Inquiring Mind Wants to Know 1 (ontopic semirant)

[Slinky]

Thanks, RG, for saying what I've been holding my tongue and fingers for as I read thru each post to get to the bottom of this thread.

THE LAW OF GRAVITY is the key to the failure to make a personalized mask.

[roster]

However, facial contours are going to change with every change of position.

I don't think there's any way to create a mold that can handle things that are likely to happen in "real life" sleep:

Pillow smushing against side of face and against side of mask.

Simply turning the head to one side or the other even if the body is not turned can change the "thickness" of one cheek or the other. Good old gravity.

RG, I will never forget, when I first started here, how you would tell us about the ResMed Mirage Activa nasal mask. You made it sound like it would fit what you wrote above. You always said it sealed so well it "would provide good therapy if worn on the knee."

Too bad the design of a full face version of the Activa is problematic. It sounds like what M.D. is looking for, except in an off-the-shelf design.

Is your opinion of that nasal mask, or the newer version, still so high?

[DoriC]

Thanks, RG, for saying what I've been holding my tongue and fingers for as I read thru each post to get to the bottom of this thread.

THE LAW OF GRAVITY is the key to the failure to make a personalized mask.

Of course, why didn't I think of that? I was describing it so well in my own post:?

[GumbyCT]

At least give me one point for making reference to pantyhose.

Knee-highs were on Sale at the Dollar store 3pr/$.50 - I bought the rest of their inventory.....I'm GOOD

I'm not gonna disagree with the thought but I will say I think the nares are much easier to fit and seal. If only we could spend some time teaching the noobs to "Learn" to breath thru the nose.

We take breathing for granted and no longer know how to breath correctly or in a healthy manner.

[unadog]

.

[Janknitz]

Faces are so dynamic that I fear this is an extremely difficult task. It's one that manufacturers try to compensate for with inflated seals and gels that respond to body heat, but with poor success.

Perhaps another approach is to apply some substance to the face or cushion (brush it on?) that would lightly stick the mask to the face (like a post-it note for the face!) and be strong enough to maintain the seal with normal movement of the face. The substance would have to remove easily without a trace, and not cause skin, sinus, or lung irritation. Dream on, huh!

I've used Mack's silicone ear plug material like that with some success on the Mirage Micro mask, but it couldn't hold against movement and pressure blowouts at the bridge of the nose because the mask itself didn't have enough give there--that darn mask ALWAYS leaked into my eyes, terribly. I think this dream substance would work better with something that has a very flexible cushion to begin with like an Activa, but I discovered nasal pillows before I made "friends" with the Activa mask so I never tried the Mack's silicone stuff. Even on nasal pillows, something like my dream stickum would really help reduce the leaking and slippage that can occur.

Finally, I wholeheartedly agree with what others have already said. If the DME providers would take the time to do a good an proper fitting and take into consideration the individual's facial structure, size, sleeping position, and sleeping style, there would be a lot less discomfort and a whole lot more compliance going on. It may be a pipe dream to make custom masks for every face, but with the wide range of masks available, it ought to be easier to get one that approximates a best fit. And, since nasal pillows have the least contact with the face, it was an excellent point that was made that nasal pillows are often the best bet if we can help people learn to breathe through their noses whenever possible.

[Mr Capers]

M. D. Hosehead,

I agree with you. I've got some very custom fits, eyes, feet, toes, and I won't name any more. The underlying bone structure of the face is pretty much the same sitting up and lying down except for the jaw dropping or moving back. I think we could do a lot better than the current situation and found your illustrations very apt. And, I fully expected RG to give at least a rousing "ATTABOY" for the panty hose. But, you must remember, she uses tights. So maybe you would have fared better mentioning tights but I think panty hose works better from a literary point of view.

Happy Naps,
Mr Capers

[DreamStalker]

A mask custom made to fit a person's face sounds like a good idea.... IF a person lies motionless in one position all night... with head in same position all night long... same exact position in which the custom fit was made in the first place.

However, facial contours are going to change with every change of position. We won't even get into the problems of how well (or poorly) a mask cushion is designed to withstand CPAP air pressure inside.

Back to just the molding process... I don't think there's any way to create a mold that can handle things that are likely to happen in "real life" sleep:

Pillow smushing against side of face and against side of mask.

