Newbie struggling to find a mask

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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raftergirl
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Newbie struggling to find a mask

Post by raftergirl » Fri Aug 29, 2014 7:25 pm

I've been using cpap for three weeks. All night, every night with the ResMed AirFit N10 nasal mask. Good fit, with minimal leaks and no sore spots. However, I wake up in the morning with a very dry mouth. My tongue is practically glued to the roof of my mouth. My sleep clinic says I must be opening my mouth at night and I should get a full face mask. I have been working with the RT at my DME with no success. I have a small face and a pressure setting of 17. Not a good combination apparently. I've tried 6 masks so far.....ResMed Air Fit F10, Quattro Air, Quattro FX, F&P Simplus, Respironics Amara and one other Resmed that I can't remember the model. All in size small or petite/extra small. Some are instant fails, and some are ok for about 15 minutes, but only with them very tight, and absolutely no movement from me. Nasal seal seems ok, but terrible "face farts" around my cheeks. Squealing, fluttering, farting something terrible. The closest one to fitting was the F&P Simplus, but it was still very tight on my head, and started to leak after about 20 minutes. So I'm using my nasal mask with a chin strap. I sleep great, but still have dry mouth. I'm using Biotene mouth rinse before bed, and the Xylitol mouth lozenges. I've also tweaked the humidity level on my machine. It was set at level 1, and I'm experimenting with level 2 and 3. Level 3 seems to much, and I wake up more stuffy than usual. None of the humidity adjustments have stopped the dry mouth.

I have been 100% compliant, and I am sleeping so much better. Feeling a lot better also. I do have a stuffy nose and sinuses, but that's getting better with Xlear spray, saline rinses, and Nasacort. Cpap gas is getting better, but I'm still a bit constipated, which I never was before. According to my SleepyHead data (which i kind of understand) my % of time above the leak rate threshold since I've started is 0.10%, and my AHI has gone from 25 before cpap to 2.11

The RT at my DME seems to think that the nasal mask with the chin strap is my best bet because of my high pressure setting. I'll just have to keep adjusting the humidity and learn to live with dry mouth. Any thoughts?

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Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: AirFit™ N10 For Her Nasal CPAP Mask with Headgear
Additional Comments: SleepyHead software

library lady
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Re: Newbie struggling to find a mask

Post by library lady » Fri Aug 29, 2014 7:39 pm

I don't know if you can do this with a chinstrap in place, but this is how I solved the dry mouth problem... I got a covered mug with a straw, filled it half-full of water and put it on a little stool about 3 feet from my bed... not on the nightstand with the machine in case of spills. With my AirFit F10 in place, if I woke up in the night with a need for a sip, I pulled the connector off the mask, and took a couple small sips... not too much, or I might I have get up in couple hours for a trip to the loo...for those with FF mask if your mouth is not in line with connector, just use a flexible disposable straw instead. This should work well for those who have nasal mask or pillows as long you don't have a chin strap... Maybe with a chin strap if you can at least get your lips open enough for a straw, this would work but I know the idea is that a chin strap needs to keep you from breathing through your mouth, and if your lips are open, breathing can still take place. I've never used a chin strap since I've only used FF masks... so I don't know if this will work.

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Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: AirFit™ F10 Full Face Mask with Headgear
Additional Comments:  Sleepyhead
Now using AirFit F10 mask; Quattro Air is backup mask. RemZzzz mask liners with both.

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Sheriff Buford
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Re: Newbie struggling to find a mask

Post by Sheriff Buford » Sat Aug 30, 2014 7:01 am

The nasal mask is less intrusive... and I think you are better off. Stick with the mask. You'll get used to it and will learn to work the kinks out of it.

Sheriff

purple
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Re: Newbie struggling to find a mask

Post by purple » Sat Aug 30, 2014 7:43 am

Salt Lake city Utah is, in terms of humidity, like a desert. Might be one of your meds is part of the issue. So a chat with whomever prescribes those things might help.

I know that when I lived in SLC, the sleep clinic at the University of Utah was enormously helpful. As they are always training people, they always have a lot of very conversant staff around.

This is the kind of issue a DME is supposed to help with. For a newcomer the DME is supposed to be holding your hand through all this process. Have you, hopefully in a friendly way, maxed out all the advice the DME might give you. Usually a DME has an RT on call. Can you speak with that person on a sustained basis?

Just because others do not have your problem, does not mean you do not. A lot of RT's are busy. if you do not get an answer that helps, call again, in a friendly way. They will presume that if you do not call back, your problem got solved.

