Pap-cap II Review

[mindy]

Hello all,

I'm new at writing reviews so I hope you'll bear with me. SleepGuy kindly let me join the trial so I've been experimenting with the revised Pap-Cap. As a caution: I use a variety of masks at different times so that limits the amount of time I've used a particular mask and the Pap-cap.

First, the Pap-cap is very comfortable. I had seen photos and had thought it would be too hot but the fabric is very light, and it fits my head very well. The chin strap feels much better than the neoprene Tiaras (Ruby and Topaz) chinstaps. It has a lighter "touch" and yet works very well.

Imho, the Pap-cap is a good solution for the Nasal-Aire II. Previously I had sewn velcro strips onto my Topaz chinstrap and that worked better than the supplied headgear. The Pap-cap works even better for me. About the only change I *might* make would be to sew the velcro strips onto the cap or strap. As it currently works, I have a tiny bit of trouble finding the best place that has velcro to attach the rip strips, so it gets a little messy. Even at that, it's still the best solution I've found.

As I see it, it can be used with any number of masks. I'm planning to try some others since it seems to reduce my "helmet head hair" in the morning.

Since this is a trial, I realize that the documentation is not ready for prime time. Bret did a good job in attempting to explain the intricacies of attachment. Unfortunately I'm a very visual person so I look forward to his drawing version!

The Pap-cap is now a permanent part of my xPAP "armamentarium" and I hope to use it with more of my masks as time goes on.

The bottom line pros: it's light, it's comfortable, it's not hot, it's easy to get on and the chin strap is better than any others I've tried.

Cons: needs the final documentation with drawings; I'm not sure I can envision a way to do the rip straps so they work with everything; with the NAII, it's a little awkward to get it all attached and leave it that way but otherwise it works well.

Depending on your needs, this could be a good choice.

Thanks, Bret! I won't hesitate to buy one when I need a new one. And as I work with other masks with the Pap-Cap, I'll add my comments on those.

Mindy

[carbonman]

Thanks, Bret! I won't hesitate to buy one when I need a new one.
Mindy

Mindy, great review. I totally agree w/your thoughts.
You summed it up very well.
I can not speak to the use of the chinstrap, because since I switched
to a ffm, I don't need it anymore. When I started cpap w/the Optilife mask
and did need the chinstrap, the original PapCap w/chinstrap worked very well.

I can only add this (I hope this is ok w/ Bret)
he indicated to me that the PapCapII will not be commercialized.....SO,
I placed a custom order for two PapCapII......in the original Voyager(Vger) material.
They are in transit as we speak.

After using this cap w/my UM and Quattros, everyday, for the past month,
I consider it a necessary, required piece of my cpap equipment.

[carbonman]

SleepGuy(Bret) is mess'en w/my mind.

First it was those smells.....you know...aromatherapy.
Spice is nice. I use it or Fresh or BlackCherry, everynight.
It is my subconsious connection to Grace.

....and now, it is visual......and mechanical.

I have been using a demo PapCap2 for the past month.
Bret sent me a kind of purple, tie-dyed.....
kind of psycho-delic pattern......which was perfect for me.
Not only did it work, mechanically, for mask headgear,
it fit my personality.

Yesterday, delivered to a post box located at the end of my driveway,
were 2 brand new, custom PapCap2's,
in Voyager(Vger) material.

Maybe it is just that I am so easily amused, but I love
this kind of starry-milkyway pattern.
I went through the initial installation/adjustment as
soon as I opened the package.
I swear I slept better last night......
As soon as I see that cap now, I'm already on my way to the abyss.
When the Spice hits my mind at 12cm,
I AM on my way.

So now, along w/extras of masks, machines and pieces and parts,
I have my PapCap2's, too.

THANKS! Bret. Great product! Outstanding service!

[StevenJ]

I tried the papcap II last night and was disappointed. I used its chinstrap, and woke up about 1:30 becasue the front of the cap was down over my eyes and was irritating my eyelids. Throughout the night I had to keep pulling the back of the cap down to get the front of the cap up and off my eyes. I tried attaching the strap farther back on the cap to be better centered (front versus back) but the velcro patches on the cap do not go back far enough for that. I also attached my Opus 360 to the cap to eliminate the headgear, and struggled with leaks most of the night: when the cap was pulled down over my eyes, that changed (loosened) the tension on the mask straps. I'll experiment a little more with it in the light of day, but I think I'll probably go back to my Deluxe strap and standard head gear. That's too bad. I really like the idea of the cap: it's comfortable and it's less stuff on my head. Anyone else had trouble keeing the cap positioned?

