Strange Problem for Newbie

[cpapbob2]

I done a search on this problem and can't seem to find any info . . .

Using an Ultra Mirage II nasal mask and mouth taping, I've gotten good results so far as relief from sleep apnea goes. The problem is the area between my lower lip and chin is puffy and swollen. It's as though the area below the lower lip that expands when CPAP pressure pushes against the mouth tape is "set" in place and puffiness results.

I've tried two full face masks, the Fisher & Paykel 431 and the Comfort Full 2. The first has to be so tight it hurts to prevent leaks and the second leaked around the eyes, causing puffiness in that area.

Any suggestions?

Thanks.

CPAP Machine: Respironics SleepEasy

[Julie]

You may be either allergic to that particular tape, or why not try the Ultramirage FF mask which works for so many people?

[roster]

The Hybrid ff mask will address your issues. http://www.respcare.com/hybrid/

[GuyK]

I've tried two full face masks, the Fisher & Paykel 431 and the Comfort Full 2. The first has to be so tight it hurts to prevent leaks and the second leaked around the eyes, causing puffiness in that area.

I have had exactly the opposite experience with the F&P 431. The more I tightened it (I mistakenly thought the forehead bumper should rest against my head) the more leaks I got. I loosened it up, and I keep it and my face clean, and I can get it to pretty low leakage rates. Most of the time. There still are times where I get leaks. I can even twitch my face in a certain way and it will leak.

It's not like I'm highly experienced at this (yet), but to me it feels like the 431 needs a certain amount of looseness in order to inflate and create the seal.

Guy

[cpapbob2]

Thanks so much for the suggestions. I hadn't thought about the allergic angle. I do find the tape annoying and painful to remove, however.

I like the concept of the "Hybrid" but according to the sizing guide on cpap.com, it isn't "ideal" for my face size. The UltraMirage FF mask does come up as a recommended choice, as does the Mirage Quattro. Can anyone tell me the difference between the two?

As to loosening the F&P 431, I'll give that a try but I've tried it loose, tight, and in-between and can never seem to get a satisfactory seal that will tolerate the least bit of movement on my part.

[GuyK]

As to loosening the F&P 431, I'll give that a try but I've tried it loose, tight, and in-between and can never seem to get a satisfactory seal that will tolerate the least bit of movement on my part.

Not that I'm trying to push you into this, but from my experience, the upper straps are kind of loose while the lower ones should be tighter. I also tried the other two inserts (in my case, the small and the large) and found both of them to be leakier than the one I use.

For me, I'm finding it to be a balance of several factors...it also seems like the straps stretch out over time, so periodic retightening is needed. Daytime dirt and grease on my face seemed to affect the seal, as did the residual facial dirt and grease left on the insert. So I clean those just about every day. I also keep a very short beard -- as the hair grows out, I think I get more leakage. So then I shave it back down. And yes, if I shift a certain way, either the hose might pull it away, or a pillow might jog it a little, and then I get a leak.

I honestly have no idea if I could get better results from a different mask; this is just my first one. I'm just trying to figure it out and make it work. Comfort has never really been a problem, other than I think my facial narrowness compared to my chin to nosebridge height means I get a bit of a red mark on the bridge of my nose. About every other week it hurts a little, but the mark goes away after a half hour or so.

And I'd agree -- if I had to tighten my mask up to the point of pain, I never would have lasted with it.

[cpapbob]

Worked some more with the F&P and got a better result. Thanks for the tips.

I do wish I could make my Ultra Mirage II Nasal mask work without mouth taping, but the over-the-head chin straps are too cumbersome for my tastes. I have seen an ad or other reference on this forum to a chin strap that attaches to the bottom straps of a nasal face mask. Can anyone tell me where to find that chin strap?

[Julie]

Well I haven't used the Quattro, only the UM FF, but while the UM covers your mouth along with your nose - really just an extended nasal mask, I believe the Quattro is one of those (like the Hybrid) that covers your mouth 'first' and has nasal prongs, or a version of them, extending north from the mouth part.