Nearly always, the advice of an RT (who sees lots of cases of failures and successes, whereas we only see our experience for a limited number of nights) is gold. But if you are determined to use a FFM, I used a Fischer and Paykill Forma mask for a long time. it has what is called a chin cup. Masks with chin cups move around less on the face, and develop fewer leaks. Also, I found using a hose hanger system was a big help, in that the hose pulled on the mask and helped develop leaks. While one might just tie the hose to the head board with a piece of string, I bought a "Hose Buddy" from out sponser, cpap.com

I have found that the elastic straps wore out faster than Medicare allows renewal, which means I cinched them down too tight, and woke up with pain where the mask pressed my face. I know some masks can be overtightened. If the silicon cushion is smashed down, it does not keep the seal as well. Also, my face, will become smaller at night, so waking up with a little leak is not so unusual.

A lot of us, have bought mask liners from Pad a Cheek, which help with leak and comfort. I have no affiliation, just another satisfied customer. However, a mask liner is more for a FFM. Better wait until you know which mask works for you.

Eventually, you might want to consider a regimen where; when one gets up, scrub your face clean. While water is still on it, put on skin oil. This helps to make the skin more supple, less likely to leak. The problem with doing this before going to sleep is that nearly all skin oil are bad for the silicon of the mask.

Some use Lanisoh, as it does not, (I have heard) not hurt silicon, and can help with nasal pads. Someone else will have to correct me, I have never used Lanisoh.

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raftergirl
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Re: Newbie struggling to find a mask

Post by raftergirl » Sat Aug 30, 2014 8:23 am

I have been working directly with the head RT at my DME on the mask issue. He seems quite knowledgable on mask fit, but so far no dice on a FF mask. I have been into the DME office 6 times in three weeks, and have now tried 7 different masks. They all leak terribly within 5-20 minutes of use. I have tried small and extra small masks. Silicone and gel masks. The best fit so far was the F&P Simplus, but it only worked when super, painfully tight, and it leaked terribly after 20 minutes of use. Other than the dry mouth, my nasal mask is comfortable and I sleep very well with it. The RT has recommended that I stick with the nasal mask (ResMed Air Fit N10) and the chin strap. I have experimented with the humidity and temp levels on my machine (suggestions from another dry mouth thread) and this morning my mouth is less dry. I was hoping to find a FFmask that would work comfortably so as to make this more simplified, but so far no luck. I also have a time frame issue.....my 30 days to swap out and try new masks ends on Sept. 7, and I leave for vacation on Sept. 4. So my window to try new masks is just about to close. My vacation is 10 days of whitewater rafting in the backcountry of Idaho. I'll be "off the grid" for those 10 days, so I'll be powering my cpap machine via battery. That means no humidifier for 10 days. We'll see how that works?

_________________
Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: AirFit™ N10 For Her Nasal CPAP Mask with Headgear
Additional Comments: SleepyHead software

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LSAT
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Re: Newbie struggling to find a mask

Post by LSAT » Sat Aug 30, 2014 9:20 am

A FF mask with a mask liner may be your solution. Has your RT suggested that? Check padacheek.com...there is a liner for almost every mask.

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library lady
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Re: Newbie struggling to find a mask

Post by library lady » Sat Aug 30, 2014 10:01 am

You could also get RemZzz liners, available at most DMEs, and online from the sponsors of this forum at https://www.cpap.com. Pad-A-Cheek liners are used by many here, but they were not comfortable for me, and I use RemZzzs with my FF mask.

I don't know why people keep insisting that one certain mask is the one you need, or that one type of mask is better than another. They are all good masks for the purpose, but everybody is different. FF masks, because they have a larger footprint on the face, will still leak... all masks have an intentional leak built in to release the CO2 to prevent rebreathing it. Be firm, but polite, until they let you try a FF mask.

_________________
Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: AirFit™ F10 Full Face Mask with Headgear
Additional Comments:  Sleepyhead
Now using AirFit F10 mask; Quattro Air is backup mask. RemZzzz mask liners with both.

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englandsf
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Re: Newbie struggling to find a mask

Post by englandsf » Sat Aug 30, 2014 10:53 am

Have you tried pillows? P10 maybe?

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Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: Sleepyhead SW. NeilMed and Alkalol Nasal rinses. Veramyst. AutoPAP 11-20 cms. Started June '14, untreated AHI 31-38, with PAP around 1.

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Sheriff Buford
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Re: Newbie struggling to find a mask

Post by Sheriff Buford » Sat Aug 30, 2014 11:45 am

library lady wrote:I don't know why people keep insisting that one certain mask is the one you need, or that one type of mask is better than another.
Stick around longer... it won't stop...

Sheriff

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raftergirl
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Re: Newbie struggling to find a mask

Post by raftergirl » Sat Aug 30, 2014 1:37 pm

I am very happy with my nasal mask, except for the dry mouth. I don't want or need nasal pillows. I don't think they would solve my problem. They might make it worse with my pressure setting of 17. The FF mask was the suggestion of my sleep clinic because they felt a super dry mouth meant that I was opening my mouth during sleep. They thought a FF mask would alleviate my dry mouth and optimize my therapy. The RT at my DME has been quite nice, and has had me try 7 different brands & types of FF masks. He did not talk about a mask liner though. My biggest issue right now is time. I leave in 4 days for a 10 day vacation. My 30 day window to try out masks for free will expire while I'm out of town. I may pursue the FF mask after I get home? So far the chin strap and some humidity and temp adjustments have cured about 75% of the problem.

