Suggestions for which FF masks to try?

I just got my CPAP about a week ago, and it came with a F&P Simplus mask.

I wouldn't say that it works especially well, I usually end up waking up at about 3 in the morning because the pressure has increased enough to cause a leak.

I ordered an InnoMed Hybrid, a Swift LT Nasal Pillow, and a Mirage Quattro.

I don't like the nasal pillow because of how it blows the air out, but even if it was perfect, I have to consciously hold my mouth closed pretty hard, even at 10cm, to keep the air from leaking out. So I don't think a nasal pillow or nasal mask will work for me. I bought the return insurance so I'll be sending this one back.

The hybrid is ok, but I feel like it is pressing on my upper teeth too much and I'm concerned whether it will cause problems over time.

I bought the Mirage Quattro because of the forehead adjustment, but even at the farthest-in setting, it still leaks a bit into my eyes. With such a broad adjustment range, I'm surprised that it doesn't go in any farther. So I'll be sending this one back also.

Anyway, to my question: is there some method to the madness of trying masks? Do most people just kind of randomly order different ones? There are so many different ones it's hard to know where to even start, not to mention the different sizes. There's also no indication of which are newer vs older models.

As I said, I have the Mirage Quattro, and I see that there is also a Mirage Liberty and Quattro FX. Are these all similar? What do the names in common mean? (edit: just realized the Liberty is a Hybrid) If I don't like one, does it mean I likely won't like the others?

Thanks for the help. The sheer number of options is pretty intimidating.

FlyingMoose wrote:I just got my CPAP about a week ago, and it came with a F&P Simplus mask.

I wouldn't say that it works especially well, I usually end up waking up at about 3 in the morning because the pressure has increased enough to cause a leak.

I ordered an InnoMed Hybrid, a Swift LT Nasal Pillow, and a Mirage Quattro.

I don't like the nasal pillow because of how it blows the air out, but even if it was perfect, I have to consciously hold my mouth closed pretty hard, even at 10cm, to keep the air from leaking out. So I don't think a nasal pillow or nasal mask will work for me. I bought the return insurance so I'll be sending this one back.

The hybrid is ok, but I feel like it is pressing on my upper teeth too much and I'm concerned whether it will cause problems over time.

I bought the Mirage Quattro because of the forehead adjustment, but even at the farthest-in setting, it still leaks a bit into my eyes. With such a broad adjustment range, I'm surprised that it doesn't go in any farther. So I'll be sending this one back also.

Anyway, to my question: is there some method to the madness of trying masks? Do most people just kind of randomly order different ones? There are so many different ones it's hard to know where to even start, not to mention the different sizes. There's also no indication of which are newer vs older models.

As I said, I have the Mirage Quattro, and I see that there is also a Mirage Liberty and Quattro FX. Are these all similar? What do the names in common mean? If I don't like one, does it mean I likely won't like the others?

Thanks for the help. The sheer number of options is pretty intimidating.

It can be a rough period trying to put everything into place. You're not alone, and hang in there.

The mask listed under my name is a full face mask (FFM) and I've found the large size works pretty well for me.

One piece of advice that I would have as you try different FFM's to find the right one: focus not only what the problems are mask by mask, but also more generally. For example, I figured out as I was trying different FFMs that there was a consistent problem for me across every FFM that I tried (and also other types of masks): jaw drop or mouth opening. As I fall asleep, my mouth relaxes and drops. I figured out that this was not only contributing to dry mouth, but also to the leaks that would occur in the middle of the night and wake me up. It finally dawned on me that while I might have a mask on in a good position as I fell asleep, once asleep my face would relax and the mouth would open, and then my face would "change shape," the seal would break, and the leaks would occur and wake me up -- even with the benefits of a full face mask.

That's when I discovered the partial mouth taping solution and also the tongue placement technique, described elsewhere on this site. These two things have worked greatly for me, and I have the sense that I would take them with me even were I to change FFMs or types of masks. Using the two together in combination allow me to breath through my nose, with my mouth shut during the night, and thereby skip some of the problems that can come with not breathing through my nose. I also learned to breath in a slightly different way while using the Aflex software with my machine (software that allows a slightly lower pressure while you exhable, and is called different names depending on the manufacturer).

I'll put a description of both below if you're curious. Sorry I don't have more specific suggestions, but I wish you the best and hopes maybe this helps a little.