[cpapbob]

From looking at the masks on cpap.com, they both appear to be full face masks. In fact, they appear so similar I can't tell any significant difference and hence, my question: What is the difference between the Mirage Quattro Full Face CPAP Mask with Headgear and the Ultra Mirage Full Face CPAP Mask with Headgear?

[DoriC]

We have both but my husband primarily uses the UMFF and we're experimenting with the Quattro for naps. They're basically the same, the Q has a somewhat narrower frame and the air vent is built into the Quattro and is shaped differently. Also the Q has a convenient knob for adjusting the nose bridge for those who might need frequent adjustments. My husband tells me that the airflow on the Q is not as comfortable for him. I'm sure the "pros" can help you further. These seem to be the most popular FF masks.

[echo]

Indeed, the Quattro and the Ultra Mirage (UMFF) full face masks are very similar. Conventional wisdom seems to indicate that if one works for you, the other probably won't... they both seem to fit different types of facial structures (though I couldn't tell you which one would fit which face!). They have all sorts of small nuances that make them different from each other - the best is to read about the features on cpap.com -> search for Quattro and Ultra Mirage full face.

Personally I tried the F&P FFM and it didn't fit me at all. I own the UMFF and although it was fine at first, I can't stand it now. I'm going to try the Quattro next.

The Hybrid and the Liberty are both in the style of nose prongs/pillows combined with a separate oral interface (like a full face mask but it only covers the mouth). I don't know if the cpap sizing guide is accurate regarding the Hybrid and the Liberty (in fact I didn't think they were part of the sizing guide at all, but what do i know).

If your DME is not able to help you fit and size masks, we have some mask trials on this forum, where you can try out both the liberty and the hybrid. Check out mask test drives. Note that the Hybrid trial comes with all the sizes (because it's sold like that), but for the Liberty we have two trials: one for the SMALL, and one for the LARGE. The liberty sizes (for the oral interface) are NOT interchangeable so you have to buy the small and the large separately.

You can also find good deals on masks at http://www.cpapauction.com (spin-off of cpap.com).

For taping, there are a few tips you can use to make the tape come off easier in the mornings:
- At night, apply some milk of magnesia to your lips/skin before putting the tape on - it will reduce the stickiness.
- In the morning, apply some hand lotion or cold cream and let it soak in for a few minutes before removing the tape, and that will reduce the stickiness quite a bit. It's the only way that I can get the tape off in the mornings, because I have really senstivite skin, and if I don't use this tactic then the skin around my lips would already be raw after two days.

Good luck!

[DoriC]

Echo, why can't you stand the UMFF now? Just curious. So far we're having some success with it, still a little too much leaking sometimes but he's comfortable and his #'s are good, and not enough time using the Quattro to give an educated opinion. These seem to be the only choices except for the Comfort series which were anything but. I love the idea of the Hybrid or Liberty but my husband doesn't like the idea of anything in or around his nose. Of course we haven't seen what they look like except on cpap.com so when we're due for another mask in Jan, we'll inquire about them at the DME.

[echo]

Hi Dori! I'm not sure what happened between me and the UMFF. The first few weeks/months I used it on and off with no problems, but now I can't get it to seal for anything. It leaks around the eyes and around the mouth and I have to tighten it a lot to get it to stop leaking, and then it's too tight and gives me facial pain and headaches. I gained some weight in the meantime, maybe that was it?? I even bought a new seal, and that didn't help very much. (I also have a receding chin and I think that makes it difficult to get a good seal in the lower jaw).

I loved the Liberty, but I bought the large and it was too big around my mouth. I've ordered the small now and hopefully that will fit better. I really like how it fit on my face, and it was very very quiet. The nasal prongs were much less annoying than I had anticipated (and they are very soft), but you do have to fiddle with them a bit at first to figure out how to get the nasal pillows in the right way so they don't pop out or leak. You might want to give it or the Hybrid a try!

I've never tried the comfort series but i have heard they aren't very comfortable! I also tried the F&P full face, but that didn't fit me at ALL. There is also the Zzzz and some people really like that one... when you go to the DME you should try to get a fitting for those too, who knows! Good luck in the Odyssey of the Mask