_________________
Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: AirFit™ N10 For Her Nasal CPAP Mask with Headgear
Additional Comments: SleepyHead software

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SleepyEyes21
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Re: Newbie struggling to find a mask

Post by SleepyEyes21 » Sat Aug 30, 2014 1:58 pm

raftergirl wrote:I am very happy with my nasal mask, except for the dry mouth. I don't want or need nasal pillows. I don't think they would solve my problem. They might make it worse with my pressure setting of 17. The FF mask was the suggestion of my sleep clinic because they felt a super dry mouth meant that I was opening my mouth during sleep. They thought a FF mask would alleviate my dry mouth and optimize my therapy. The RT at my DME has been quite nice, and has had me try 7 different brands & types of FF masks. He did not talk about a mask liner though. My biggest issue right now is time. I leave in 4 days for a 10 day vacation. My 30 day window to try out masks for free will expire while I'm out of town. I may pursue the FF mask after I get home? So far the chin strap and some humidity and temp adjustments have cured about 75% of the problem.
Hi raftergirl - I'm not sure a FF mask will solve the dry mouth problem. I've only been on CPAP 2 days, and I'm using a FF Quattro Mirage. The first night, I had my humidifier at 2, as recommended when starting. My mouth was just a bit dry upon waking, but enough so that it was noticeable. I turned the humidifier up to 3 at first last night, but that was way too warm for me right now, tho it might be great for FL winters. So I backed down to a 1, and my mouth dryness was less than the first night. I will try a zero tonight, but I'm thinking it may just take a while to get used to breathing with a mask on at night.

I have the same machine that you do; there is a 'Check Mask Fit' feature on it that you should be able to set yourself. It helps to detect if the mask is fitting properly at least at the start of use.

My suggestion is to ask your PCP if there are any meds or OTC or home remedies for dry mouth. I've heard of Biotene also, but it doesn't work for everybody.

Have fun on your vacation

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Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Additional Comments:  viewtopic/t114176/OT-Time-out-andor-Duke-it-out-thread.html
SleepyEyes21

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SteveMP170
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Re: Newbie struggling to find a mask

Post by SteveMP170 » Sat Aug 30, 2014 2:15 pm

Hi. I don't know if this will help you but I used to use a full face mask when I started out two years ago. It took me 9 months of no help until I saw my doctor. I had air leaks, claustrophobia with this huge mask on my face; I think I feared getting into bed with this beast! My doctor immediately changed my mask to a nasal mask (Res Med Mirage FX) which has been unbelievable!!! It comes with a headgear with four straps that attach with Velcro so you get a nice snug fit. I have very little air leaks now and I sleep 7-8 hours of uninterrupted sleep a night. I hope this helps you--the mask could make all the difference!!! Steve
Steve

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Pugsy
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Re: Newbie struggling to find a mask

Post by Pugsy » Sat Aug 30, 2014 2:31 pm

Unfortunately dry mouth from mouth breathing isn't/can't always be fixed with a full face mask even if maximum humidity is used.
The oral cavity is simply larger and takes more added moisture to alleviate the drying by the exchange of air through the mouth.
Especially at the higher pressures. Add in the fact that some people's mouths are just drier than others or dry out more easily than others maybe from meds or just in general because that's they way their body is.
Using a full face mask eliminates the loss of therapy pressure by mouth breathing though.

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I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

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raftergirl
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Re: Newbie struggling to find a mask

Post by raftergirl » Sat Aug 30, 2014 5:52 pm

Thanks Pugsy. I think, based on my data on SleepyHead that I'm doing pretty well with my cpap therapy. In a total of 23 days, my AHI is 2 or less. I'm sleeping well, and feel a lot better during the day. My cpap gas, and nasal stuffiness are getting better. The only hurdle was the dry mouth.....and trying out all these silly FFmasks. By the way, how do I attach a screen shot to a post? I know how to save one on my Mac, but I can figure out how to attach one to a post.

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Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: AirFit™ N10 For Her Nasal CPAP Mask with Headgear
Additional Comments: SleepyHead software

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Pugsy
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Re: Newbie struggling to find a mask

Post by Pugsy » Sat Aug 30, 2014 5:59 pm

We can't attach things to our posts here but we can embed images/screen shots.
Here in this thread we talk about how to get screen shots and upload them to some place like Photobucket and then embed the links so the images show up in our posts.

Screen shot thread viewtopic.php?f=1&t=81072&p=737779#p737779

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.