Yet another hybrid mask review

[tooly125]

Hello to all,

I have had the hybrid mask for a week now and would like to share my results with a review

My background;
Diagnosed with severe sleep apnea
On cpap for about six months
Pressure set at 19 cm
I have a mustache that goes down to my chin (see avatar).
I have always used a full face mask I have tried nasal interfaces briefly however had terrible results.
Because of how tight I wear my masks to prevent leaks the bridge of my nose is always getting beat up, moleskin has become my best friend.
The hybrid is now the fourth mask I own and is my first real experience with nasal pillows.

My first night I chose the large mouthpiece and the medium pillows cranked the straps down tight but there was a problem the fifth strap that goes over my head it kept popping off, I got up put a safety pin in it and went back to bed. Kind of hurts my nose but I have no leaks so off to sleep. Seven hours later the alarm wakes me to a very sore nose it even hurts to take the pillows out of my nostrils!
I have heavy strap marks on my face and an impression of the chin cup on my chin.

Second night with my nose still a little tender I try the small pillows and sew on a piece of Velcro (the fuzzy half) to the top strap, the top strap now holds nice and tight, I figure on doing the rest of the straps later because in process of putting the mask on they keep popping off. I went to sleep only to wake five hours later with my nose in great pain. Took the mask off went back to sleep bare faced.

Third night I went back to the medium pillows, my nose is still a little tender. I notice that the headgear from my HC431 which also has five straps looks like it would fit the hybrid. I make the switch and it seemed to stabilize the mask better and the fifth strap is easier to adjust on the HC431 headgear. Went to bed and six hours later the alarm woke me up my nose feels better but there still is pain when I remove the mask but not as bad.

Fourth night I trim the top part of the mustache down about an eighth of an inch after reading a post from rested gal about how if you wear your top straps too tight it could cause nose pain .The trimmed part allows the mask to seal better and allows me to loosen the mask. Sleep through the night and wake with almost no pain.

Fifth night slept well, only slight pain in my nostrils. Leaks have not been a problem with this mask. All I need to do now is order some pad a cheeks for the strap marks and I should be all set.

This Mask for me is definitely a keeper, I am already used to sleeping with the hose in the down position and the amount of air coming out of the exhaust ports is not a problem as I side sleep facing away from my wife.
This mask has been a very positive experience for me the only disappointments were in the headgear I won’t go back to the hybrids headgear the Hc431’s gear controls the mask better and has stronger Velcro.
As others have stated the little posts that the clips attach to look like they could easily break off they may never break but being a toolmaker I have already started making plans on how to replace them if they ever break.

After five nights of nothing chewing up, bruising or otherwise harming the bridge of my nose I see no turning back .

Gerard

[maskjkie]

Hello to all,

I have had the hybrid mask for a week now and would like to share my results with a review

My background;
Diagnosed with severe sleep apnea
On cpap for about six months
Pressure set at 19 cm

Tooly125,

You might want to get a re-titration done with the Hybrid. Your pressure might go down by 2 cm or so and then you do't need to wear it so tight. I just re-titrated a patient yesterday who was using a UMFF with a pressure of 18.5 cm and the pressure required went down to 16.5 cm.

[tooly125]

Tooly125,

You might want to get a re-titration done with the Hybrid. Your pressure might go down by 2 cm or so and then you do't need to wear it so tight. I just re-titrated a patient yesterday who was using a UMFF with a pressure of 18.5 cm and the pressure required went down to 16.5 cm.

I actualy have a follow up visit with my sleep doctor next month.
I am trying to also drop 20 pounds have lost 8 so far. Could be possible with the new mask and the wiegt loss to drop the pressure further?
Anyway thanks for the advise I will be sure to tell her your findings.

[maskjkie]

I am trying to also drop 20 pounds have lost 8 so far. Could be possible with the new mask and the wiegt loss to drop the pressure further?

If you can do that, you might be able to drop 4-5 cm. I also suggest that you pay particular attention to the AHI value during re-titration. I've found it to be the case on a few of my patients, several others reporting on this forum also say that their AHI value has come down significantly (in several cases dropping from 4 to 1). This has a direct correlation to the quality of sleep you are experiencing.

[roztom]

Nice job Gerard:

I agree on those nubs, the headgear was where they cut a corner with the Hybrid.

Glad to hear your taming that varment.

Best,

Tom

[tooly125]

maskjkie,
4 to 5 would make a huge difference on how tight I wear my mask.
Guess I'll skip the midnight snack

Thanks Tom I hope you have more luck with yours after the surgury!

[Snoredog]

for them sore nares:

Try some "Ayr Gel" nasal saline gel sold at pharmacy like Longs for a few bucks. Put some of that in them nares it will keep them moist, help with the pillow seal and help with the nare pain.

[Issac]

Tooly, To find a good mask with our pressures is rare, indeed.

