Inquiring Mind Wants to Know 1 (ontopic semirant)

[M.D.Hosehead]

Why is there so much trouble getting face masks to work for us?

From an audiology evaluation, I learned that I need a hearing aid. Did the audiologist “fit” me with a hearing aid by trying a few in my ear and sending me off with the one that fits least badly? Do I need to buy a series of hearing aids in the quest for one that works for me? If it is too loose and tends to fall out of my head, maybe I can fashion pantyhose into a headband that will keep it in my ear. Or, if it’s too snug, perhaps a dollop of Astroglide would facilitate insertion.

Well of course, it’s absurd. Of course the audiologist made a mold of my ear and the hearing aid fit perfectly from day 1.

When my dentist excavates one of my teeth, he takes a mold of the defect, and a dental lab fabricates an inlay that exactly fills the gap and restores the contour of my tooth.

My optometrist doesn’t stock a line evocatively named products (Hawkeye Plus Ultra, Sharpshooter III Pro). He measures my refraction and a lab produces lenses that restore my vision to 20/20.

If I am so unfortunate as to need a prosthetic limb, one will be made for my unique anatomy.

I’ve even had a podiatrist order pair of shoes custom-made to fit plaster casts of my feet. (For the curious, they fit well, but were 4+ geeky with an appearance suggestive of clown shoes.)

Do RT’s notice that the products they sell (I refer here to the masks) are technologically inferior to what they themselves expect when they patronize an audiologist, dentist, optometrist, prosthetist or even a podiatrist?

Is there a reason a mold can’t be taken of my face and a mask made that fits me exactly?

Or perhaps better, use a 3D scanner and 3D printer, technology already in use.

http://en.wikipedia.org/wiki/3D_scanner

http://en.wikipedia.org/wiki/3D_printer

Inquiring mind wants to know: why aren’t we, every one of us, using custom-made CPAP masks?

[elena88]

I agree with you one hundred percent, and the first time the dme brought me masks, I could not understand why
they just couldnt scan my face, or why he didnt pull out a wax mold and give me a couple straws and have at it!


NO wonder so many people quit!

[roster]

Talk to me about economics.

[kteague]

Frustrating, yes. I think the mask designers consider the gel based and inflating edges a form of customization, along with varying sizes. I can only speak for my face, but it would be like shooting a moving target. There's a whole lot of shifting going on when I change positions. Out of curiosity once I used a hand held mirror and leaned over and then leaned to each side and was shocked at what I saw. Maybe those without excess or laxity would have a better shot at a custom fit. I do think your suggestion for utilizing technology for customization should be a part of mask style and size selection because I don't think poor fit is as much a shape shifting issue as just plain a bad fit no matter what position. Semirant shared.

[DreamStalker]

The bird squawks ... blames government ... Aarrk!

Check out the price at the bottom then add the cost of flying to Australia.

http://www.cpapaustralia.com.au/shoppin ... -masks.htm

[base2balls]

I agree they should fit you for a mask like that , just like they do wiht hearing aids and the like. Instead the masks come in small, medium and large, but not to fit all faces. All of our faces have diffrent shapes and sizes, slim or round ans such so they should be "custom fitted" for us. Maybe one day some one will get smart and do this. Take care and have a great day, Huggies, Fay

[Wulfman]

Why is there so much trouble getting face masks to work for us?

Inquiring mind wants to know: why aren’t we, every one of us, using custom-made CPAP masks?

In my opinion, from reading the forum for over five years........I don't think people put enough thought and research into selecting them. They seem so cavalier about spending everybody's insurance money. I've seen SOOOO many posts where somebody said something like "I'm due for a new mask, I think I'll try a ____________".......kind of like an "eenie, meenie, minie, moe" selection criteria.......and usually inserted in there somewhere is the phrase "insurance pays".

I'm still using the very same mask I selected in my initial order from CPAP.COM to begin my therapy. Since then, I've "TRIED" three other masks.....two were purchased with my own money (out of curiosity) and the other one I received for doing a mask comparison evaluation. The only other one that sort of works for me is the Quattro, but I haven't felt the need/desire to wear it for about three years. The other two are "torture devices".

If a person has the financial wear-with-all to buy one and make a couple of trips to Australia, the custom masks ARE available.

http://www.sleepapneamasks.com.au/

(note: DreamStalker was doing his research from past posts, too.......but his post was shorter)

Den

[unadog]

.

[elena88]

Well, when a yank decides to do molded masks, the price should come down a lot..

after all, it was an ausi who invented cpap with a vacuum cleaner and look how far the machines
have come now..


I would hope the same for the molded mask situation..

