Hybrid Mask Questions-PLEASE<PLEASE Help

[FeelingBetter]

I just received my Respmed hybrid mask and I can't figure it out. The chin rest pulls the mask over my top lip, the pillows aren't seating and when I turn on the machine the pressure blows my cheeks out the pills leak terribly, plus the pillows aren't the right angle to go in my nose. Very disappointed. Someone help me please!!

[drdrew]

Search this forum for "taming the hybrid" however it sounds as though this mask and your face don't mix.

[cflame1]

Please note that the taming the Hybrid instructions are for the Hybrid, not the Liberty (which is a similar mask but not all of the instructions may work).

When you list a subject please say that it's for the Liberty or the Resmed hybrid.

I've been told that the Liberty is harder to adjust then the Hybrid (by Innomed). There's more options for fitting with the Hybrid (by Innomed) both with the multiple sizes of pillows and cushions and with the headgear adjustment points.

[b360155]

I've been using the ResMed Mirage Liberty since 10/19 and have gotten very good AI/AHI and Leak rate scores with it. The first thing to determine if you have the right size. Were you fit in person at a DME or did you purchase over the internet or mail order? For the mask part that goes over the mouth, there is only two sizes, small or large. Hopefully, if I did this right, the following link should take you to a fitting template to determine which size is right for you.http://c0192001.cdn.cloudfiles.rackspac ... mplate.pdf

The second sizing item is the size of the pillows: small, medium or large. If you ordered online, I'm not sure how you're supposed to determine the correct pillow size. You really need to try them in person. I got mine from a DME and they fit me to a large mask and medium nose pillows. After a couple nights, I asked the DME if I could get size large pillows to try out and they gave me some to try.

It is a little tricky to get the mask leak free and perhaps even impossible if the structure of your face isn't something that this particular mask can accommodate, but play with it some and you should be able to determine if the mask will work for you or not in fairly short order.

As I said, I was able to get 95% leak rate results under 5.0. However, I do have to sometimes play with the nose pillows a bit. They have a "trampoline" action, so you want them to compress about half way down and you want the pillows to rest on the opening to your nose. They shouldn't be jammed in real tight. I seemed to have a harder time getting a complete seal around my mouth. Most difficut for me was on the upper side of the mask above my lip where I could often feel a very small leak of cold air. To resolve this, you have to just play around with the tension alternating between the upper then the lower straps. You don't want to overtighten the straps...use the lightest amount of tension as possible where you can get a complete seal.

Having said all this, even though I've been getting good results, I'm still in search of a better solution for me. For the past 3 nights, I've been trying out a Quattro FX ffm that I got through the CPAP Library trial program. After 3 nights, I think there is a good possibility I'll be switching to the Quattro FX. Again I'm getting excellent scores all around and last night I had a 95th percentile leak rate of 0.0 for the very first time in my CPAP experience. I'm finding the Quattro FX so far to be easier to get a complete seal and just more comfortable to sleep with.

[LSAT]

Probably should change your name to...'NotFeelingBetter'.

[drdrew]

The OP said chin rest, so I assumed it was the hybrid not the liberty....but then they said respmed....which I guess means resmed...and that would be the liberty....if you think you have a chin rest on the liberty, then therein lies the problem!

[nanwilson]

I use the Respcare/Innomed Hybrid and I love it. I still read Rosters "taming the hybrid" thread every so often to make sure I haven't missed something or just plain forgot. I, like Roster, have cut off the chin thingy, but I would not recommend doing that until you have exhausted all other tweeks. I find the chin flap too hot and since I have a long face, it pulled the mask down too far and I had trouble seating the pillows. I use the medium cushion and the medium pillows, with the pillows being at their "longest" seating. If you have looked at the video that came with your mask you will see that you can use ANY size cushion and ANY size pillows that suit your mouth and nose. I've even heard of a few that have different sized nares so had to cut the pillows so they could use two different sizes. As has been recommended before read Rosters thread and read it again and again........it takes a week or two to get it right, so keep at it.
Good luck
Nan

[FeelingBetter]

My apologies.....it is the Respcare/Innomed. Yes, I ordered off the internet with the 3 cushion sizes for the mouth and 3 cushion sizes for the nares. I will check out the "Taming the hybrid" thread.

[squid13]

Here is a link for taming the Hybrid. viewtopic.php?t=14422

[LinkC]

I firmly believe the Hybrid* can be made to fit 99% of patients. But, because of the numerous adjustments, it takes more time and effort to properly fit it. A two-edged sword.

Yeah, I went thru all the pantyhose, nipple grease, coathanger-nose-ring "fixes". But by careful tweaking over several months, I was able to eliminate the entire pre-bed ritual. Now I put it on and go to sleep. (I DO still need to center the pillows on my nares with the pressure on. Takes maybe three seconds.) I think many folks give up too early and rely on the gimmicks/fixes to get by, when a little more effort would properly adjust it. Just MHO.

*A Hybrid is a name, hence the InnoMed/RespCare. A hybrid is the design, and would also include the Liberty.

[Perrybucsdad]

What exactly is the benefit of the hybrid? I've been searching for a post that talks about that but have come up empty. The reason I ask is I am considering getting one as I can't get my AHI down with my Quattro FX. I don't have leak problems with it, and I find it comfortable, but someone suggested a nsasl mask may get my AHI down better than a FFM. Being that I am a mouth breather though, I don't want to fuss with jaw straps and all that, so the hybrid was an option. Will the nasal help lower the AHI better than the FFM though?

[Pugsy]

What exactly is the benefit of the hybrid?

If you couldn't stand anything on the bridge of your nose...the Hybrid just uses the nasal pillows.
Mouth is covered for possible mouth breathing issues so therapy pressure is not lost.
So a comfort benefit for some. No torn up nose.
Does it give better therapy as in lowering the events that occur? I don't know. Perhaps some members who have used both can offer their experience. Though pressure preventing events should be same pressure regardless of how the pressure is maintained.

[Perrybucsdad]

Though pressure preventing events should be same pressure regardless of how the pressure is maintained.

That's sort of my thoughts too.

[Pugsy]

Pugsy wrote:

Perrybucsdad wrote: Though pressure preventing events should be same pressure regardless of how the pressure is maintained.

That's sort of my thoughts too.

That said, there are some in the medical community that advocate nasal only breathing therapy as being better. Some discussion here a while back about it. SleepingUgly is up on it and who it was and why. I didn't read the reports and I forget which doctor it was that was promoting nasal breathing alone. Dr Krakow or Dr Park...I can't remember..might not be either. Last spring early summer maybe it was discussed quite a bit.

[lullaby]

The Hybrid does seem to taker longer to 'tame' than other masks. I've had mine about a month now and prefer it to all the other ffm that i've tried. Having said that, i actually had it fitting really well up till about a week ago when i stupidly decided to have a 'fiddle' with the straps. Dumb idea. The last week has seen me waking up every couple of hours with the nasal pillows leaking. I've also realised that i need to have this mask quite tight on my face so that the pillows stay seated properly in my nose. Overall, my leak rate (when the mask was sitting well) were the best out of all the masks i've tried. I also like the chin starp as it keeps my mouth from opening and is making me beathe through my nose for the first time. Anyway, back to fiddling with those straps.