Relaxing the jaw or opening/closing the mouth during sleep.

Simply turning the head to one side or the other even if the body is not turned can change the "thickness" of one cheek or the other. Good old gravity.

...snip ...

Can be a long, frustrating (and expensive!) quest to keep trying masks until a person finds one that suits. I don't think "custom molded" is necessarily the answer.

Ah yes, the quest for the mask.

Occam's razor rules!

Ahhhhh ha ha ha ha ha ....

Sorry, I had a few Optimators this afternoon.

[roster]

Perhaps another approach is to apply some substance to the face or cushion (brush it on?) that would lightly stick the mask to the face (like a post-it note for the face!) and be strong enough to maintain the seal with normal movement of the face. The substance would have to remove easily without a trace, and not cause skin, sinus, or lung irritation. ....

That is the kind of good unique thought that is needed to find a good, unique and economical solution. Good job.

You should also think about all these studs, rings and other hardware people wear in their faces and orifices. Maybe something could be implanted that would interface with a mask?

Maybe magnets implanted under the skin to match up with magnets in a mask? (Side advantage - fashionable refrigerator-type magnets could be worn on the face during the day. )

[cobra4x4]

One other thing that seems to be forgotten ...

For those new to cpap quite often there will be a loss in weight which in turn will create havoc with mask fitting. You might say wait until your weight has stabilized before getting a custom fit mask, however peoples weights often change many times a year and quite often weight gain/loss occurs in the facial area as well as others.

[sandster]

I would have to agree for the most part about custom fit masks. I spent the better part of an hour today, and am grateful my sleep technologist had the time, looking at full face masks. I have a short face so finding one that is short enough is a job. She was able to provide me with options and together we found a solution. I guess the truth is that I believe that I got as close to a custom fit today as is possible with the resources available today. Once again it is sad to hear that most DMEs are not that helpful or knowledgeable and expect folks to figure this adventure or endeavor out by themselves. That is where I find this site so helpful. I would suggest that if you think it will help go back to your DME person or doctor and consult some more. Best of luck.

[SleepingUgly]

M.D.Hosehead, I'm not up to speed on what masks you've tried, and what difficulties you've had, so if this is redundant, I apologize. I did see that you returned a Hybrid and were trying a Liberty and that the issue seems to be the pillows come out at night. Is that still where you are with this?

I had those issues with the Hybrid, and I ended up using Bleeping Beauty's modification of White Beard's Liberty Fix (I have to laugh while writing that). Here is a link:

viewtopic.php?f=1&t=48808&p=446185&hili ... hy#p446053

I used Lansinoh in my nostrils to protect and to improve the seal. I found that I needed very little upward pull on the scrunchies to keep the pillows in my nose, and because there was not a lot of tension on them, I did not have to cover the scrunchies with felt to make it comfortable. It worked reasonably well.

Initially I had some pillow experience, then switched to FFMs, and skipped nasal masks. That was a mistake. IMO, it is easier to find a nasal mask that seals well than a FFM that seals well. (If you think about it, there are just so much more surface area for leaks, and just because a mask is the right height or seals well around the mouth doesn't mean it's good for the bridge of the nose--too many variables!) So unless you are so congested that you can't breathe through your nose, after trying the "fix" for the Liberty, if you haven't already tried nasal masks, you might want to. You may need a chin strap or to tape your mouth if you tend to open it, and neither are loads of fun, but you may have an easier time getting a seal. A lot of people like the Activa LT.

[jdm2857]

At a minimum, I would think that 3-D scanning technology could be used to match standard masks to non-standard faces.

[M.D.Hosehead]

Thanks, S.U. for the suggestions.

I did try a rubber band around the pillows, and also taping the pillows to my nostrils. But after too many nights of short, fragmented sleep, I gave up, sent the Liberty mask back, and joined the tapers. The last four nights, I think I am making progress adapting to xpap, but still working at it.

[chunkyfrog]

Hubby and I made custom latex Halloween masks 40 years ago.
--he's threatening to get out the craft supplies.
It was a real mess--my brother-in-law lost a fair amount of moustache hair.
This could be fun/funny. I'll let you all know how it turns out.
Picture old guy nose hairs stuck in plaster.