A newbie with nose bridge issues--already discouraged!

[elcincogrande]

I began using a CPAP about a month ago, beginning with Swift nasal pillow and chin strap. After several weeks it became clear that even with a chin strap I would breath through my mouth. So I switched to a full face mask: Mirage Quattro, medium. After a couple of nights, I began bruising on the bridge of my nose. A couple of more nights later, my bridge was sore. Last night I tried to wear it, but because I had to tighten the knob to prevent leakage, it irritated the bridge of my nose too much (I was feeling pain). I was able to wear it this morning at 5:00 a.m.--I figured some sleep with it was better than none.

I had no idea when I begin CPAP therapy it would be like this. I'm not having a problem falling asleep with a mask, but I can't continue with this issue. I'd like to go back to the nasal pillow, but that's not going to solve the open-mouth breathing issue.

I've read some suggestions in this forum about nose bridge issues. Folks offer various solutions that work for them. My questions are:

1. If I go a small Mirage, might that help alleviate the problem?
2. Is there an alternative? Go back to a nasal pillow and tape my mouth (every night)?
3. How is it that many of you get to experiment with different masks? Do you just go to your DME and pick out a different one? I have to go to my sleep doctor's office as this is were I decided to get my equipment rather than a conventional DME. Therefore, I have to make an appointment. Is that how it works with DMEs? Or do you just order masks online?

I was so hopeful about CPAP therapy. I know it will make a difference in my life. But I'm finding that the solution is easy in principle, but not in implementation. Any words of encouragement?

Thanks--

elcincogrande

CPAP--Resperonics REMStar Pro M Series
Pressure: 9
Mask: Mirrage Quattro, medium

[zweible]

Do a google search on resmed hybrid. This is a nasal pillow system that also extends down and covers your mouth. No seal around your nose bridge. I have not tried it, but it looks very interesting.

Dan

[ifrimmel]

I have a cupboard full of masks- trying to sell bits and pieces on cpapauction - $1 bid .. wonderful .. next place they are going is in the trash. That's how I experiment. cpap.com loves me Burning through my flex savings account like WILD FIRE.

What is your pressure? You don't say. The DME gave me a Fisher Pykel Forma to try - it felt great and seal well when I was sitting in the chair - roll onto your side - you are screwed ..

I have had 0 success with 5 different FF masks - the Quattro is BY FAR the worst of all of them - I have no idea how people can use it ? The Resmed ultra was by FAR the best - but it's built like SH!T broke it in 2 days - GLUED it - broke it in another place in another 2 days. GLUED it . Broke it in another place - threw it AWAY ! Sad - if it was built like the Quattro they would have something.

Resmed Swift FX was awesome - SIMPLE - EFFECTIVE but - can't go over 15 or so - yes, mouth taped.

Resmed Softgel gives a good seal but it feels horrible to me .. to much material smushing up against my face BUT it will go to 21 without leaking - which is AWESOME - NONE of the other masks will do that.

It's all trial and error. If it's hurting you - GET ONTO THE DME !! You have the wrong mask.

Hope this help ! Stick with it !

[ifrimmel]

The Hybrid IS very interesting .. well worth a try if you are a mouth breather ..

[montana]

Try a bandaid tonight . Alo use the lanolin cream.

[jmelby]

My DME (associated with sleep lab) let me exchange my first mask within 30 days (2 different full face masks), then the 3rd one, a nasal mask, they were able to charge to insurance as a change in therapy since it was a different type of mask.

I also bought a couple of masks on my own on http://cpapauction.com/ ... much cheaper than at a DME and even less that my coinsurance would be in most cases. Besides, my insurance only pays for a new mask every 6 months. You should get a copy of your CPAP prescription from your doctor's office so you could also buy masks from retailers like cpap.com (sponsor of this forum).

Hang in there on the masks... I tried several before finding what worked for me. The full face masks seem to have many more issues with nose bridge than nasal masks that go over the nose. I have never tried nasal pillows as I just don't want anything touching my nostrils like that. I don't have issues with mouth breathing like many seem to, but there are also many solutions for that--pap cap seems to be a popular solution for a chinstrap.

