Looking for some advice on the Amara View

[cathyf]

Since I've lost so much weight my face has changed shape, and it's been an increasing struggle to keep my F10 on and sealed. So Friday I went to the DME and we went on a mask search. After trying a few things that didn't work, I tried the Amera View, and I really like it. There are a few things that I think I'm not "getting" with this mask, though.

With the F10 I started with a size small mask and was having a tough time keeping it sealed -- there was a sweet spot, but the tiniest movement up made it leak out the top, down made it leak out the bottom, sideways made it leak on the side. I went to a size x-small and that was great, and then after losing 100 lbs I realized that the size small worked better, and so I went back to an old cushion and have been using it since January. This was my first time with this dme (Lincare), as my husband's employer changed insurance companies and the provider list changed. This dme doesn't seem to have a selection of sizes. ("Most people are mediums, so I'd have to special order a different size.") So ended up with a size medium cushion, and I it seems ok, but of course I don't have another size to compare against. But the width and height of the mask do seem to be a bit too big for my face. It's really hard to keep it sealed if I close my mouth -- with mouth open the bottom is comfortably nestled below the indentation between lower lip and chin, but when my mouth closes the bottom of the mask slips down to the underside of my chin, which is sloping away from the mask rather than towards it. I'm a mouth breather, but only when I'm asleep -- normally when I'm lying in bed before I fall asleep I have my mouth closed. I've found that when it starts leaking I need to open my mouth slightly and then the pressure inflates my cheeks out chipmunk style against the cushion and it seals. The problem is that during the night when my mouth gets dry I close it to swallow and try to get some saliva going. But this causes leaks, which wakes me up, and then I have to fuss with the mask to get it sealed before I go back to sleep.

Does this sound familiar to other users of this mask? I know that the sizing on this mask is different -- it's all about how far your nose sticks out from your face, not about the width and height of the area that the mask covers -- so I don't know if the size small would really be any smaller where it matters to me. I found the sizing guide on our host's website (why is it that the cpap.com online catalog is more useful than the in-person dme staffed by a so-called expert?) and according to that I am just on the small side of the border between medium and small.

Also, I'm not really sure that I have the mask positioned properly. The description is that you don't want any part of the cushion up over the tip of your nose, but I find that I leak out 360-degrees until I skootch the mask up a little bit. (Which is why I think it's just too big!) Does anybody else find the positioning instructions kind of confusing? The mask has a pretty complex shape, and it would really help to have an explanation of how the hole in the silicone is supposed to be aligned with my nostrils -- in both the up-down direction and the in-out direction. (Side-to-side I DO get -- it's supposed to be centered!)

[chunkyfrog]

Can't help you on the mask--they don't make MY size.
Props on getting rid of the hundred pounds! AWESOME!
I might suggest you play with the headgear settings.
Start with it almost too loose, easing it up until the cushion nearly floats

[grayghost4]

My wife and I both use amara view ... I use a large ... wife medium
The tip of the nose goes into the curve in the front of the mask and goes up around the tip and sides of the nose.
this places the bottom in the crease below the lower lip.

[PoolQ]

Some things I have learned:
1. as Grayghost said, the end of the mask "cup" goes just over the tip of your nose
2. the nose is sealed by inflating around the edges of your nose and not by pressing up from underneath
3. as with most masks, it is quite sensitive to strap pressure, adjust 1/8" at a time
4. do not force it up under your nose, your nose will get sore and it's not needed
5. sometimes, even now, it may take a couple tries when I first put it on to get it sitting correctly.
6. that little strap near the breathing slot is meant to sit flat against your upper lip and not sit against the bottom of your nose
7. put is on, turn your machine on, then pull slightly away from your face to inflate it, then let it sit back down
8. practice when you have time and not just before you go to bed.

[bpb21]

Some things I have learned:
1. as Grayghost said, the end of the mask "cup" goes just over the tip of your nose
2. the nose is sealed by inflating around the edges of your nose and not by pressing up from underneath
3. as with most masks, it is quite sensitive to strap pressure, adjust 1/8" at a time
4. do not force it up under your nose, your nose will get sore and it's not needed
5. sometimes, even now, it may take a couple tries when I first put it on to get it sitting correctly.
6. that little strap near the breathing slot is meant to sit flat against your upper lip and not sit against the bottom of your nose
7. put is on, turn your machine on, then pull slightly away from your face to inflate it, then let it sit back down
8. practice when you have time and not just before you go to bed.

Thanks! This will help me - especially with #4 and #6, I can't seem to get these right and have a blister under my nose. I have the same mask.

Tip: if you think you need another size and your provider doesn't carry it - eBay! You can get different sized pillows priced quite reasonably on there (and new in packaging, name branded, too; not just ones that someone else has breathed through for months! Probably for the same price your provider would charge, or the same copay).

And to the OP, excellent job on losing 100 pounds! That's amazing!

[cathyf]

We called Respironics about this mask because 9 out of 10 were being returned for "bad fit" reasoning.