Maskjkie.
I currently have the Resmed S8 Vantage that I will be changing out for a Bi-Level mashine of some sort, soon. First week of August, I will be able to order a Hybrid and I am wondering about these reports of lower pressures from the Hybrid Mask.
Would it be wise to hang on to the Autopap for a week or so on my new Hybrid , assuming I like the mask? If my pressure could be lower, I would want the Bi-level device to be set lower. Might this also save me a trip to the hospital for retesting? Also, I cannot get right ,in as the wait is almost a month for a test. Can the tech lower my Bi-level based just on the report of the Autopap?

[Isaac]

Tooly, To find a good mask with our pressures is rare, indeed.

Maskjkie.
I currently have the Resmed S8 Vantage that I will be changing out for a Bi-Level mashine of some sort, soon. First week of August, I will be able to order a Hybrid and I am wondering about these reports of lower pressures from the Hybrid Mask.
Would it be wise to hang on to the Autopap for a week or so on my new Hybrid , assuming I like the mask? If my pressure could be lower, I would want the Bi-level device to be set lower. Might this also save me a trip to the hospital for retesting? Also, I cannot get right ,in as the wait is almost a month for a test. Can the tech lower my Bi-level based just on the report of the Autopap?

Isaac,
Before I suggest anything, I would like you to report to me the pressure, AHI and leak rate after using the Hybrid with the Resmed S8 Vantage for 3 days. Please use the UMFF setting on the machine.

[Snoredog]

Tooly125,

You might want to get a re-titration done with the Hybrid. Your pressure might go down by 2 cm or so and then you do't need to wear it so tight. I just re-titrated a patient yesterday who was using a UMFF with a pressure of 18.5 cm and the pressure required went down to 16.5 cm.

I actualy have a follow up visit with my sleep doctor next month.
I am trying to also drop 20 pounds have lost 8 so far. Could be possible with the new mask and the wiegt loss to drop the pressure further?
Anyway thanks for the advise I will be sure to tell her your findings.

I've read where if you can drop your weight you can address up to about 70% of your SDB events. So they say, but I have never found any data or long term study to support that. It's like one bad doctor has that idea and passes it on to another, then you see it in sleep litrature.

But personally, I don't believe weight has much to do with it. When I was first diagnosed at age 45, with 76 events per hour and SAO2's down to mid 60's , I was 6' 1" and weighed 175-177lbs., in pretty good shape. I went a good 7 years with severe OSA because I didn't fit the typical mold for it and I even asked my doctor repeatedly about it. Finally after 2 strokes, I went in one day and told him if he didn't schedule me for a PSG I'm getting a new doctor, I had been with him since he got out of medical school for more than 20yrs now. I've gained weight since then, up to 225lbs., my pressure is the same as it was 5yrs ago even with the extra weight.

The pressure needed to stent your airway depends on how much pressure it takes to push your tongue up and out of the way. They can say airway collapse all they want, but for most people it is simply the tongue falling into the back of the throat. Remove your Uvula, remove your tonsils tongue still falls back into the throat, reason the UPPP surgery isn't very effective in treating OSA. It is only when they do a GA/MA do they see results.

Your best bet is to determine where your obstruction is (based upon your pressure, I'd say your tongue). If you snore you could have a palatal blockage from a extra large Uvula.

Look at your pillow, don't use a pillow that is too thick, this can jack the head up and make your OSA worse. If you sleep on your back, sleeping without a pillow can sometimes be better, or one that supports your neck to cock your head into a CPR position is what your trying to achieve, but that is hard to do and sleep in.

Sleeping on your side or stomach can dramatically lower your pressure requirement, but it requires a autopap. If they told me my pressure was up in the high teens like yours is, I'd be wanting to see a copy of that titration study results and observer any CA's, MA's, noted on it.

A mask might result in lower indices based upon CO2 retention characteristics but they typically do NOT result in a lower cpap pressure. I can see you wanting to try and lower your pressure as that has to be difficult to deal with, you might want to look into a auto-bipap. Ted Nugent or Titrator would be the guy you should seek out, he has had some experience with that machine. PM him, I'm sure he will respond.

[birdshell]

Tooly125,

The pressure needed to stent your airway depends on how much pressure it takes to push your tongue up and out of the way. They can say airway collapse all they want, but for most people it is simply the tongue falling into the back of the throat. Remove your Uvula, remove your tonsils tongue still falls back into the throat, reason the UPPP surgery isn't very effective in treating OSA. It is only when they do a GA/MA do they see results.

What is a GA/MA? Thank you.

[rested gal]

MMA = maxillomandibular advancement

GA = genioglossal advancement

BillinSeattle has some very interesting posts about going through both the MMA and GA procedures. Smart guy. He researched it well.

Jan 20 2006 subject: any mma/ga pictures??? Billinseattle???

Jul 26 2005 subject: 6 months after MMA/GA ...Wheew !

May 16 2005 subject: MMA/GA 4 months ago...

Feb 02 2005 subject: 2 weeks out from MMA/GA...whew!

Jan 22 2005 subject: Brother considering MMA surgery

Those links were dug up from this one...discussions about MMA and other surgeries are at the bottom third or so of the page:

Clickable LINKS to surgery, turbinates, Pillar, TAP experiences