[SleepingUgly]

See this current thread about masks:

viewtopic.php?f=1&t=49793&st=0&sk=t&sd=a#p456718

I can make a long list of all the ways I protected my nose from the Quattro. But ultimately I threw in the towel when the bridge of my nose had such bad skin breakdown that it was bleeding (which was actually less unsightly than the pimple farm stage, come to think of it...). Some people swear by the Comfort Care Pad, but I couldn't get it to work for me. BTW, supposedly there is an insurance code for it now. Some people have good luck with Remzzzs. I couldn't avoid the red mark on my nose with that. It seemed like whatever I put to protect my nose (Transpore tape, paper tape, cushioned tape, duoderm of various types, etc.), I still wound up with a red mark. I tried thicker things to buffer it more, but that may have caused more pressure on it. I tried thinner things so there would be less pressure. Some of these things work for others, so they may work for you.

Yes, it is possible that you're in the wrong size and are having to strap it on too tightly because of this. Can you get it to seal if you make it looser? There are some threads about this. Search on this forum for "hovercraft" as it's been described.

[PST]

i'm a Quattro enthusiast, but people have widely differing opinions. You might have too big a size. There are many posts by people who were surprised to find that the best fit was from a smaller than expected size. For example, I have a big head, 7 7/8 hat size, and I assumed I was an XL, but an M fits me best. It's the distance from the bridge of the nose to the indentation under the lower lip that counts. The ResMed web site has a measurement tool for estimating what size will fit best.

I had trouble with a sore nose at first, but I got over it when I learned to strap the mask on less tightly and "float" it. What worked for me was this:

1. Tighten the lower straps pretty tight.

2. Let the upper straps remain a bit loose. Air should fill the liner, between the inner and outer layers, producing a sort of pneumatic cushion. Experiment with this. You actually get fewer leaks when the cushion floats a bit than when it is smashed down tight.

3. Use the dial to fine tune the distance to the bridge of the nose. If something hard is resting on the nose, move the mask out a little.

4. When you find the right settings, hang onto them. Memorize the dial setting and, as far as possible, use the buckles and don't undo the velcro.

I was afraid I was going to have an open sore on my nose the first couple of weeks, but I haven't even thought about a sore nose in ages. On my face, at least, the Quattro can be made pain free without relying on pads. Leaks are a bigger question, but many people have found that if they fiddle with it long enough, they can make the Quattro form a good seal. Occasionally, I have no leaks whatsoever, and most nights they are small and episodic.

[torontoCPAPguy]

I would be going to my DME and screaming bloody murder! Mine gave me two that were disasterous and then I bought one on my own and it fit great and was light at a feather. So I bought my own.... and am still looking for better but am quite pleased with the one that I am presently using. You need patience; this is a long process and I find that without the machine blowing the mask is a bad fit ... so there.

Good luck. Hang in.

[slibhart]

i'm a Quattro enthusiast, but people have widely differing opinions. You might have too big a size. There are many posts by people who were surprised to find that the best fit was from a smaller than expected size. For example, I have a big head, 7 7/8 hat size, and I assumed I was an XL, but an M fits me best. It's the distance from the bridge of the nose to the indentation under the lower lip that counts. The ResMed web site has a measurement tool for estimating what size will fit best.

I had trouble with a sore nose at first, but I got over it when I learned to strap the mask on less tightly and "float" it. What worked for me was this:

1. Tighten the lower straps pretty tight.

2. Let the upper straps remain a bit loose. Air should fill the liner, between the inner and outer layers, producing a sort of pneumatic cushion. Experiment with this. You actually get fewer leaks when the cushion floats a bit than when it is smashed down tight.

3. Use the dial to fine tune the distance to the bridge of the nose. If something hard is resting on the nose, move the mask out a little.

4. When you find the right settings, hang onto them. Memorize the dial setting and, as far as possible, use the buckles and don't undo the velcro.

I was afraid I was going to have an open sore on my nose the first couple of weeks, but I haven't even thought about a sore nose in ages. On my face, at least, the Quattro can be made pain free without relying on pads. Leaks are a bigger question, but many people have found that if they fiddle with it long enough, they can make the Quattro form a good seal. Occasionally, I have no leaks whatsoever, and most nights they are small and episodic.

I agree with PST....try his remedies for your challenge. When I first used this mask, I had a very sore and bleeding nose. Once I got it all adjusted right, to fit my face, the soreness went away. Leaks are minimal and I am getting restful sleep. The sore nose drove me nuts and was very painful. I kept adjusting, adjusting, adjusting and finally got it down. Now, I like the mask. Good luck!!