After a brief in-service with Respironics, they recommended the following:

1) Whatever your nose measures, go one size LOWER
2) When placing the mask on, lean your face over your lap, place mask onto face firmly, as you straighten your head pull the headgear over and affix, adjust, etc.
3) the mask shouldn't be tight or loose

Once we advised these changes we have had ONE return.

I read CanadaVoice's post, and then it got deleted. (I think because he/she linked back to his/her own online cpap supplies store. C'mon, linking that way is obnoxious!) Anyway, following that advice, I'm DEFINITELY a small! (Note the faint line -- that's where I marked with pencil where my nose was.)


Grayghost -- is your wife's medium smaller all around than your large, or is it just a different shape? From what you and bpb21 say, I think I've been trying to keep it a little too low. Tonight I'll see if I can get it to work a little better.

THANKS SO MUCH everybody!

[bpb21]

Any chance that nose card thing would be to scale if I were to print it out? I hadn't seen one of those before. (And feel like I should have...)

[Okie bipap]

Any chance that nose card thing would be to scale if I were to print it out? I hadn't seen one of those before. (And feel like I should have...)

This page of out sponsor's site has a link to a printable size guide: https://www.cpap.com/productpage/respir ... -mask.html

[cathyf]

Any chance that nose card thing would be to scale if I were to print it out? I hadn't seen one of those before. (And feel like I should have...)

The sizing template is rather clever -- on the top of the page they show the outline of a credit card and a quarter. If they print out credit-card sized and quarter sized, you are good to go!

A lot of the cpap.com masks have sizing templates. They've obviously thought hard about how you can buy something and get the right size without being there in person to try it on.

[grayghost4]

how did you mark there with pencil ... that part should be cut out to make the sizing card work .... cut along dotted line ... that means cut it out ! that changes the way it work .

https://5faacd0c97cf0d23c6dc-064f3cd61b ... -guide.pdf

No the lower portion of the mask is the same size.

[airborne2016]

I just started CPAP a few months ago. February and March were ROUGH, barely using it 2-3 hours a night and mostly awake. As soon as I tried the Amara View, it was love. I can read before bed, and I don't have any claustrophobic freak-outs with it.

HOWEVER, it has been a tricky mask for me to get under control. I wear a medium. Honestly, at the DME, we saw the sizing chart, and just decided to try them on to see which one fit instead. When I took the medium home, I actually did the sizing chart for fun, and I could have gotten a small ... I was right on that line, but I'm glad I went to medium.

Every night, I very loosely put the mask on first while sitting up. I do the top straps first until I feel like the mask is JUST secure on my face. Then, do the bottom so that it is just firm pressure against my cheeks. Then, I turn the machine on, and the cushions kind of inflate while it is reaching the set pressure. Then, I get into my sleeping position... usually on my back but I have used it on my sides. THE MOST IMPORTANT PART: I take the mask and lift it until it isn't touching my face. Then, I DROP it back down a little closer to the nose than you would think it would go. I have to do this 2-3 times at the beginning of the night, but I know when it works because it is absolutely silent when you drop it down on your face correctly. I basically think of it as dropping it down right on my nose (but still making sure your nose doesn't slip completely into that breathing hole ). You should be able to see the top part of the cushions surrounding your lower nose because they are so inflated with air.

If I do feel any leaks, I push down on the mask with one finger near the area where it is leaking while also tightening the headgear strap nearest the area where it is leaking. I only tighten the straps a "length of a grain of rice"-size at a time. It also really all came together when I got the velcro strap at the top of the head correct for my face shape. I just had to play around with it, but right now, I can easily slip 2 fingers under all of the mask straps on the headgear when set-up is complete.

For the past week and a half, my machine has read the 90% leak rate to be less than 0.1 every night.

It really is a finicky little mask, but now that I figured out how it works for me, I wake up most mornings worried that it isn't on my face until I reach up and feel it there.

[cathyf]

how did you mark there with pencil ... that part should be cut out to make the sizing card work .... cut along dotted line ... that means cut it out ! that changes the way it work .

OH!!! DUH! LOL Ok, I said at the beginning that there was stuff that I wasn't getting!

No the lower portion of the mask is the same size.

Oh, well, it sounds like a size smaller isn't going to help me anyway. Knowing that the mask is supposed to be going a little up the nose makes it fit on my face better. I'm still struggling with leaks, but it's not as bad and my AHIs are down.

But, one thing is really weird, even for me, the Queen Of Weird. For the last 18 months it's been true that as long as I'm awake I have no FLs and my pressure stays at the minimum, and then as soon as I fall asleep it's flow limit city and my pressure zooms up over a few minutes. It's only been four days, so it's not really a pattern yet, but last night I kept trying to figure out why the pressure kept climbing because I was still awake. Tonight looking in sleepyhead I can see that I was having a huge number of FLs when I was still awake. What the heck is up with THAT?!?

Every night is an adventure, I guess...