Activa Shallow vs. Standard?

Requesting any input from anyone familiar with the particular fit of the ResMed Activa nasal mask. I had a comfort gel medium and was having a lot of eye links. Went to a small and it's better. Now I have a large Activa and like it better than my Comfort Gel small, especially because the headgear is a little lighter and does not have to be tightened so much. However, I'm still getting eye leaks. I've found that when I pull the mask down lower on my nose, so the top cut out sits lower on my bridge, eye leaks are reduced considerably. However, in this position the bottom of the masks rests nearly on my upper lip line, not just below my nostrils. I don't get leaks down there, but it doesn't feel right.

I'm thinking of trying the Activa in a shallow or standard. The shallow would fit lower on my bridge that the standard, but it would be wider around my nostrils. Also the shallow is significantly wider over the bridge than either the standard or large. The standard would just fit my nostrils, according to the template and looks like it would be an overall tighter fit than the shallow. Actually the standard template matches up pretty close to my comfort gel small.

So, any suggestions if going to either the standard or shallow would help with the eye leaks, or if it either would make any difference at all from my large?

Thanks for any ideas.

Joe

I think the Shallow would be an excellent idea to try. I can wear either Standard or Shallow in the Activa, but the Shallow suits me better. The difference between those two cushion shapes is miniscule, but often it's just a small difference that makes a mask be more comfortable or seal better.

Several years ago, a cpaptalker who was able to talk to an RN who worked the support phone at ResMed asked her about "Standard vs Shallow." The nurse told him she thought the Shallow fit more people better than the Standard did, and that in her opinion the Shallow ought to have been called the "standard."

I guess then the "Standard" would have had to be renamed the "Deep."

DME's are going to stock more of something called "Standard" no matter what, as that word sounds like something that would fit more people than a specially named size.

DME's are going to stock more of something called "Standard" no matter what, as that word sounds like something that would fit more people than a specially named size.

Thank you RG . The DME does have to order the Shallow I think, which corroborates your observation. My concerns about the shallow are that I have a fairly narrow bridge and that cut out seems fairly deep. So will the additional wideness allow for gaps around the bridge for more leaking? This seems to be what the DME thinks. Also the shallow is wider around the nostrils. He thinks it will leak there though I have not had leak problems with either the Activa large or Comfort Gel Small in that area. I've done abit of experimenting with my comfort gel insert and the Acitva templates. By lining them up to each other and squishing the gel mask to match the template shape, I then put it up to my face and see how it may fit. Using my small comfort gel, it seems to match up close to the standard, but the standard is a tad shorter, which is good. when I squish it more to the shape of the Shallow, its sits even lower on my bridge which is better yet, but it is wider than my bridge. The sides do go out from the notrils more, but up against my face it doesn't seem significant. The bridge of the standard seem to fit mine very closely.

So, at first my DME said if the large is causing leaks, the other sizes will too, all along saying the shallow will be too wide for me -Maybe that's not the mask for me. After describing my anatomy to him and some of the stuff I've told you (I've never met this rep in person, just talked to him on the phone so far BTW). then he said perhaps the standard would be a better fit- this after all along saying the standard wouldn't help as it's only a fraction lower that the large. Seems he just wants to send me one or the other at my 3 month interval this month. All this after in a previous phone conversation he explained how a proper fitting should go (which was the textbook explanation) Sigh... so I'm back here for obvious reasons... I thiink maybe I need to insist he bring both those to me and do a proper fitting, which I never got with this DME (or any other) with the Activa Large they left me. My hope is that I can fix the eye leaks and make the Activa my workhorse mask, then branch out from there. BTW I've also started washing mask and face daily/nightly at his suggestion, which helps, but doesn't change the clear fit problem with the large. Have gone back to the Comfort Gel this week to make a comparison. It's about the same leakwise that's why I think the Activa holds more promise, i.e. the comfort gel pretty much fits. And the biggie for me... the headgear on the Activa can fit looser and much more comfortable.

Well a little more background if you have any other thoughts. Thanks again . - Joe

SleepyJoeMS wrote:Well a little more background if you have any other thoughts. Thanks again . - Joe

Yeah, I do have another thought, given that background you posted. My thought is... it's absolutely essential to have a mask a person can actually "sleep" in, in order to do this kind of treatment...

And... any DME who talks about the importance of proper mask and proper mask fitting should BEND OVER BACKWARDS to help a person find that. The DME should let you try BOTH a standard and a shallow, at home, for several nights with each cushion....that is, if the DME really, really, really cares about helping you get a good "fit."

But then, I'm not a DME trying to watch every penny.

