Mask recommendations

I've been using the AirFit20 since I started just over a month ago. Started with the foam one and it leaked a ton, so I switched to silicone. It's been fine until my most recent minimum pressure bump. Just went up minimally from 7 to 7.5, which is not very high, and suddenly I'm having leaking problems all night (3 nights in a row). Because I am still getting clusters of events during REM, I'd like to be able to try different minimum pressures. I've tried to adjust the fit, but can't seem to find a way for it to work. I will try making a mask liner, but I'd also just like to get some recommendations for a different FFM to try. Most importantly, I need one that doesn't blow air near my eyes - they are extremely sensitive to pretty much everything. I've heard one of the FFMs out there does this, but I don't remember which one.
Thanks.

Have you looked at the Respironics Amara View full face mask?
https://www.cpap.com/productpage/respir ... -mask.html

Just wondering RainMom, do you clean your mask seal often? If I forget to clean mine for a couple nights I have horrible leaks.

RomeinDNVR wrote:Just wondering RainMom, do you clean your mask seal often? If I forget to clean mine for a couple nights I have horrible leaks.

Wipe nightly with a non scented baby wipe to remove facial oils. Cheap and fast.

Yes, I clean mine off with a wipe every other night.

I use the F20 and the Amara View masks. I use pretty high pressure (18 - 21) and keep both masks slugger than most people recommend. If I don't, I get bad leaks once I fall asleep and my facial muscles relax.

I use the F20 and like it a lot. When I replaced the cushions recently, I began to experience pain on the bridge of my nose and long-lasting facial marks. I placed a pad-a-cheek liner on the mask last night. This morning I noted that there were no facial marks or discomfort, my leak rate was the highest in months, and my AHI was the lowest in months. Problem solved!

Comfortably Numb wrote:my leak rate was the highest in months, and my AHI was the lowest in months. Problem solved!

Just how high are we talking about here and for how long? Was it so high and lasted so long that the machine was clueless and the low AHI was because it was asleep and couldn't sense anything?
Or did you mean lowest and not highest?

Comfortably Numb wrote:I use the F20 and like it a lot. When I replaced the cushions recently, I began to experience pain on the bridge of my nose and long-lasting facial marks. I placed a pad-a-cheek liner on the mask last night. This morning I noted that there were no facial marks or discomfort, my leak rate was the highest in months, and my AHI was the lowest in months. Problem solved!

I have noted that some cushions are a bit stiff for the first few days--even to the point that a nose blister forms.
Wearing a band aid over the tender spot saved my schnozz while my mask was "breaking in".
I used mask liners for a while, but stopped after my skin toughened up.

Pugsy wrote:

Comfortably Numb wrote:my leak rate was the highest in months, and my AHI was the lowest in months. Problem solved!

Just how high are we talking about here and for how long? Was it so high and lasted so long that the machine was clueless and the low AHI was because it was asleep and couldn't sense anything?
Or did you mean lowest and not highest?

I was being sarcastic while truthful, Pugsy. Last night my AHI was only 0.38 while my average leak rate was 12.41 and my 90% was 25.2 (large leaks 10.2%). Over the past 6 months my AHI has averaged 1.35, my average leak rate has been 1.24 and my 90% has averaged 0.69.

It seems that I may have been focusing too much on leakage. By loosing up on the straps and adding a liner, my leak rate has soared but my AHI dropped. Is the primary goal a low leak rate or comfort and a lower AHI at the expense of leaks?

Comfortably Numb wrote:It seems that I may have been focusing too much on leakage. By loosing up on the straps and adding a liner, my leak rate has soared but my AHI dropped. Is the primary goal a low leak rate or comfort and a lower AHI at the expense of leaks?

My primary goal has always been get good sleep and feel better and scoring a 100% on the math test never has even made it to the list of my goals.
Numbers don't mean squat if you don't sleep good or feel good.

I do keep one eye on the leak numbers but I don't go to extra ordinary means to attain perfection because I learned long ago that for me getting perfection usually meant I had to sacrifice sleep quality.

Comfortably Numb wrote: Last night my AHI was only 0.38 while my average leak rate was 12.41 and my 90% was 25.2 (large leaks 10.2%). Over the past 6 months my AHI has averaged 1.35, my average leak rate has been 1.24 and my 90% has averaged 0.69.

Last night could have been a fluke bad night. We all have them from time to time. Even if it wasn't a fluke night...those numbers wouldn't cause me to panic at all. 10% of the night over the red line...out of 7 hours of sleep...that's 42 minutes and I bet it was broken up into lots of little short lived big leaks and some barely over 24 L/min. 90/95% numbers don't mean much...they are too easily skewed by just a very short time in big leak. I take them with a grain of salt. Now it's nice when they are say 10...then that means I don't bother to look further....lessens my work.

What I do when I see the leak numbers maybe be a little higher and into large leak territory.
First I look to see just how it went...I don't even bat an eye until I go over 35 L/min (ResMed machine numbers) and even then I might not get all excited...I then look to see how long I was over 35...short length of time or half the night kind of stuff.

