Resmed Liberty difference b/w S and L mask?

[jules]

The headgear is rather simple. I will take the pictures and post them sometime. I need to borrow the teddy bear to do it.

It follows my standard design of using elastic with an X behind the back of my head. In this case I have used one long piece of elastic (3/4 inch will do but think this was smaller as I had it on hand) looped into all the clips with a band on the top of my head towards the front, then into the top clips, then the X across the back of my head and sewed into the bottom clips. I have one more loose band between the top piece and the X in back that would go down the back of my head. You adjust all the elastic once you put it on and my plan is to never reinsert the clips.

I have used it two night now. I haven't looked at the leak from last night yet but the night before last, the graph was very flat.

I am bothered by the noise when the mask vents onto a blanket. I am used to sleeping with my head halfway under the covers and find that is too noisy. Otherwise the mask is very quiet except when I yawn.

[jules]

Headgear - I used one long piece of elastic sewn into the lower clips and run through the upper clips. I had checked the length a few times before sewing it - your needs will vary of course. I used just over 36 inches so it might have been a new package piece. I sewed the ends on the clips

I used one wider piece of elastic (around 18 inches - it is halves to have the distance be around 9 inches) to go across the top of the head (not super visible on Teddy in front) to go into the X across the back of the head.

The only modification I might need still is to add another strap just between the lower clips to keep the angle correct on the face.

[CPAPRRT]

Hi!
I've tried the Liberty on a few of my patients, and only had success with 2 of them, and they were both asian, so anitomically, that's who I've found it works well for. The large mask is wider in the mouth. The pillows, contrary to some other advice on here, should be the SMALLEST possible. Larger ones are more likely to cause sores and less likely to seal well (though, every nose is different, that's why they have trials!). The pillows should go into the nose and stop just before the 'ring', which creates the seal, if you can't see the 'ring' outside of the nose, they're too small. The problem that I find with the Liberty is that it seems that you can only choose one good seal, either the mouth OR the nose, but not both. I see a lot of rigging things up on here and I think that's wrong, not of the patient for doing it, but that it needs to be done at all. You shouldn't pay a couple hundred dollars for something that isn't working for you.
Have you tried nasal pillows with a chin strap instead, or do you need to be able to breathe through your mouth? The sleep specialist I work with much prefers a chin strap to having the mouth covered. It needs to be a good chin strap and worn properly, of course. There is the Respironics Optilife. It is a nasal pillow mask with a built in chin strap. Works ok, when it works, but the separate chin strap seems to work more universally. There is also the Fisher and Paykel Oracle. It is for the mouth only and actually seals from inside your mouth and comes with nose plugs. I haven't had to use it much, but it seems to work when I try it.
Good luck!

[jules]

There is the Respironics Optilife. It is a nasal pillow mask with a built in chin strap. Works ok, when it works, but the separate chin strap seems to work more universally.

Glad to see you fit the RRT stereotype here - don't know what you are talking about. We do have exceptions here.

The Optilife's chin strap isn't a chin strap at all. It is only an anchor. Personally, I found the Optilife a POS.

[pudellvr]

Hi!
I've tried the Liberty on a few of my patients, and only had success with 2 of them, and they were both asian, so anitomically, that's who I've found it works well for. The large mask is wider in the mouth. The pillows, contrary to some other advice on here, should be the SMALLEST possible. Larger ones are more likely to cause sores and less likely to seal well (though, every nose is different, that's why they have trials!). The pillows should go into the nose and stop just before the 'ring', which creates the seal, if you can't see the 'ring' outside of the nose, they're too small. The problem that I find with the Liberty is that it seems that you can only choose one good seal, either the mouth OR the nose, but not both. I see a lot of rigging things up on here and I think that's wrong, not of the patient for doing it, but that it needs to be done at all. You shouldn't pay a couple hundred dollars for something that isn't working for you.
Have you tried nasal pillows with a chin strap instead, or do you need to be able to breathe through your mouth? The sleep specialist I work with much prefers a chin strap to having the mouth covered. It needs to be a good chin strap and worn properly, of course. There is the Respironics Optilife. It is a nasal pillow mask with a built in chin strap. Works ok, when it works, but the separate chin strap seems to work more universally. There is also the Fisher and Paykel Oracle. It is for the mouth only and actually seals from inside your mouth and comes with nose plugs. I haven't had to use it much, but it seems to work when I try it.
Good luck!

Thank you for your fit suggestions. Unfortunately, most professionals that do not have behind the mask CPAP experience have limited influence here. There are things that can be learned from you but without actual "driving" experience it is hard to get respect. I agree with you (as per my rant earlier) that these things should not require extensive mods due to the cost involved. I have used a nasal pillow mask with several chin straps. I am a life long mouth breather and no chin strap will work for me. The mouth is too easy an orifice to open.