Mask woes, just when I thought I mastered it.

[yoshi]

Sorry this is a long post--It's partially me venting but I'm also hoping maybe someone has tips or encouraging words?

So I guess I'm really stubborn. I say stubborn because my yap doesn't want to stay shut at night (or depending on who you ask... during the day too. ) but also in that I'm determined to stay positive through this--that I WILL find a mask that works with me instead of against me. But after my 4th visit to the DME today, I'm starting to lose determination.

I was originally set up with a P10. After some helpful advice from you folks, I thought I mastered it. I got around the nare irritation using lansinoh. For a while, I actually started to love it. But that's where things went from awesome to a trial. I was consistently waking up to the sound of a tornado and dry throat. Each day on sleepyhead, the leak rates were consistently going up. Day 1 I had no leaks but by day 10, I was at a 10.8. So I got a papcap from amazon. It sort of helped, the leaks went down to around a 4 but I was still waking up in the middle of the night blowing raspberries, with a jaw ache from tightening it down further, or a muted wind tunnel. I REALLY tried to get the P10 to work for me--to the point where I had 11 days left for my mask swaps for insurance to pay for it.

So I went to the DME, was fitted and given a choice between the Mirage Liberty and the Amara View. I was told that both were not very successful and they doubted it would work. But since I loved the P10, I decided I'd keep an open mind and try the Mirage Liberty and if it didn't work I'd try the Amara. Took the Liberty home for a test nap, and tried for 2 hours to make it work... it was a failure, as my teeth (just beneath my nose) were aching from the weight of the mask (lying prone). Went back to the DME, got a different rep and she was sure that the Amara was not for me so she fitted me with a F10.

The F10 was comfy, and it worked lovely the first night, 0 leaks. Night 2 was horrible. I woke up with aerophagia, and the whole day my stomach hurt from being "over inflated' then releasing air. Night 3, I figured out if I slept with my jaw to my chest I that I wasn't swallowing air... I noticed I was starting to get an itchy nose along the crease of my nose, but I didn't think much of it since the mask makes contact there; I had slight leaks but nothing I was alarmed with. Last night I woke up in the wee hours feeling like someone punched me in the nose. My nose crease line, where the mask forms around it, is bruised and my leaks are around 6. I never changed the strap tension, and I had it as loose as I could get it without feeling leaks at a pressure of 5 (my min) and 10 (my max).

Incidentally, I noticed all of my problems with leaks, arousals, etc. (according to Sleepyhead) seem to come around the time of an OA and my pressure shoots up to it's max.

To get through the night, I tried to use the P10 and a Mirage Quattro that I purchased out of pocket as a backup. Both hurt too much to use, so I just went maskless the rest of the night.

So back to the DME today. That was "fun". I tried on every single mask they carried in Philips and Resmed--with a bruised nose. This time they sent me home with two different masks, a Fitlife total face and a resmed Quattro air. I tried the Fitlife while taking a nap, so far so good. But I thought that of the P10 and F10 at first. I'm going to wait a couple of days to try the Quattro Air so my nose can recover a little.

By the time I get through these two masks, I will have used up my 30 days with insurance. To top it off, the DME said basically if neither of these work I'm out of options and I need to "pick the lesser of evils". That's why I'm a little bit worried and frustrated. I just wish I had more than 30 days to zone in on a mask--I don't feel that 3 days or even 2 weeks to trial a mask is quite enough. The idea of 6 months with a mask that hurts kind of scares me--despite all these trials, I still feel a thousand times better than pre-cpap so I don't want to become a non-compliant because of a bad mask.

I'm questioning myself if I should have just stuck with the P10 and hope I can train my mouth to stay shut--or if I should go with a larger mask and hope that my face toughens up (or optimistically that one of the masks I got today will just work.) Okay, I'll go breathe now and get my mind into optimistic mode--maybe tonight's mask will be "the one". *happy thoughts*

[Okie bipap]

If your nose is still sore, and you want to try the quatro, try using a band aid on the nose. Once it heals, you can try useing a piece of moleskin on your nose. The person I was working with at the DME said her husband uses moleskin on his nose every night. I have tried it, and it really helps me.

[yoshi]

your nose is still sore, and you want to try the quatro, try using a band aid on the nose. Once it heals, you can try useing a piece of moleskin on your nose. The person I was working with at the DME said her husband uses moleskin on his nose every night. I have tried it, and it really helps me.

Question about bandaids/moleskin: is that for the bridge of the nose or the sides? I had read about that on this forum but I interpreted it to be useful for the bridge, like where glasses sit. My bruises follow the fleshier part of my nose where it meets my cheeks.

[Pugsy]

Approx how many times a night did wake up from mouth breathing or leaks when using the P10?
Actually wake up?

Leak numbers of 10 L/min....man I would be doing a happy dance if that was all I ever saw.