--Sleepy DC

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Ultimately, I stumbled on the following system that works very well for me: the Quattro Air FFM; tightening the seal on a slant; using a partial mouth taping system; learning to breath a bit differently while using the A-Flex system on a 1 setting; and learning to sleep in a relaxed state with my tongue placed up against the roof of my mouth. That last part is described elswhere on this site, and took a little getting used to, but now I do it automatically and comfortably without thinking about it. All of this works very well for me almost all of the time (nothing's perfect, not even my sleep pre-apnea), and seems to elminate dry mouth, waking up, and leaks. I get amazing sleep now, with all of its benefits!

1. Somewhere on this site I read advice that in sealing the Quattro Air, the trick seems to be sealing tighter on the lower portion of the face and less on the top. So it's somewhat at a slant, with the top portion being sealed across the nose just tightly enough to prevent leaks at the top and blowing of the air into the eyes, but not any tighter than that (initially I would just automatically tighten both the top and the bottom straps equally, without really thinking about it): '

(nose)
(mouth) /

I tend to tighten the bottom portion a bit more, so that it slightly presses into my cheeks. (I also wear a dental mouth guard from my dentis from my pre-apnea days to prevent teeth grinding), and the whole thing works pretty well.

2. As I said, the "tongue placement" trick is described elsewhere on this site.

3. Breathing differently: My machine uses the A-Flex system; different machines use other systems. All of them aim to lower the pressure just a bit on the out breath, so it's a little more comfortable exhaling. From a yoga/meditation technique I learned to inhale "normally" and consciously like I do when I'm awake, but then to exhale a bit less consciously than normal: the sense of droppng the breath, of just letting my lungs collapse on their own by suddenly relaxing and exhaling (but without forcing it). To put it a bit differently: during the day, I often slowly inhale, then slowly exhale, sort of controlling both in the same way; I'll do the same while exercising, though with quicker and more forceful breaths. I've learned to relax and sleep with an exhale that is not controlled in the same graduated way, but that consists of a sudden collapse of the lungs and the air being expelled more quickly (but not in the controlled way that one might do while exercising, for example).

And below is what I do with the partial taping system. Good luck and best wishes!

*********

For my FFM (full face mask) use I found it started working a whole lot better when I started using tape. For me, the "partial tape method" solves most of the issues with "mouth breathing" and "draw drop," which interrrupts the seal of a FFM (full face mask) because my face changes shape when that occurs and the seal is broken. It's not for everyone, but here's what I'd suggest:

Some people end up using chin straps with FFM's. I tried and disliked chin straps. I have now been using surgical tape for about a year now, and it has worked wonders and works very well for me. I use silk surgical type tape you can get off of Amazon, 2" wide. There's also a 1" wide version. If you gently pull it off in the morning, there's usually no problem. Just type something like "3M-Durapore-Silk-Tape 2 inches x 10 yards - box of 6" or the like on the Amazon site. For me, it works very well with a full face mask (FFM) -- the FFM helps prevent pressure problems if my jaw does open slightly, and the tape substantially prevents my jaw from dropping and also thereby keeps my face largely in the same "position" as I fall asleep (thereby avoiding the inevitable leaks that can occur when your facial shape changes from the point of initial placement/tightening of the mask). .

I was actually worried about not being able to breath with the tape if there was a shut-down. I've found that this set-up, however, offers very few worries:

For the silk tape, apply a 2inch wide strip vertically from a spot just above your upper lip (the indentation just below your nose) down to just under your chin (with your lips closed and your jaw in a comfortable place). As you bring the tape and press it underneath your chin, "fold" the edge back on itself (maybe a 1/2 inch or so) so that the edge hangs a bit from your chin -- makes for easier removal in case of emergency. Because it's only 2 inches wide and vertically placed, your entire mouth is actually not taped -- you can, in a pinch, breath around the edges -- and the silk tape itself I've found by accident (in opening my mouth with it being placed) will also let a little air in if you open your mouth forcefully. In short, it doesn't take too much force to maneuver or breath around the silk tape, but at the same time the tape seems to mostly keep my jaw from dropping when I relax and fall asleep, which is the whole point. [The setup also seems to work best when combined with the technique, described elsewhere on this site, of learning to relax with the tip of your tongue against the roof of your mouth as your mouth is closed, which "seals" the mouth from the nasal passage and helps prevent dry mouth]. (In placing the tape, I've also found it helpful to focus on firming the contact with the skin at the point below the nose and under the chin more than the lips, which seems to leave a little area of the lip region feeling less taped, if that makes sense). [To remove with less "tear", try pulling up vertically from underneath the chin till you reach your lip, then pull across "horizontally" for the remainder.]

The usual caveats about making up your own mind about this, considering safety issues, etc. apply, of course. But frankly, I'm surprised more people don't do this

The Resmed F10 is a very popular mask. You need to know that all face structures are different and what works for me may not work for you.