[tonyo]

i cannot remember where i got it, but there is a band that fits over your head and onto your chin that keeps your mouth closed. very comfortable. you can ask your doctor.

[RoninHouston]

I am have used the Quattro since early February, my first mask as I am new to CPAP. After my sleep test my nose bridge was red with a dent. Knowing I was going to have a problem I searched here. I decided to use a lanolin, LANTISEPTIC from the start. It is a Skin Proctectant used for patients with bed sores.

I use it every night before putting on the mask and every morning after shaving. It kept me from getting a sore on my nose bridge and treats the sore spot already irritated. Buy it in the drug store, no prescription needed but it maybe kept behind the counter, mine was.

DST gave excellent advice on adjusting the Quattro. I found a properly adjusted forehead dial will keep the mask from pressing my nose bridge along with loosing up on the top straps. DST is correct in the mask should float on your face like an air cushion rather than strapped so tight as to press against it. This mask needs to be adjusted with pressure to activate the cushion effect. Also if the mask is too high on your nose it may/will press your nose bridge.

Using this mask I have been 100% compliant 32 straight days without needing a nose bandaid.

Good Luck

[SleepingUgly]

I decided to use a lanolin, LANTISEPTIC from the start. It is a Skin Proctectant used for patients with bed sores.

RoninHouston, is this what you're using?

http://www.lantiseptic.com/sp.html

It says it has beeswax and petroleum jelly in it... do you think it's OK for the mask?

You people are making me want to try again with the Quattro...although I can't imagine how I could spend any more time with the straps than I did. There were some nights I spent a couple of hours trying to make it work, with two different size Quattros. But I did feel my best using that mask (minus the bridge of my nose anyway), so, if I could get it to work, I would like to...

[Cosette]

Your problems seem almost if they had been written by me! The sleep center where I had my study has provided me with many different masks to try. I finally have a system that works! It's the Mirage Ultra with a comfort care pad and a big white chin strap to keep the mask from leaking at the bottom. The trick I found with the care pad is to wash it and dry with a towel before applying so it stays nicely in place. No more sore nose. The chin strap was so large for me that I cut about a third of it away. Unless I sneeze, I'm all cozy and quiet for the night. What a great feeling that is after four months of experimenting. This forum has been a great help to me in figuring out what to try and not giving up. Best of luck to you and do keep us posted with how you are doing.
Cosette

I began using a CPAP about a month ago, beginning with Swift nasal pillow and chin strap. After several weeks it became clear that even with a chin strap I would breath through my mouth. So I switched to a full face mask: Mirage Quattro, medium. After a couple of nights, I began bruising on the bridge of my nose. A couple of more nights later, my bridge was sore. Last night I tried to wear it, but because I had to tighten the knob to prevent leakage, it irritated the bridge of my nose too much (I was feeling pain). I was able to wear it this morning at 5:00 a.m.--I figured some sleep with it was better than none.

I had no idea when I begin CPAP therapy it would be like this. I'm not having a problem falling asleep with a mask, but I can't continue with this issue. I'd like to go back to the nasal pillow, but that's not going to solve the open-mouth breathing issue.

I've read some suggestions in this forum about nose bridge issues. Folks offer various solutions that work for them. My questions are:

1. If I go a small Mirage, might that help alleviate the problem?
2. Is there an alternative? Go back to a nasal pillow and tape my mouth (every night)?
3. How is it that many of you get to experiment with different masks? Do you just go to your DME and pick out a different one? I have to go to my sleep doctor's office as this is were I decided to get my equipment rather than a conventional DME. Therefore, I have to make an appointment. Is that how it works with DMEs? Or do you just order masks online?

I was so hopeful about CPAP therapy. I know it will make a difference in my life. But I'm finding that the solution is easy in principle, but not in implementation. Any words of encouragement?

Thanks--

elcincogrande

CPAP--Resperonics REMStar Pro M Series
Pressure: 9
Mask: Mirrage Quattro, medium

[RoninHouston]

SleepingUgly I had not look at the contents of Lantiseptic. The link you have shows the jar I have. I was more concerned with not developing a sore than I was at the contents damaging the mask. Plus I had not found anything anybody recommended that would work except Lanisoh. I thought Lanisoh was going to be too mild and better used for keeping pillows from making sores in your nostrils.

I only put it on the nose bridge and in morning when I wipe my mask it has no residue on it. I think my nose is toughening up and I am using it less.