Brand newbie with mask questions

[NoREMs]

Hi everyone,

I've been diagnosed with mild/moderate sleep apnea. I just got my machine and mask yesterday. They sent me home with 2 full face masks to try (Mirage Quattro and another Resmed model that's slightly older, can't remember the name)...I have such allergy and congestion issues that I need to use the full face option because I never know when I might need to mouth breathe.

They used the Quattro on me during my titration and I seemed to do OK with it except at the end of the night when I started getting eye leaks. Then the technician adjusted the tilt downward on my nose (too tightly) and I was sore on the bridge of my nose the next day. I started last night with the Quattro, tried it out for a while when watching TV and it seemed OK. After lying down for a while I felt eye leaks so tried to adjust. Then it started leaking around the chin. It seemed like I'd get a decent seal and after 15 minutes or so, leaks. From there it was like a comedy of errors -- NOTHING I tried could get that thing to seal. Same deal with the other model. So I guess my questions are:

• Where exactly is the mask supposed to sit? I have a feeling I had it either too high or too low (or both during my endless adjustments!) Is there a particular technique you should use to get it in the proper position?

• Is it good/OK to lift the mask while you're at full pressure to readjust? I had a hard time trying to reseat it on my face with the air blowing.

• If the mask "sucks" down slightly toward your face when you breathe in, does this mean an improper seal?

• Once the mask is on and your straps are tightened, is it a good idea to fiddle with the seal with your fingers (pushing it inward or adjusting)?

• Why do I still feel like I'm wearing a mask hours after I removed it?

• Am I ever going to get used to this and get a proper fit?!

Thanks for any suggestions you veterans can provide!

[Muse-Inc]

Welcome abord! You've come to a great place for info and support..great folks here!

Go to the User Control Panel (top left under the cpaptalk.com blue bar) and complete your equipment profile; use "TEXT" not "ICONS" so we know what equipment your'e using. Please tell us your pressure too.

I am now wearing the Hybrid mask which might work for you. It covers your mouth and has nasal pillows so your nose is not covered (no sore bridge, no eye leaks!). Click on its link at the bottom of this post and it will be displayed. Comes with 3 sizes of mouthpieces and 3 sizes of pillows for max ease in getting the right fit.

Mask fit is critical... it shouldn't hurt. Our mantra here is patience and persistence.

[Rustyolddude]

I've posted my Quattro wisdom in these 3 threads, Hope there is something that will help you. The quatto requires a gentle touch. Notice how thin the seal is? No you should feel it on your face hours after you removed it. In fact, you should be barely aware of it when you are wearing it.

viewtopic/t43884/viewtopic.php?f=1&t=43 ... 28#p389928

viewtopic/t43884/viewtopic.php?f=1&t=43 ... 48#p389537

viewtopic/t43884/viewtopic.php?f=1&t=43 ... 67#p388867

[NoREMs]

Muse and Rusty,

Thanks so much for your replies. Muse, I've now added my equipment info -- thanks for the tip. (Always something to learn when you're new to a forum!) It's frustrating when you're so excited about getting your machine and finally getting a good night's rest, and then you're up until 3:30 adjusting and readjusting!! I will try to be patient and make sure that I get the right fit. If Rusty's suggestions for the Quattro don't work for me I'll definitely look into the Hybrid. Sounds intriguing.

Rusty, thanks for the great tips on getting the Quattro to fit right. I will print them out and try them tonight. So it looks like it IS a good thing if the mask feels like it's puffing up and down a little as you breathe. I thought I was doing something wrong. The technician at the titration study wasn't very helpful and the DME lady was nice enough but I don't think she uses a CPAP so you have to wonder how much she really knows!

I'll keep poking around the forum and see what else I can find. What a great resource!

Shari

[Muse-Inc]

With a pressure of 16, I'd investigate swapping out for an APAP (RedMes AutoSet 11 for example) they deliver different amts of pressure based on your previous 5 breaths with the goal of delivering the least amt of pressure to help you maintain that pattern breathing. When they detect flow limitations (you are not breating in as much air), they begin to increase the pressure up to the machine's set maximum. Your ramp pressure is the machine's lowest setting but if you're comfortable breathing at 4, I'd leave it alone as that low pressure might actually be helping you fall asleep.

Do a search for APAP and read up.

[NoREMs]

You know, I think it's kind of sad that the doctors don't give us more detailed info about our conditions and the options that are available. From some reading I've done, I think I need to "fail" with a CPAP in order to move to an APAP (at least for my insurance company to pay for it). This, of course, begs the question of exactly why I need such high pressure, which nobody has ever really explained to me either. (Do you need higher pressure if you're overweight? Is it purely due to the physical structure of my throat tissues?) All the doctor really told me when explaining my results was that I have "mild to moderate OSA" and that my RDI on my back was 9 and in non-supine positions only 5. I thought that sounded very mild and wondered why I was having so many daytime symptoms with such low averages, then the DME lady looked at my report and said that my average apneas during REM were 42 per hour! (No wonder I'm not getting restful sleep!). I think I will call the sleep center and ask for a copy of my report so I can study it in more detail.

Thanks again for the welcome and info.

/S

[Muse-Inc]

...why I need such high pressure...

I takes that much pressure to stent open your airways. Nothing to do with severity of apnea, just anatomy. If you are very large, losing wt might mean less pressure if your airways change shape. After losing 53#s mine did and I need less pressure now (some do not experience this). I have more wt to lose and want an APAP (ins says 'no' so far), so I don't have to go thru the mess these past few months have been with waaaay more events at night.

[jdm2857]

Your other mask is probably an Ultra Mirage. Is this it? https://www.cpap.com/productpage/resmed ... dgear.html

[NoREMs]

Muse -- yeah, I could lose 50 pounds or so myself. Will be interesting to see if that makes a difference in required pressure. Thanks again.

JDM -- yes, that's the other mask they gave me. Any experience with it yourself? I found it harder to adjust the tilt but other than that it was comparable to the Quattro.

/S

[gasparama]

If you have your choice of machine, you might ask no only for the APAP, but you might want a data capable machine. Here is one link to a discussion about these:

viewtopic/t43884/viewtopic.php?f=1&t=42 ... ne#p379583

My doctor was so glad that he ordered one for me because my mouth leaking was yielding some pretty bad results that would not have been discovered without the data. It can be difficult to get insurance to provide one without the specific directive of a doctor. Having one of these machines is not absolutely essential, but it can be helpful if you want to monitor your on progress. Many CPAP users don't want one and that is understandable.

[NoREMs]

Gasparama: thanks for the tips. I'll see how I do with this machine and talk to the doctor and the DME place about options. I don't want to buy the wrong machine and then have insurance not pay for the next one...

About the masks, I went to the DME this morning and got a few other masks to try. I suspect that part of my problem was that the masks were too small, so she gave me a Mirage in medium and another one (not sure of the name) that has gel. She didn't have a medium Quattro in stock. We'll see how it goes tonight!

[NoREMs]

Quick update: after no luck trying even more masks, my dr. has finally agreed to try APAP with me! Can't get the machine until some time next week but am excited that it might help. The DME also said she'd try ordering a Full Life since the other full face masks I've tried have not worked well (although that may have to do with the pressure as well...). So I'll hopefully be posting my Full Life review soon as well! '

Thanks again everyone for the good advice.

/S

[Muse-Inc]

Quick update...

Thanks for the update! Keep us posted.