Sheriff

I used Sleepydc's tape advice and it helped greatly with my ffm masks leaks and fitting. It also allows me to use nasal masks and nasal pillows after looking at my data and making sure I am not mouth leaking at night.

A lot of other users have found that mask liners such as Padacheek and Remzzz work well. Some actually make their own out of cotton t-shirts. You can do a search on mask liners to read all about them.

As to mask models and types. It's all abut personal preference, performance, and comfort. Only you will be able to make the decision. It is madness! There are many to try and you need to give each one a little time. Sometimes one that you might give-up on works well when you discover the secret. Of course, any mask that causes nose sores, congestion, poor therapy, etc. should be moved aside. For leaks and comfort, give each some time if all else is working ok. For nasal interfaces, make sure that you aren't losing therapy by looking at your data on sleepyhead software, available from the first page on the forum or just ask for help in another post. You will also know if a nasal interface is leaking via the mouth the old fashioned way....you wake up with a wicked dry mouth!

Of the hundreds of masks, there are probably some old and some new that would work for us. However, you have to have a place to start, and I recommend the newer, popular versions or each type, espcially for those of us starting out. These usually have comfort features that help with the adjustment such as light weight, few parts, simple/comfortable headgear, softer seals, etc. For full face masks, they are the Resmed Quattro Air, Resmed F10, and F&P Simplus you mention. For nasal masks, the Phillips Wisp, F&P Eson, and the Resmed Swift Nano. For nasal pillows, Resmed Airfit P10, Resmed Swift FX, Phillips Nuance models, and Aloha. If you ask about any of them of or do a search, you can find out a lot more from users of those models that interest you. Then you have to let the trials begin. You can use your free period of trade with the DME if you have a good relationship, or you can take advantage of the free insurance for a 30 trial of many models from the forum host cpap.com. The nice thing is that many of these newer models include free insurance and shipping. Also, insurance isn't a great deal more to include on masks that don't have promotions.

Lastly Sleepydc mentions learning to breathe with your machine and the comfort features that help with exhale. I too use exhale relief on my machine and find it really helps. Others dislike it or have no use for it. Keep in mind that sometimes pressure relief features may affect your therapy. I use EPR on my machine which is a 3cm pressure decrease on exhale. This effectively reduces my exhale by that amount at all inhale pressures. Thus, I have to adjust my prescribed setting to make sure that the pressure drop doesn't lead to unwanted events. Again, you need need to monitor your data to keep an eye on things like this and most importantly the general success of your therapy.

Masks will work themselves out over time as best as possible for sleeping with an elephant trunk, yet nothing matters if your therapy isn't effective. You won't know without monitoring. I looked at my AHI of 2 to 3 for 8 weeks thinking how great I was doing and didn't look at my data. After getting really sick, I looked and found out that I was having all 20 or so of those apneas in a 30 minute period with some lasting over a minute. Don't be me! You will get a lot of help here. Just keep asking and reading! Good luck!

Best,

Mike

Imho, mask fit is by far the trickiest part of CPAP therapy, and everyone is different, so you won't know until you practice, practice, and experiment. If you have issues with getting a seal on the bridge of your nose, due to a narrow or prominent bridge, I would suggest you keep giving the hybrids a try. I use the innomed hybrid with a pad-a-cheek liner. I haven't perfected it, by any means, but it saves my poor bridge, which really took a beating with all the other ffms I've tried. Try the different sizes of pillow, and if you have nostrils that are uneven, you can cut the pillow connector and use different sizes, as needed. There's a lot of helpful information on here, so I hope you figure out a solution that works for you. If you find the holy grail of ffms, please let me know !

FlyingMoose wrote:The hybrid is ok, but I feel like it is pressing on my upper teeth too much and I'm concerned whether it will cause problems over time.

You have it adjusted too tightly. I have used one for years without leaks and my pressure runs up to 20 cm nearly every night. No need to adjust it tightly.

I do use the ladies' tights fix to stabilize the nasal pillows on my hybrid.

FlyingMoose wrote:I just got my CPAP about a week ago, and it came with a F&P Simplus mask.

I wouldn't say that it works especially well, I usually end up waking up at about 3 in the morning because the pressure has increased enough to cause a leak.

I ordered an InnoMed Hybrid, a Swift LT Nasal Pillow, and a Mirage Quattro.

I don't like the nasal pillow because of how it blows the air out, but even if it was perfect, I have to consciously hold my mouth closed pretty hard, even at 10cm, to keep the air from leaking out. So I don't think a nasal pillow or nasal mask will work for me. I bought the return insurance so I'll be sending this one back.

