felt like a dog with my head out the car window *smile*. Didn't need to use an FFM enough to trim my beard to the point where the mask starts to work. Maybe at some point, but not yet *smile*.

Nasal masks and nasal pillow masks do work for me, though. Luckily, I haven't had a problem with mouth breathing to this point...currently using a TAP PAP until I can go back to a decent nasal mask *smile*. So it goes. Anyways, the TAP PAP does work for me, even though I hate it with a passion.

Good luck to the OP in case they're still reading...keeping cpap working optimally is always a process. Not for sissies, got to be willing and able to try new things sometimes.