Hi. I have no idea what I'm doing.

I'm 18 days in. I have no idea what I'm doing, but sleeping isn't one of them unfortunately.

I'm using the ResMed S9 w/ humidifier and the Airfit N10 nasal mask. My sleep study gave me a lot of data that I'm sure I don't understand. My pressure is at 9, one of the few things I know for certain. I stumbled across SleepyHead (awesome! and more on that in a moment). Between that and all of the information I'm reading online, I'm starting to become overloaded. If you'll excuse me for a moment, I'd like to get some general feedback.

I started with the P10 pillow. The setup came with several different pillow attachment sized which I'm sure you're all intimately familiar with. I couldn't find a size that either didn't leak (too small) or stretched out my nostrils like something like "vandersex" of the nose (too big). Having found no middle ground I went back to the specialist to redirected me to the N10 which is where I am today. Standard sized fitting.

I'm struggling with leaks. Most of them appear to have it out for one - or both(!) - of my eyeballs. I don't know how they leak in such a precarious direction, but it's enough to wake me. I thought I was going nuts but the data from SleepyHead supports what I'm experiencing. The highest points of leaks during the night accurately reflect the moments I wake up search for the voodoo doll that is A) my ENT and/or B) my very loving wife who suggested all of this to begin with.

I've read about adding liners from other posts in the community to help with the leaks and I've just placed some on order. The mask applies some very slight pressure to the top of my upper lip though not so much to honestly complain about. Loosening the straps compounds the leaks, and anything tighter is likely to give me something extra to actually complain about.

I'm tired and I'm looking for some advice, encouragement, <something> before I owe the insurance company a check for the shattered plastic that's about to be my 19 day old ResMed.

Thanks in advance; I'm happy to have found the community already for the wealth of information here.

How is the airflow through the mask and out again? Are you congested when not leaking? Does it seem to fit your nose and bridge?

I'll pretty much guarantee you'll need a different type or brand of mask - the devil of this whole game is often the damned mask, and finding the right one...

Tell us more about your equipment and complete your profile, please...

Ignore that last sentence please, I reread your post and saw all I'd asked

My apologies, I'll take another look at my profile to ensure I saved everything.

ResMed S9 CPAP w/ Humidifier
Airfit N10 Nasal Mask

The pressure feels ok actually. I'm an avid scuba diver so I'm actually quite accustomed to having air shoved into my lungs. For the most part, I'd say that I'm no so congested. I'm using Flonase (allergies, etc) and I've tried mixing some Neti Pot salt into the humidifier to help. Past that... not sure. The mask and straps are comfortable enough I suppose. I "feel" the leaks are coming from the bridge, or are perhaps the normal exhaust ports that have it out for me?

You just need to try other masks (like the rest of us have) until you find 'yours'. It's out there, but you do need to look, particularly lying down when trying it, being sure of the size, wiggling it up and down and sideways because your face changes when you move (big surprise, right ). The liners should definitely help but you must get rid of the air going into your eyes - not acceptable or good.

Make sure you are washing your face really good before you mask up. You need a very clean face in order to get a good seal
with you mask.

I wish you well

Thanks Julie and Bill. In your experiences, are most insurance companies pretty lenient with charging through various mask setups or is it more often than not done so out-of-pocket? I know this is definitely one of those your mileage may vary circumstances but I'm curious all the same.

Edited for words.

grass wrote:Thanks Julie and Bill. In your experiences, are most insurance companies pretty lenient with charging through various mask setups or is it more often than not done so out-of-pocket? I know this is definitely one of those your mileage may vary circumstances but I'm curious all the same.

Edited for words.

In my case I got 2 masks that was it. They did not have the option to try a few on. It was choice 1 or choice 2.

I ended up out of pocket to get the right mask.

Thanks again, Bill. I'm off to suit up into my "choice number 2" and see what awaits.

I appreciate the quick responses tonight and look forward to getting this sorted out.

grass wrote:are most insurance companies pretty lenient with charging through various mask setups or is it more of than not done so out-of-pocket?

