Mask Suggestions

I have been using a BPAP machine for almost 4 years. My pressures are 12/16 and I was using the WISP mask. When I changed doctors last year, he recommended a different mask, as my data showed high leak numbers. I switched to a F&P Eson nasal mask. Two weeks ago my machine was replaced to an AirCurve 10 VAuto and the technician indicated that the Eson mask was probably not the best choice as it tended to leak also. I called my equipment supplier and changed to a Mirage FX. I couldn't even get it on last night where air wasn't blowing out the sides. So i'm wondering if my pressures are too high for these types of masks. I really don't want to switch to a full face mask, but I also don't want to keep having leaks. Any suggestions on masks? I am a side/stomach sleeper, meaning I hug a pillow and most of my face is down towards the pillow. I have read through quite a few of the posts and it does seem many of you use full face masks. Should I just get over it and try one?

Thanks in advance for any suggestions.

Samantha

My bilevel pressures are higher than yours when in auto mode and I use a nasal pillow mask quite successfully....even with pressures over 20 cm at time.
Like you...I really didn't want to go to a full face mask for any number of reasons and the primary one being I simply didn't want to.

Any mask can be worn at any pressure as long as it is the proper size and fitted correctly.

Do you have the available software to see just what the leaks are doing? If not, get it.
https://sleep.tnet.com/equipment

If you were happy with the Eson....use it no matter what the tech says...she/he isn't using it..you are and just because someone else has problems with it leaking doesn't mean everyone else in the whole world has the same problem.

If your data is showing really high large leak numbers...maybe it wasn't the mask ...maybe it was mouth breathing.
Lots of possibilities.

Let's start with a mask that you feel you can sleep with and leaks don't wake you up and go from there.

I can give you suggestions as to what else to try but in reality they are meaningless because just because a mask works for me doesn't mean it will work for the next person. When it comes to masks....one man's treasure is another man's trash.
I tried the Wisp...absolutely hated it...lasted all of 90 minutes with it and it got returned. That doesn't mean anything though because there are a lot of people out there using the Wisp and absolutely loving it.

The Mirage FX...I tried one of those on. Never could get it to remotely seal for some reason or other. Others swear by it and others hate it as much as I do.

The old wives tale about needing a full face mask at higher pressures is just that...an old wives tale and not without any grain of truth or medical need to it. Now if you are indeed mouth breathing a lot then we might have a different discussion but how about using the software and let's see just how bad those leaks are before going down that road you don't want to go on.
I mouth breath on occasion...I know I do because I wake up with a dry mouth and mouth wide open breathing away. When I look at my software reports for the leak...maybe I was mouth breathing for 5 or 10 minutes...yeah some large leak then but not horribly horrible and even if it was horribly horrible I am not going to switch to a full face mask just to take care of 5 or 10 minutes of mouth breathing every now and then. It's not like FFM masks don't have their own leak challenges anyway.

Use the mask that you like the best with your new machine and let's look at the leak data available and see if you have anything that needs work or is maybe bad enough to be seriously impacting your therapy. Your new machine will work fine with Sleepyhead software and it's a bit easier to manage than ResScan but we can get you ResScan if you want it (Windows only though because there is no other operating system other than Windows for ResScan).
SleepyHead works on multiple operating systems...just get the version for your computer.

Thank you so much for taking the time to share that info. I actually have Sleepyhead already. My old machine didn't use the MyAir app so Sleepyhead was how I read my data.

When you say "what the leaks are doing", what do you mean? What data am I specifically looking at?

How much time are you spending over 24 L/min leak?
If more than 10% of the night...how much more and how high does it go?

According to the MyAir app my leaks are between 9 and 13 L/min.

Heres the data from Sleepyhead. I tried to clean it up some. I'm only including last week because the data prior was a different machine and different mask.

387 days of CPAP Data, between Mon Apr 20 2015 and Sun Jun 11 2017
Details Most Recent Last Week
CPAP Usage
Average Hours per Night 08:43 08:22
Compliance 100% 100%
Therapy Efficacy
AHI 1.61 0.99
Obstructive Index 0.80 0.43
Hypopnea Index 0.23 0.15
Clear Airway Index 0.57 0.38
Leak Statistics
Average Leak Rate 10.95 10.96
90% Leak Rate 27.60 27.60
% of time above Leak Rate threshold 13.05% 11.61%
Pressure Statistics
Average EPAP 11.00 11.27
Min EPAP 11.00 11.00
Max EPAP 11.00 12.00
Average IPAP 15.00 15.27
90% IPAP 15.00 16.00
Min IPAP 15.00 15.00
Max IPAP 15.00 16.00

Odd...MyAir should be reporting the 95% leak number and all the 95% leak number is where you were at OR BELOW for 95% of the night and if that's the case and this is indeed what you are having then I wouldn't be worrying about leaks at all. Well below the 24 L/min threshold that ResMed gives us which is actually a really conservative number anyway. The machine is still fairly accurate to a little about 30 L/min.

saduve1 wrote:According to the MyAir app my leaks are between 9 and 13 L/min.

Your SH 90% leak number is the same sort of number only for 90% of the night you were at or below that number.
Odd that there is such a discrepancy within the last 2 nights unless you have some other data mixed in there messing with the numbers.

saduve1 wrote:90% Leak Rate 27.60 27.60
% of time above Leak Rate threshold 13.05% 11.61%

So these numbers don't jive with what MyAir is reporting and I don't know why.