[mindy]

Sorry to hear it didn't work well for you! It's like anything else in the xPAP world - I don't think there's anything that works for everyone. I've read great reviews of some products that haven't worked for me and bad reviews of others that have worked. It's too bad that there isn't a way to trial just about anything but I think that would get too expensive for the folks that make them

Mindy

[jrt]

Perhaps the Pap-cap II is larger than the original papcap. I have been trying to find out that information without success. It would be nice to know the approx. size difference in inches before investing in the papcap II. Everyone has a different size/shape head and different masks/positionings so what works great for one head and/or mask may not work for another.

The original papcap size works excellent with the Micro mask for me but not others . It is rather small for me and looks/fits like a Jewish male skull cap. I bought several of the original ones on clearance to try to get the ZZZ full face mask(that came headgear for a huge/long head) to work using old velcro straps.

[SleepGuy]

I tried the papcap II last night and was disappointed. I used its chinstrap, and woke up about 1:30 becasue the front of the cap was down over my eyes and was irritating my eyelids. Throughout the night I had to keep pulling the back of the cap down to get the front of the cap up and off my eyes. I tried attaching the strap farther back on the cap to be better centered (front versus back) but the velcro patches on the cap do not go back far enough for that. I also attached my Opus 360 to the cap to eliminate the headgear, and struggled with leaks most of the night: when the cap was pulled down over my eyes, that changed (loosened) the tension on the mask straps. I'll experiment a little more with it in the light of day, but I think I'll probably go back to my Deluxe strap and standard head gear. That's too bad. I really like the idea of the cap: it's comfortable and it's less stuff on my head. Anyone else had trouble keeing the cap positioned?

Steven, I am very sorry to hear about your initial experience. I would like to troubleshoot with you a bit to see if we can't get it working 100%.

The chinstrap is designed with a "forward" tension so it does not pull the jaw back. Depending on how much tension you put on the chinstrap this tends to pull down the front of the cap. The PAP-Cap II was a redesign of the original in order to better address that issue.

1. The biggest suggestion is to make sure that you start with good tension on the cap in the back of your head, below the occipital ridge (the ridge on the back of the skull). This tension serves as the best anchor for preventing the front of the mask from sliding down, especially the occipital ridge bone. If the back tension is good below that point, it should be more than enough to offset forward chinstrap tension.

2. You might be putting more tension on the chinstrap itself than you need. Less is more in chinstrap tension. You need just enough to keep the jaw closed and move the bottom, fleshy part of the chin up so the bottom lip is moved up about 2 cm. More tension than that can be counterproductive.

3. The Velcro sewn into the cap at the temples is oriented to provide good forward tension. However, there is more than enough Velcro material that the orientation, angles, etc. do not need to match 100%. Try positioning the chinstrap at the angle you feel best and then hitting the Velcro on the cap wherever that might be. There's a good chance that there will be more than enough contact bewteen the 2" Velstretch material and the 2" hard velcro on the cap to meet your needs for chinstrap tension. I've experimented with many different chinstrap orientations and positions and even 50% coverage should be enough. If desired or needed, once you find that optimum position for you, it's a ten minute job (for someone with basic sewing skills and a machine), to mark out a better orientation, pick out the stitches, and re-position the hard velcro on the cap where you want it. Be careful not to result in too much backwards tension, as this may pull your jaw back and make your apnea worse.

4. As far as the Opus 360 headgear replacement, the PAP-Cap II is currently optimized for headgear replacement for traditional four-point attachment masks with a forehead bridge (ComfortGel, Activa, Quattro, etc.). Time and money permitting additional versions of the cap will be developed that are optimized for other mask systems. Having taken a look at the Opus 360 it seems to me that you could easily use the cap as a stable platform for replacing headgear but it will take some customizing. Again, that shouldn't be that difficult for someone with some basic sewing skills and some small Velcro pieces to sew into the optimum location. The basic idea with the headgear replacement is that the RipStrips, once positioned where you want them, will remain permanently attached to the mask. To install the mask all you do is put it on your face and while holding it with one hand, grab a strip and hook the Velcro from the strip into soft velcro sewn onto the cap at the optimum location for that particular mask. To remove the mask, simply detach the strip from the velcro on the cap. I would recommend starting with the cap as a chinstrap only first (not as a headgear replacement), getting that working right, and then figuring out how you might use the cap to replace the headgear.