Overall, a lot of time, money, heartache, face aches, and lives would be saved.

[BlackSpinner]

This mask fitting drives me nuts. They don't even try them on right. Shoe sales staff are better at fitting shoes the RT's at a DME. Are shoes more important?

Also they seem to be made to break down in 6 months - Hello guys - this thing is for life for us. I resent the planned disintegration of my masks so that you can make a profit - Yes I know this is a great "business model/ opportunity" "they have to come back to buy replacements" no cold calls required - once you hook the sucker you have them for life.
They are made of the cheapest plastic - I once worked in a plastics factory - trust me there is not much material or labour in these things - once the mold is made the machine just pumps them out by the hundreds. Most are probably made in the far east so the labour is probably 25 cents.

[PST]

Check out the price at the bottom then add the cost of flying to Australia.

Not counting the trip to Australia, the price is a little under US $1,300. If such masks were really good -- if they were comfortable and prevented leaks in all positions -- I think there would be a market. It's like buying a bicycle: for many people $1,300 is unaffordable, for many others it crazy, but lots of people pay that that much or more for a bike and find it perfectly reasonable. And if you could capture 10 percent of the market, for example, with a custom molding process, the price might come down. Have any of the Australians here ever tried one of these?

If you are going to indulge in a luxury, the best place is something that affects quality of life every day.

[rested gal]

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.

Here was an interesting topic from Feb 2006 in which Kelly Rudolph (Hans Rudolph -- mask manufacturer) wrote:

We have technology that allows us to send a digital Camera mounted to & calibrated with a small projector to your Dr., Lab, or Homecare Dealer so they can take a photo of your face & then email that jpeg file to us so we can make a custom shell/cone that follows your exact face geometry/curves and therefore allows a leakfree comfortable custom fit.
viewtopic.php?p=56092#p56092

Neversleeps, ozij and I had doubts.

Never saw any more about it from the Rudolph company.

Never heard much about ia1234's attempt at a custom mask, or "Acurest's" custom mask...at least not from cpaptalk members:
Mask for Sale: $1450.00 - topic posted by roster (rooster) May 01, 2009
viewtopic.php?p=364810#p364810

"Acurest" describes his company's "Logical" mask on page 3 of that thread:
viewtopic.php?p=387067#p387067

Acurest wrote of having the person relax for 30 minutes before the mold is made. That still can't duplicate the total relaxation of muscles during sleep. Nor duplicate the changes in facial contours when a person turns over, say from being on their back to on their side.

For a very still sleeper, perhaps a custom molded mask would work. For a sleeper who moves their head much, or especially one who changes position often -- a toss 'n turn sleeper -- I don't think a custom mask would be much, if any, better than masks off the shelf.

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.

[Wulfman]

Well, when a yank decides to do molded masks, the price should come down a lot..

after all, it was an ausi who invented cpap with a vacuum cleaner and look how far the machines
have come now..


I would hope the same for the molded mask situation..

Overall, a lot of time, money, heartache, face aches, and lives would be saved.

Don't bet on it. By the time they got done with the FDA approval in the U.S., the prices would be up to about $3000.

These masks we have now probably only have a couple of dollars worth of material in them and sell (in the online market) for well over $100 in most cases (brick & mortar prices are much, much more).


Den

[DoriC]

There's a whole lot of shifting going on when I change positions. Out of curiosity once I used a hand held mirror and leaned over and then leaned to each side and was shocked at what I saw.bad fit no matter what position. Semirant shared.

I witness that every night as I do adjustments of hubby's mask. Everything looks fine sitting up but his face definitely shifts when he lies down. His cheeks become unevenly matched under the mask when the seal inflates, so I have to then adjust for that, then when he turns head from side to side, again his face shifts and slight adjustments are again needed. The seal kind of molds itself after the break-in period with a new mask and seems to get better with age. I also find that the straps do not always match evenly on each side even with new headgear. I suppose that a custom fit mask would probably make this therapy easier but once we found the mask that works for us(UMFF) after many trials early on, we haven't been the slightest bit curious to try anything else.

[M.D.Hosehead]

ArGee, you're one of my heros; if one tenth of the good you spread around comes back to you, you must be wallowing. I see your point, and confess I had not done a search for custom masks before posting.

Looking at the big picture though, there seem to be CAD/CAM processes that haven't been applied to CPAP. A laser scanner can scan the same person in different positions, awake and asleep. It seems possible to have a CAD algorithm that could compute a shape compatible with all the scans, and test different designs A mask might have points of articulation, or parts made of fabric or Tyvek-like material to allow shape changes. I don't claim to know what the end product would be like, but I wish someone were working on the problem.

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