Which version of SH are you using....version is in the upper left corner when SH is open?

If you would register here at the forum then you could share with us a screen shot of what you are seeing and maybe we could figure out why the discrepancy.

What does the LCD screen say the leak number was? Again the LCD screen reports a 95% number. Do you know how to get to it?
You may need to change a setting in the clinical setup menu to see the detailed data available on the LCD screen.
This link is for a different model machine but how to get to the clinical menu is the same on all the AirSense or AirCurve machines.
And you have to change the setting called "Essentials" from "usage" to "plus" for the data to be available on the LCD screen.
https://sleep.tnet.com/home/files/resme ... -guide.pdf

If the leak number on the LCD screen matches the MyAir leak number and it is indeed that low then I wouldn't worry about leaks or mouth breathing and I would use the mask that I like the best and not worry about what the tech or doc says.

Actually even if the 90/95% was the really the 27 L/min I wouldn't worry about it then either. I don't start getting nervous about large leaks until I am over 35 L/min for a prolonged period of time.
90/95% numbers are easily skewed to the high side with just a short time in larger leak.
Here's a thread where I show a good example of that happening. Pretty ugly 95% leak numbers but in actuality I wasn't in big leak all that long...not nearly as bad as the numbers made it out to be anyway.
viewtopic.php?f=1&t=108724&p=1036669&hi ... t#p1036669

Changing from a Wisp to a full face mask essentially changed my ability to tolerate the therapy. I am a mouth breather and I couldn't deal with the chinstrap. I use a Fisher and Paykel, Simplus mask and I have had nothing but success with it.

Pugsy wrote:My bilevel pressures are higher than yours when in auto mode and I use a nasal pillow mask quite successfully....even with pressures over 20 cm at time.

mine too.

still waiting for my account to be activated. Once that happens I will post the info from my machine. It looks like what I see on the MyAir iPhone app is not extensive as what is in the machine. I did scroll through the My Report on the machine and it seemed to mirror the Sleepyhead numbers.

I would go by what's on the machine and the SH report.
The MyAir website doesn't always seem to report accurately or timely for some reason or other.

I see you use the P10. Did you ever use the Swift FX prior? I have that one that I never really tried.

saduve wrote:I see you use the P10. Did you ever use the Swift FX prior? I have that one that I never really tried.

The Swift FX nasal pillow was my primary mask from it's release in 2010 I think it was until the P10 (so probably 3 years or so) with a slight diversion in there for another different type of nasal pillow mask. I try pretty much all the nasal pillow masks that get released. Tried the F & P Brevida not long ago and currently trying the new Respironics DreamWear Gel nasal pillows.

I don't fiddle much with the nasal cushion masks because I don't really like anything on my nasal bridge area at all.
That of course really limits any full face masks except maybe a couple of the hybrid types. I don't need a full face mask and I don't want one so I don't normally bother to try to get one and experiment with it. Just doesn't interest me...but the nasal pillow masks...not many I haven't at least tried at some time or other.

I am of the opinion that if a person wants to try something then they should try it...never know what they will learn about it.
Now sometimes the only thing I learned was how much I hated so and so mask...but I always learn something.

I would love to use only a pillow mask. I got this one very early in my therapy and i think it was just too soon for me to try something so small, so I stayed with the nasal masks. But I found this one packed away when I changed out my machine, so I am thinking I might give it a try, since the other two don't seem to be working for me right now. What are you thoughts on the Dreamwear Gel you're trying? I saw that one on the website as well as the P10. I'm going to give the Swift FX a try tonight and see how that goes, but i'm guessing the P10 replaced it.

And again, I really appreciate you taking all this time to answer my questions. You have been extremely helpful!

Also, my Sleepyhead version is:

SleepyHead v1.0.0-beta-2

To save my fingers some typing and my memory since it sometimes isn't optimal...here's a thread with some comments about the new DreamWear Gel pillows. Not many have tried it yet but as more people try it there will be additional input.
I have several comments in the thread.
viewtopic/t118356/Respironics-DreamWear ... hread.html

Overall I like the mask..it's not 100% perfect ( I have yet to find one that was as they all seem to have some little something that I might want to be just a little different) .
My 2 main negatives and they are very small negative and no where near deal breaker status
1...I wish they had an XSmall in the pillows
2...I wish the venting at the nose was more diffused like the P10 or the F & P optional diffuser system.

The diffused venting was the really one main big improvement I felt with the P10 over the Swift FX. The Swift FX had the direct venting and was bit loud and annoying when it hit hubby or myself. The P10 is silent and you can't feel the air coming from the vent holes unless my hand is about an inch away from the holes. I am surprised that more companies haven't done more with the diffused venting system...Respironcis dropped the ball on that one with the new gel pillows DreamWear.

It's still a good mask...been using it a month or so maybe longer. If it didn't like it I would have sent it back. I bought it from cpap.com and it comes with free return insurance. I used my own money...not insurance...so if I didn't like it I wouldn't keep it. These things cost too much money to be doing that.
I will keep it and for me that's saying something.

I still haven't found "the perfect" mask. Doubt it is out there. What I do is evaluate my own personal needs and wants and decide if the mask fits my needs or not. I look at the pros and cons (and there's always at least one) and decide if the good outweighs the bad and go from there.
Now your needs and wants and preferences might be different from mine...that's why we always say YMMV with this stuff. One man's treasure is another man's trash...and that's very true when it comes to masks.