Steven I would very much appreciate hearing back from you. I would like to get this working for you as it's intended to do. This will also provide me with useful product development information!

[MrSandman]

I have the PAPCAP II and same exact issue Steven has. I don't have a huge knot in the back of my head for it to hang on to. I prefer my premium or deluxe chin strap from Respironics. It may work for some people and that is great.

I also wish to point out that the PAPCAP II is not the same as the PAPCAP that is on trial. This needs to be better explained at the Papcap purchase site as well as here. I will let sleepguy explain the difference between the Papcap and Papcap II and the one on trial please.

[SleepGuy]

Browser and Steven, this is honestly the first feedback I've had on the PAP-Cap II pulling down in front (that was a somewhat common issue with the original design and I thought we had figured it out). I honestly appreciate the opportunity to optimize the design as much as possible before investing in marketing and inventory. I would like to know whether you've tried the troubleshooting steps outlined above, what worked, what didn't, etc. It sounds like the design depends perhaps too much on the occipital bone as an anchor so individuals lacking a prominent "knot" might not be the best candidates for the cap. If that's the case I'd like to be able to explain that on the website rather than have unhappy customers.

Another thought that either of you might find helpful: I would be happy to send you (or anyone else) two Velstretch - Velcro extensions that can easily be sewn into the backstraps and serve as points of attachment for headgear in the lower mouth area. This reverse tension from the backstraps to the mask provides a nice anchor to prevent the front of the cap from pulling down. These are the extensions that Carbonman is discussing above. You sew them into the backstraps so that the double-back part of the Velcro is on the outside; it's not difficult to figure out. I think this would solve your problems with the cap pulling down in the front, depending of course on the type of mask you're using. I am also thinking about including these extensions with new caps and would like to know what people think about doing that. Obviously the instructions will need to be expanded to explain all of this. Please request extensions via email at sales@pursleep.com.

I will let sleepguy explain the difference between the Papcap and Papcap II and the one on trial please.

The main difference between the PAP-Cap II and the original version is that the pattern was modified so that the back straps are lower on the back of the head so they are below the occipital process. It was also slightly enlarged so it would be more of a one-size-fits-all pattern. The "tail" in the back (intended to keep your hair down and out of the backstrap connection point) was also reduced in size. The hard velcro on the cap for the chinstrap was extended and moved up so that people could more easily fold the headband to address individual interface with the ear area. The PAP-Cap II also comes complete with fasteners that the customer may use to replace headgear on standard four-point connection masks with a forehead bridge (which the front of the cap cushions nicely I might add).

[MrSandman]

Hi sleepguy, I did get straps to replace the top two straps but I don't see anything with the Papcap II to replace the lower straps so I don't see how it can replace 4 point head gear? The only place I see those lower straps is when people who are in your trial make a post about it. Carbonman had some pictures of it. I think I like the longer tail from the original cause the short tail has a funny way of getting in the way when adjusting the back straps.

My main issue is probably that for one I do not have a prominent "knot" to anchor under and for me the Papcap II doesn't go under the knot I do have.

So the cap moves forward and it also shifts a lot causing my mask head gear to shift and cause leaks. I have made it work by pulling it really tight in the back and placing the chin strap more towards my ears but that makes it feel like a band is being squeezed around my head.

I also need more of a cup in my chin strap in order to make it stay put such as the Respironics premium chin strap has or I really like the way the Respironics white deluxe molds to my face but I don't like how it goes over the ears and how if I place it too far towards my throat it contributes to a choking feeling. Your chin strap is great in all ways except I need a bit of a cup to cradle the chin.

I wouldn't worry too much about a couple of people with issues because you will never fit or please everyone. Most of the people who post love it and that is great.

Thanks

Edit to fix spelling / grammer

[StevenJ]

SleepGuy,
Thanks for the thoughtful suggestions. I used the Topaz for a while, but moved on to the Deluxe because the wider band (across the top of my head) distributes the load better and doesn't deform my head! I did have the PapCap chin strap pulled pretty tight - that seems to be the tension required by the Topaz and Deluxe to help seal the lips. Any maybe that's where I'm going wrong . . . I positioned the strap as far backward as the velcro placement would allow to simulate the pull angle of my other straps, and still got leaks during the night according to my detailed chart. I know at least some of it was around the nasal pillows but do not now if I was losing air through my mouth. Good idea to get just the chinstrap function leveled out before using it as headgear: solve one thing at a time.

