[mikemoran]

Okay I must be becoming more like Rested Gal all the time. No not more beautiful or less hiirsute. Just in the fact that I can't leave almost well enough alone. Been using the Hybrid for 3 weeks now and just couldn't resist doing some lab ratting on it.

For those weeks I have used the Large Mouth and large pillows. The pillows have been perfect and it is the first nasal pillow system that doesn't drive my nose insane. However, the straps have had to be cinched down tight for it to work for me and I attribute it all to the extra silicone piece for chin support. I have been using the large because the support flap is the only one that comes close to fitting under my chin on my long face. But it doesn't fit snug and to compensate I strapped down hard.

So since I had one setup that worked I thought I would play around with the other mouth parts to see if Icould improve things. Now my thinking was why do I need this chin support.? It is not like I need a chin strap to keep my mouth shut. I can mouth breath with this mask so no chinstrap needed. So the only reason I could see for it was to keep the mask stable.

You have to understand this support, unless it fits completely under your chin, actually lift the bottom of the mask around your lips so you need to pull the support tight enough to seal. So out came the scissors and I did surgery on the Medium mask I wasn't using. One careful snip and the support was gone.

End result was a a mask that completely sealed around my lips, even with the stache and beard. Benefits were it made the mask lighter, I could loosen the straps at the bottom, it puffed and sealed agaisnt my upper and lower lips just like my Activa agaisnt my nose and amazingly made the mask more flexible. I could open my mouth wide and the seal moved with my mouth without breaking. A good mask made better from initial impression.

So last night I slept with my new surgically reduced Hybrid. Again not saying this will work for everyone, but it was wonderful. The looser lower straps did not pull agaisnt my head and the pressure agaisnt my face was less. I used tighter straps on the upper ones to bring the pillows to the perfect position for me. Looser, the pillows go towards the tip of the nose. Tighter, they go more towards the face. The mask was very stable (my biggest fear from taking the chin support away) and flexilbe enough to move without breaking the seal when pressed agaisnt my pillow.

End result was reasonable leak numbers, more reliable read out from my Resmed Auto and the lowest AHI i have had with any mask (2.0). so the experiment paid off. Next I think with a little trimming I can turn the mouth piece upside down so I can route hose over my head without the noise problem. I may wait on this one until replacement cushions are available.
For those of you who have had problems with the Hybrid, you might want to try this fix before tossing it in your old mask drawer.

[oldgearhead]

Mike,
Are you going to trim the one you've used for three weeks. The large one?

I'm a bit reluctant to cut my medium mask, because I'm starting to get along with it pretty well. I may cut the large first. But I don't think it will help because my problem with it seems to be the cheek-to-cheek radius. I need to locate someone who wants to trade medium or large parts for my extra small ones.

_________________

Mask: Hybrid Full Face CPAP Mask with Nasal Pillows and Headgear

Humidifier: REMstar Heated Humidifier

Additional Comments: 8-12cm/H2O--AHI 1.6

[new2]

Mike, thanks for being the first to jump off the cliff on this one. Customer service acknowledged that she knew the chin flap was obtional for some patents, but that the product designers did not indicate where or how much in any literature. I think they should have put something on the chin flap to show us where and how much to cut. So why did they chicken out? Was it regulatory issues? The extra chin flap is designed to be removable if we don't want it there that fact is not even mentioned in the instructions. I guess they don't want to end up responsible if we take the scissors and do damage to ourselves or those around us.
Mike, are you going to show where and what you did? I'll show you mine if you show me yours because I'm trimming a little off tonight.
I find that once I'm in the bed and very relaxed and my face is totally relaxed that my chin area has some momentary leaks but nothing like my other masks so I feel good overall with the fit.

_________________

Mask	Humidifier
Additional Comments: second fave is my new Bravo Pillow mask

[mikemoran]

Oldgearhead,

I didn't trim my large because that set up worked with the flap, though not as well. I didn't wnat to take the risk of ruining the mask if it didn't work out. I was suprised that the medium mask fit me just fine once the flap was gone. If you weren't planning on trading I would suggest you try it on your small first. It really sealed well around my mouth and without the stiffness of the flap I could open my mouth wider than I could with the large and the flap.

New2,

You just need to trim it where it won't interfer with the primary seal around your mouth. You don't need to cut all the way back to the mask and risk putting a hole in the main body of the mouth silicone. If you take a look at the maks you will see the flexible primary seal sticks out beyond the bottom edge of the flap, cut anywhere in there. I think I left about a quarter inch of the flap.

This is one of those design things that didn't make sense on this mouth. I think they put the chin flap in just so they could market it as no chin strap required. But I have never heard of anyone with an FF mask requiring a chin strap. Good thing they made it easily trimable.

[roztom]

Mike:

THanks for the update and lab rating. I just got mine today and the large fits me in both areas but I am leaking slightly at the pillows and yes this sucker is tight.

I will try it tonight and see what kind of leak rate I get.

THose clips are downright dumb.

I am going to reserve judgement until tonight but it doesn't look that promising.

I can see the idea of cutting that flap off could be a good one.

Thanks for going where no hose-head has gone before...

Best,

Tom

[rested gal]

Next I think with a little trimming I can turn the mouth piece upside down so I can route hose over my head without the noise problem. I may wait on this one until replacement cushions are available.

Mike, after reading what you plan to do, I was gonna hold off on presenting this until you report on how sleeping upside down works for ya. Oh wait, you said the mouth piece, didn't you. Darn, I wanted to see you clinging with your toes to the headboard like a cute little bat!