How did I come up with 35 L/min...because I once had a night where I got a good chance to see leaks go from small to large all in one night. Made it really easy to evaluate.
Over 24 to 30...the machine functioned as to be expected...flagged OAs and hyponeas as expected.
From 30 to 35..I still got the flagging of the events but the machine called them "unknown apneas"...it knew something was going on but didn't know what to call them.
Once it went over 35...no flags of any kind where 15 minutes before I was seeing those unknown flags...now I suppose it is possible that nothing happened and that's why no flags but I highly doubt it consider right before I was seeing the unknowns.

The problem with time spent in large leak...we can't trust the data....is the AHI low because nothing happened or low because the machine was clueless?
The 24 L/min red line given by ResMed...I think that is an ultra conservative number. I think the machine can actually do a decent job up to the 30 to 35 mark when things start getting iffy...over 35 and seems like all bets are off. Most people aren't going to spend much time in that big of a leak anyway.

All this is assuming that the leaks don't wake me up...
If I wake often from leaks and having to fiddle with the mask....I don't care what the numbers are...it needs to be fixed.

My primary goal is and always has been....getting good sleep and feeling decent. My leak graphs aren't real pretty but I sleep through the leaks and actually it is very rare that I even go over 30 L/min...once in a great while I get some really big leaks but they are normally short lived...or maybe I am trying a new mask and haven't got the fitting adjustments dialed in.

Good numbers don't guarantee much of anything except maybe the right to get a pat on the back. They are nice to see but they don't mean squat if your sleep quality is in the toilet because in the desire to get a perfect leak line the mask is so uncomfortably tight that we simply can't sleep very good. Yeah...the leak numbers are nice and low but we feel like crap because we slept like crap.

Newbies tend to fixate on the numbers...I did the same thing when I was new to therapy. Took me a few months to realize that good numbers don't guarantee feeling good and actually bad numbers don't necessarily mean feeling like crap. Like a couple of weeks ago I had a night with AHI of 10.2....still scratching my head over that one...leaks were very well managed for a change and I felt like I always did.

Sometimes in our desire for "perfect" numbers we do things to ourselves that causes poor sleep quality...and end up making ourselves feel a lot worse than just letting 10 minutes of large leak happen and we never know it until we see the report. Sometimes the cure is worse than the disease.
That's why I stopped the taping and chin strap and whatever search...while not horribly annoying they did cause more wake ups than the leaks I was trying to prevent.
My sleep is already fragile....I see zero sense in adding something to make it more fragile when that something really doesn't do anything good and sometimes causes more discomfort...and I end up with my sleep quality/quantity suffering.

Going back several comments ago, yes, I've been wondering about the Amara View. Love the idea of having the mask off my nose (as a glasses wearer, it seems my nose bridge is under 24-hour pressure now, rather than just during the daytime) and away from my eyes. Seems to kind of have mixed reviews, though. But, I realize everyone's different, so maybe it would work for me.

Yes the reviews on the Amara View are mixed but I think that happens with a lot of full face masks.

You won't know until you try it as to how well you like it or how much you hate it. The mask you are using now...I absolutely hate, hate it. Others love it and swear it's the best thing since sliced bread.
We can tell you our experiences about a mask but the end result is you have to try it yourself.
The Amara View is the only full face mask that I can use. It's the only one I have actually been able to sleep all night with.
Is it perfect? No, but then no mask is ever perfect. We just have to pick one that has more pros than cons.

Are you thinking about purchasing out of pocket on your own?
If so cpap.com has it with free return insurance...if you hate it you can get your money back (see the return policy for the particulars).
Also...do call cpap.com, if you buy from them, because there is a discounted price off the published MSRP.
ResMed doesn't allow discounts but Respironics will allow discounts but you have to call to get the discounted price.
So anytime you see "call for pricing" on any Respironics product at cpap.com....make the phone call because it will save you money.
How much depends on the product but if I remember right with the Amara View it was a $20 savings. Can't swear to it but that sticks in my mind for some reason.

I will have to check with my DME about getting a different mask. Have no idea what their policy is on this. Thanks for the tip if I need to buy it myself. And thank you for your help!

Rainmom17 wrote:Going back several comments ago, yes, I've been wondering about the Amara View. Love the idea of having the mask off my nose (as a glasses wearer, it seems my nose bridge is under 24-hour pressure now, rather than just during the daytime) and away from my eyes. Seems to kind of have mixed reviews, though. But, I realize everyone's different, so maybe it would work for me.

I have been using the F20 for some months and although it works for me, I do have some comfort issues with it. I have also been considering the Amara View and I like your comment about being a glasses wearer, I hadn't thought about it like that but yes it would be good to free up the nose bridge for a few hours.
My main concern with the Amara View is how the direction of vented air may disturb my partner's sleep but I'm sure I'll find a way around this. I think I'm going to give it a try.