I am a cpap user though, who knows that getting good cpap treatment is almost all about the mask, the mask, the mask. Such a little thing, that means so much. A couple of little pads of silicone are all you're asking to try. Yeah, the stuff costs way too much in the first place, imho. But the mask can absolutely make or break being able to sleep AND get good treatment at the same time.

Geeze, Mr. DME...most of your customers never question what you give them, never complain, just try to make do, and never even know they are leaking like crazy. And a good many drop out quietly without ever telling you why. Here's Joe...a good guy who is educating himself about the treatment and is determined to do it. For goodness sakes, let Joe try a couple more sizes of cushion, even if you don't think one or the other will work!!! Ya never know, until you try. Under real home sleeping conditions.

I would go with the shallow. The shallow does fit more people than the st or the lg. The trick with fitting the activa is to not overtighten the bottom straps. Tightening the bottom straps causes it to leak at the upper lip. Going from a comfort gel to the activa can be a big difference because most people are used to tightening down the comfort gel.

I would go with the shallow. The shallow does fit more people than the st or the lg.

Thanks. That seems to be the thought so far. Am I getting the right impression that the width of the bridge cut out, being somewhat wider than the large (and my bridge) is not that significant? And I'll keep working on the straps too.

Thanks you for your input cpapqueen1 . Joe

Yeah, I do have another thought, given that background you posted. My thought is... it's absolutely essential to have a mask a person can actually "sleep" in, in order to do this kind of treatment..

Thanks RG, for your additional encouragement I have a follow up phone call for Wednesday with the DME. You've encouraged me to push more for a proper fitting than to throw darts and have them send me one or the other. I am hopeful about this mask and do want to make it work.

Joe

Interesting thread!!!! I am going to request an Activa mask from my DME on Monday. From all the descriptions here, I should choose the Standard....
My "main mask" is a Headrest (nasal pillows), but I also use a ComfortGel on occasion and I'm looking for a replacement for that mask -- though I do like the CG now that I have one that fits!!!!
Like you Joe, they gave me a Medium and I kinda made do with it because it worked ok -- I had some eye leaks that I could eliminate by poking my fingers in the silicone seal and making it seal better, or like you, move it down on my nose which made it press against my upper teeth causing soreness in the teeth (just didn't feel that was right!!!). I also learned the "don't tighten it down so much" lesson on the CG....you have to leave room for the silicone to inflate and seal, so my straps are very loose.....When I got the small it was like a godsend -- Fits. Doesn't leak (much). Doesn't hurt my teeth.....works pretty darned well. I just really like the headrest best of all...
I've heard so much good about the Activa here that I figured I'd give it a try since I really don't "need" a new mask -- I'm always looking for that "perfect mask"......

I am going to let my DME know that if they need to order the mask they need to order all the interface sizes, so that I can "fit it" properly -- and I will try it for a week or so (unless it's totally a hoser), take a look at the data, and decide on how I feel and how it feels -- if it ain't right, I'll send it back --- Done it before!!!! If it is right, I'll put it in my "stash" and use it in place of the CG (basically just put it in the rotation)......

Good thread!!!
cheers
goose

try also adjusting the forehead piece--i find this to be an excellent mask---but you do need to find the sweet spot for fit---

Like you Joe, they gave me a Medium and I kinda made do with it because it worked ok -- I had some eye leaks that I could eliminate by poking my fingers in the silicone seal and making it seal better, or like you, move it down on my nose which made it press against my upper teeth causing soreness in the teeth (just didn't feel that was right!!!). I also learned the "don't tighten it down so much" lesson on the CG....you have to leave room for the silicone to inflate and seal, so my straps are very loose.....When I got the small it was like a godsend -- Fits.

Goose - I have the same thing with my teeth too over time during the night. With my CG though, it seems I have to tighten the straps more to avoid leaking, not less, which is one reason I'm trying to make the Activa work. One thing for you to be aware of, because the Activa is "active" so to speak, it does tend to "bellow" or move in and out with your breathing. It can be subtle, but noticible at first. If it bothers you stick with it and I predict it won't be an issue. I don't even notice that now. The Activa is also bigger over than the CG, but my feeling is if I can just sleep I won't notice that either.

Good luck and I'd like to hear your progress on it as it sounds like your CG experience was similar to mine therfore perhaps your Activa experience will be helpful.

Joe

try also adjusting the forehead piece--i find this to be an excellent mask---but you do need to find the sweet spot for fit---

I've noticed this and it's true. Actually it's counter intuitive for me. I need to set the forehead piece furthest out from my face. That is, the opposite of bringing the top of the mask in closer or tighter. I get the fewest eye leaks in that position. With my comfort gel, it's just the opposite and probably more typical. I have to bring it in tighter to my face to reduce the eye leaks. Go figure -

Thanks for replying. Joe