For me, the key to keeping air from blowing out my mouth is to put the tip of my tongue in the roof of my mouth where it meets the teeth. Perhaps if I try to the forward tension method, less tension will be needed to help accomplish that. That's pretty easy to do while I'm awake, but of course during sleep all bets are off. Also, I'll try a little more tension on the cap itself to see if that helps hold the back down.

Steve-

[carbonman]

Just to balance this out, I have been using my Vger PapCapII for one month now.
After initial installation, it required 2 additonal adjustments in the first week.
This was probably required as the entire cap material stretched out.
I leave the upper clips attached and after the initial adjustment, have not messed
with them again.

Since then, I simply slide the cap on, clip the lower straps to my mask
and I'm set for the night. I really like that if I need to get a drink in the night,
I can just unclip the lower straps, get a drink, reclip, and all is well.

I will never go back to the neoprene headgear.
This just is too comfortable and works too well.

SleepGuy, the only suggestion I can make is keep the full tail piece.
I liked it on the orignial cap and on the demo CapII you sent.

[MrSandman]

PLEASE UNDERSTAND I AM NOT COMPLAINING ABOUT THIS PRODUCT AS IT IS A GREAT PRODUCT ! JUST WANT PEOPLE TO BE AWARE OF THE DIFFERENCES AND TO CLEAR ANY MISCONCEPTIONS. SLEEPGUY IS EXCELLENT TO DEAL WITH AND VERY PROFESSIONAL!

I must point out again that Carbonman, you do not have the Papcap II as it is advertised on the purleep site. You have a custom made Papcap because I ordered the Papcap II and it doesn't come with lower straps to attach a mask.

I am sure I am not the only person that looked at a thread where you posted pictures of what was said to be the Papcap II with a long tail and long lower straps that wrap around and hook to the mask and ordered a Papcap II only to get one with a short tail and no long lower straps.

I do not understand why sleepguy doesn't correct this misrepresentation on this message board as it might prevent some confusion and complaints.

This thread is not correct :
viewtopic.php?f=1&t=35973&p=310242#p310242

This is not what you get when you order the Papcap II:

[SleepGuy]

PLEASE UNDERSTAND I AM NOT COMPLAINING ABOUT THIS PRODUCT AS IT IS A GREAT PRODUCT ! JUST WANT PEOPLE TO BE AWARE OF THE DIFFERENCES AND TO CLEAR ANY MISCONCEPTIONS. SLEEPGUY IS EXCELLENT TO DEAL WITH AND VERY PROFESSIONAL!

I must point out again that Carbonman, you do not have the Papcap II as it is advertised on the purleep site. You have a custom made Papcap because I ordered the Papcap II and it doesn't come with lower straps to attach a mask.

I am sure I am not the only person that looked at a thread where you posted pictures of what was said to be the Papcap II with a long tail and long lower straps that wrap around and hook to the mask and ordered a Papcap II only to get one with a short tail and no long lower straps.

I do not understand why sleepguy doesn't correct this misrepresentation on this message board as it might prevent some confusion and complaints.

This thread is not correct :
viewtopic.php?f=1&t=35973&p=310242#p310242

This is not what you get when you order the Papcap II:

[edit]: Browser was right. Based on this comment the papCAP II design has been modified and all papCAP II products ship with lower extensions attached to the cap as show in this picture. If they are not wanted it's simple enough to remove them by picking out the thread. One advantage they offer is to provide a little reverse tension that should keep the front of the cap from riding down. SG

[MrSandman]

Hello again - I just wanted to point this out because I think it has been misrepresented here that the papcap II is the one that is pictured. That is what I thought I was getting. I do think if the only issue one has is the cap slipping forward those longer straps that hook to the mask may help.

It is VERY admirable of you to offer everything you have offered. I had already decided that I would order one with the lower straps already attached if I liked the one I got. I think you deserve the new order for all you do. The Papcap II I got is a fine product but maybe just not for me. Besides the slipping issues I am not sure I like my entire head covered.

Now people can order knowing for sure what they are "not" going to get. If I had a pic of what they will get I would post it. I like the longer tail,makes carbonman look like a pirate too .

If I order another one I will ask for the longer tail and lower mask straps already sewed on. I see now the Papcap II is for bigger heads and mine is bigger than the Papcap said it would fit.