The hybrid is ok, but I feel like it is pressing on my upper teeth too much and I'm concerned whether it will cause problems over time.

I bought the Mirage Quattro because of the forehead adjustment, but even at the farthest-in setting, it still leaks a bit into my eyes. With such a broad adjustment range, I'm surprised that it doesn't go in any farther. So I'll be sending this one back also.

Anyway, to my question: is there some method to the madness of trying masks? Do most people just kind of randomly order different ones? There are so many different ones it's hard to know where to even start, not to mention the different sizes. There's also no indication of which are newer vs older models.

As I said, I have the Mirage Quattro, and I see that there is also a Mirage Liberty and Quattro FX. Are these all similar? What do the names in common mean? (edit: just realized the Liberty is a Hybrid) If I don't like one, does it mean I likely won't like the others?

Thanks for the help. The sheer number of options is pretty intimidating.

The only reason that the pressure would increase is to stop an apnea . That is the only reason the pressure would go up. (Than will only happen if you are using your machine on auto).

As far as the Quattro...the forehead adjustment should not be tight. The top should be loose and the bottom should be a little tighter. The mask should fill with air and float. If you are tightening all your masks too much you will have a hard time finding a comfortable one.

LSAT wrote:The only reason that the pressure would increase is to stop an apnea . That is the only reason the pressure would go up. (Than will only happen if you are using your machine on auto).

I am aware of why it happens, but that doesn't change the fact that it happens and wakes me up.

---

I tried the nasal mask last night. While my mouth remains totally closed and my tongue against the roof of my mouth, the air still leaks around the sides and wakes me up. I bought an ace bandage today and I'm going to try wrapping that around my chin to see if it helps. I think if I taped my mouth, it would just make my cheeks puff up.

FlyingMoose wrote:

LSAT wrote:The only reason that the pressure would increase is to stop an apnea . That is the only reason the pressure would go up. (Than will only happen if you are using your machine on auto).

I am aware of why it happens, but that doesn't change the fact that it happens and wakes me up.

---

I tried the nasal mask last night. While my mouth remains totally closed and my tongue against the roof of my mouth, the air still leaks around the sides and wakes me up. I bought an ace bandage today and I'm going to try wrapping that around my chin to see if it helps. I think if I taped my mouth, it would just make my cheeks puff up.

In my experience, the vertical, "partial taping" method some of us use does not lead to cheeks puffing up. .... The taping method, combined with tongue placement and nose breathing, for the most part keeps one's cheeks and mouth and jaw in the same place as you sleep -- thereby eliminating leaks and wakeups....

sleepydc wrote:In my experience, the vertical, "partial taping" method some of us use does not lead to cheeks puffing up. .... The taping method, combined with tongue placement and nose breathing, for the most part keeps one's cheeks and mouth and jaw in the same place as you sleep -- thereby eliminating leaks and wakeups....

Well, my teeth were still touching and the air came out through the side. I guess I have especially flappy cheeks...

FlyingMoose wrote:

sleepydc wrote:In my experience, the vertical, "partial taping" method some of us use does not lead to cheeks puffing up. .... The taping method, combined with tongue placement and nose breathing, for the most part keeps one's cheeks and mouth and jaw in the same place as you sleep -- thereby eliminating leaks and wakeups....

Well, my teeth were still touching and the air came out through the side. I guess I have especially flappy cheeks...

you might notice that teeth (unless they have enough tartar buildup to give a dentist a conniption fit) can't form an airtight seal, there's gaps between them.

palerider wrote:you might notice that teeth (unless they have enough tartar buildup to give a dentist a conniption fit) can't form an airtight seal, there's gaps between them.

I was merely making the point that my mouth couldn't be any more closed.

FlyingMoose wrote:

palerider wrote:you might notice that teeth (unless they have enough tartar buildup to give a dentist a conniption fit) can't form an airtight seal, there's gaps between them.

I was merely making the point that my mouth couldn't be any more closed.

well, if your MOUTH is closed (lips) then no air can get out... but if your JAW is all that's closed, (teeth together) but your lips are loose, then air can... was kinda my point.

just saw grannies post that snuck in while I was typing this one... *giggle*

When I first started, I had nights of dragon breathing and chipmunk cheeks. After a few weeks, things changed. I believe I relaxed and started breathing normally. My tongue automatically rests behind my front teeth and I breath using my abdomen. So, relax and try some of the suggestions, at some point you will realize it is getting better.
I've only used a nasal mask and then a pillow mask and I am on bipap 15/11. There are other posters with higher pressures using pillows. So as long as your nasal airway is patent they can work.
Whatever you choose work with it for a while trying to fix the problems before giving up.