Check with your insurance to know for certain but the usual standard operating practice is the insurance only gets billed for the first mask and any subsequent mask trials fall under the DMEs mask swapping policy and they utilize the 30 day return/swap feature that the mask manufacturers offer. They fill out some paperwork and they get credit for masks that failed so they don't lose any money.
Pretty much all the mask manufacturers offer 30 days and that's 30 days per mask and not 30 days from when you started therapy.
Unfortunately DMEs often make up their own in house rules that limit mask swapping and the time limit involved...so you have to ask them directly what their policy is. Some say one swap...some allow any number of swaps but only within the first 30 days of your therapy. Some want the failed mask returned and some just let you keep it. They don't send them back with the paperwork anymore...they go in the trash.

But insurance almost always just gets billed for the first mask and they don't normally pay for any other masks until the time frame for mask replacement rolls around. Now there are a few that pay for each mask if the doctor says it is medically necessary but those insurance plans are rare.

My DME has a little different twist to it. When I get a new mask I have 60 days to try it and swap it for any number of different masks within that 60 days. The kicker is that they make me return the mask tried before they will give me a new one to try.
They only bill insurance for the first one though...the rest that I might try and return they fill out paperwork to submit to manufacturer so they get credited for the failed mask. The mask then goes in the trash. If I wanted to try 30 mask in that 60 days I could do it. As it is I have only had to return one mask for a swap because I simply couldn't use it and sleep.
They offer this policy to newbies as well as cpap veterans like me....which is nice because some DMEs won't offer swapping once you are past the first 30 days. You just have to make a point to ask them exactly what you can expect in terms of mask failures and then trying another one.

Leaks that are small aren't normally a big deal in terms of therapy effectiveness but any leak (even tiny) that is annoying and disturbing your sleep or bugging your eyes....is seriously going to impact overall sleep quality and therefore unwanted and needs to be fixed somehow. I have never used the F10 so I can't offer any personal experience on how to help with your issues.
I am using the P10 though...so if you ever want to revisit it for some reason I could maybe offer ideas about it.
No mask is ever going to be the perfect mask for 100 % of the population though and just because I do well with a mask doesn't mean the next person will do as well. There are also other nasal pillow masks out that might suit you preferences better.
Feel free to send me a note if you want to maybe talk about nasal pillow masks....I have tried almost everyone out there to buy since I love to experiment.

Good luck...this mask thing is probably the hardest part to all this therapy and once you get it sorted out things will go much smoother. All masks have pros and cons...just have to find one that has more pros than cons for you.

Pugsy's early review of the P10 convinced me to eventually try it. After choosing the correct pillow size, I love it. I route the hose over my head and attach with Velcro to my papCap. Good luck, Earl

Just a tiny suggestion to help with the leaks into your eyes.
Lansinoh, a thick ointment sold for nursing mothers: a thin smear on the cushion like a gasket sealer will make it stick to your nose.
Good-bye leaks. You could even try goggles--I have.
Good luck.

Quick questions - how wide/narrow is your nose bridge? Narrow noses (mine is just 17mm) are very tough to get seals to work on, especially if you need the bigger size for height. Same applies to FF (tried 2 hated them) and nasal (never tried after feeling one at sleep study that sat on my nose bridge and jammed it up badly).

Nasal Pillows (p10, Nuance, FX etc) don't care - that's why I switched to them - but they do rely on clear nasal passages and no mouth breathing to work. Thankfully they act like wedges too and the dryness of the air from my S9 if adjusted right just blows my nose clear...

grass wrote: I'm using Flonase (allergies, etc) and I've tried mixing some Neti Pot salt into the humidifier to help.

Er...am I the only one to think adding ANYTHING other than water (preferably distilled) to the humidifier is a bad idea?

Tatooed Lady wrote:

grass wrote: I'm using Flonase (allergies, etc) and I've tried mixing some Neti Pot salt into the humidifier to help.

Er...am I the only one to think adding ANYTHING other than water (preferably distilled) to the humidifier is a bad idea?

Adding salt to the humidifier serves no purpose other than to promote corrosion of your water tank. The salt cannot evaporate, and will only concentrate in the water that remains behind in the tank, thus becoming even more corrosive.