Anyway, I agree with new2 that you deserve kudos for taking up the scissors and making that first cut into a mask that expensive. Jumping off the cliff was a good way to put it!

So..... here ya go:

[roztom]

MY first night with the Hybrid was a dismal failure. IT is about a 1/4 in. shy of a good fit at the pillows.

It leaked so bad that it lasted 6 minutes. It is just slightly too short for me and no matter how I pound my head I can't shrink it.

MY sleep mate turned to me and said, "Wow, you sure got a big leak there." How much more convincing do you need?

I agree with Mike that that chin support is unnecessary. Without it I just might get the extra manuverability I need for it to fit.

I have nothing to lose to try the fix.

Scalpel here I come.

Best,

Tom

[new2]

I'm having a good result so far with my Hybrid. The pillows are a dream for me solving my number one problem in full face masks,the air blowing from the bridge of my nose into my eyes. Second only to the sores on the bridge of my nose now replaced by only very slight leaks in the chin area.
The leaks are so few that it's a non issue for me and thanks to Mikes bravery in trimming his first, THANKS MIKE!, I have no strap marks from the useless (on me, anyway) chin flap. I cut the flap off my large even though I wear the small and now even the large fits. Tonight, I'll cut my small
Compared to trying every mouth sealer on the market ... I'm in heaven.
I'll tell the story of trying to sleep with a sock in my mouth to prevent the air from passing through the tape another time.

_________________

Mask	Humidifier
Additional Comments: second fave is my new Bravo Pillow mask

[rested gal]

I'll tell the story of trying to sleep with a sock in my mouth to prevent the air from passing through the tape another time.

ROTFL! Do please tell that story sometime...a good one for when lab rats gather 'round the campfire!

Sounds like it will be as good a story as when a woman on another board, in desperation to stop mouth air leaks, taped the tip of her tongue to the OUTSIDE of her upper lip. She said the pain of the dried out tongue was excruciating the next morning.

Geeze, the things we try....

[roztom]

Sock?

Wow, now I've heard eveything !!!

The visual is too much. I just threw my back out laughing.

Hey, xPAP isn't supposed to be this much fun, is it?

Best,

Tom

[mikemoran]

Ummm when someone told you to "Stick a Sock in It" that isn't exactly what they meant

[roster]

Compared to trying every mouth sealer on the market ... I'm in heaven.
I'll tell the story of trying to sleep with a sock in my mouth to prevent the air from passing through the tape another time.

I don't want to throw this good thread off track, but just have to mention that I received Dr. Sue's NoseBreathe mouthpiece and have used it the last three nights with my Swift pillows. Since my mouth still leaked a lot the first night, the last two nights I have been using the mouthpiece and taping my mouth. Of course this worked better and I am wondering if eventually I will get my tongue trained to lay all night on the shelf of the mouthpiece and then be able to stop using the tape.

A sock eh? I paid $80 plus s&h for the Nose Breathe. I guess a pair of white tube socks is $1?

In the meantime I am waiting for Apria to call and say my Hybrid Mask has arrived.

_________________

Mask: Hybrid Full Face CPAP Mask with Nasal Pillows and Headgear

Software: Encore Pro Smart Card

Additional Comments: M Series Integrated Humidifier

[roztom]

Hi:

I did the "Moran Mandibular Reduction Procedure" on both my Med and Large Hybrid cushions.

This has some interesting ramifications.

It appears I might be abe to use the Med cushion with the Large Pillows or the Large Cushion.

Considering neither had a shot in.... this is a step in a positive direction. I have tested during the day and still have some leaks at the pillows but it is SUBSTANTIALLY less than before the Mandible Extraction.

I will try it tonight and let you guys know how it goes.

In addition Id like to corroborate Dr. Moran's observation that the mouth cushion seems much more comfortable and flexible after the Mandiblectomy.

When adjusting the straps I found I got my best seal when the upper straps were backed off from very tight - not unlike other interfaces.

Headgear: I find the headgear is a pain in the b..... However once carefully adjusted I have found that if I put the Headgear on before attaching the mask that it goes pretty easily. I put on the headgear, seat the mask against my face, attach the upper straps and then the lower ones in that order. At least for me that seems better than having them pop off as you try to attach them independently.

Wish me luck, while it may still leak slightly at the pillows it has a shot at working. The truth is in the sleeping - I'll report back tomorrow.

You snooze, you WIN

Best,

Tom

[tooly125]

Headgear: I find the headgear is a pain in the b..... However once carefully adjusted I have found that if I put the Headgear on before attaching the mask that it goes pretty easily. I put on the headgear, seat the mask against my face, attach the upper straps and then the lower ones in that order. At least for me that seems better than having them pop off as you try to attach them independently.

Tom

If it looks like the hybrid is going to work out for you now that you modified it you might want to sew on the "fuzzy half" of some velcro on to the headgear.Its cheap enough and will eliminate strap pops.
I did the top strap on mine and what a difference I would have done the others but wound up using my HC431 headgear instead.
Your mask has been under the scalpel already so now it's time to stich it up.

_________________

Mask: Hybrid Full Face CPAP Mask with Nasal Pillows and Headgear

Humidifier: REMstar Heated Humidifier

Software: Encore Pro Smart Card

Additional Comments: titrated at 19 cm

[roztom]

Thanks: IF I get past the leak and Nare survival test tinight, I'll take you up on the specifics of the velcro fix.

Thanks,

Tom