Perhaps step back and evaluate sleep quality in general along with the various discomforts you have had or are experiencing now. In all honesty...sometimes we do make compromises or choose "the lesser of the 2 evils".

Did you return the past mask trials or did they let you keep them?

[PEF]

Hi, I have the same problem with my mouth and I can't figure out why it is happening. While I am awake and in bed, everything is perfect with my Airfit P10 or my Swift FX nasal masks - love them - no discomfort anywhere. Then just as I am falling asleep, the mouth farts begin and wake me up. It takes hours to get back to sleep. Then I wake up in the morning with the dry throat. A few nights I taped my mouth shut, but that did not work so well either. Instead of mouth farts, I awakened with bubbles of air dashing around the inside of my mouth and my cheeks blowing in and out. Really weird!

I think I want to try the Airfit F10 - I love the Resmed products. That will probably be my next purchase. Thanks for your review of it.

[yoshi]

Approx how many times a night did wake up from mouth breathing or leaks when using the P10?
Actually wake up?

Leak numbers of 10 L/min....man I would be doing a happy dance if that was all I ever saw.

Perhaps step back and evaluate sleep quality in general along with the various discomforts you have had or are experiencing now. In all honesty...sometimes we do make compromises or choose "the lesser of the 2 evils".

Did you return the past mask trials or did they let you keep them?

Leaks: The times when I was fully awake from leaks ramped as the days progressed. I don't know if it's considered extreme, or if I'm just hypersensitive because of a new experience--first few nights (no papcap) I had no awakenings but sleepyhead showed leak spikes (in other words, I must have slept through some of the leaks). Each day seemed to add one extra awakening until I decided to get the papcap--at that point it was about 6. I noticed towards the end of the no papcap trial that I was waking up most often to a hiss instead of a "mouth wide open" sound. The papcap did help, the worst of my awakenings was 3 per night. Both scenarios I was able to fall back asleep quickly.

Masks: I still have my original P10, I didn't return it for reimbursement yet. All others were demos that I had to return with exception of the Mirage Quattro that I purchased.

[yoshi]

Hi, I have the same problem with my mouth and I can't figure out why it is happening. While I am awake and in bed, everything is perfect with my Airfit P10 or my Swift FX nasal masks - love them - no discomfort anywhere. Then just as I am falling asleep, the mouth farts begin and wake me up. It takes hours to get back to sleep. Then I wake up in the morning with the dry throat. A few nights I taped my mouth shut, but that did not work so well either. Instead of mouth farts, I awakened with bubbles of air dashing around the inside of my mouth and my cheeks blowing in and out. Really weird!

I think I want to try the Airfit F10 - I love the Resmed products. That will probably be my next purchase. Thanks for your review of it.

Taping is one thing I did not try with the P10, I was fearful I was running out of time for an exchange before I could try it. I tried to do a boil and bite mouth guard (top and bottom holds forward position) but I think the guard was too thick for my petite jaw line, I was a drool monster because of the bulk. My actual retainer didn't make any difference. I've been practicing the tongue to roof of mouth planting--even before cpap I tended to drool when I was on my side and this method seemed to reduce that, but I'm finding as the days go on with cpap that I'm relaxing to the point where the tongue doesn't stay put through the whole night.

I hope the F10 works for you, I really did like how light it was (to me) compared to all the other FFM that I tried... but then again, today the bruises makes everything feel heavy.

[Pugsy]

See how you do with the new mask tonight.

If you well then great...if not, well, let's make a list of pros and cons with any of your choices and be sure to factor in sleep quality along with day quality.

[yoshi]

See how you do with the new mask tonight.

If you well then great...if not, well, let's make a list of pros and cons with any of your choices and be sure to factor in sleep quality along with day quality.

Thanks Pugsy, that's actually a good idea. I'll start up a list while it's still fresh and build on it until I need to make a final decision.

[PoolQ]

Here is my story, see if anything sounds familiar:
I used to think I was a mouth breather so I got a FFM and noticed that I did not breathe through my mouth when using CPAP.

After hearing great things about the P10 I bought one out of pocket and bingo I was now a mouth breather.

Turns out for me it's not the mask, it's that I hate exhaling into pressure. If I use anything like the P10 (small and nose only) I open my mouth to avoid the pressure.

I didn't want to go back to the Simplus FFM that I started with because it was hard to seal on the bridge of my nose and irritated the outside of my nose.

Doctor suggested the Amara View and I have to admit that it is tricky to get it fitted correctly, but once I do I don't even notice it with few to no leaks.

I also used EPR of 3 on my AirSense A10 and still had some level of problem with exhaling into pressure

I now have the AirCurve VPAP BiLevel and have had zero problems with keeping the mask on all night, leaks, or a sore nose. Sometimes I do have to fiddle with the Amara View still to get it on correctly. This effort is well worth it IMHO.

Just saying that the mask alone might not be the largest issue you are having. If like me you have a mask/exhale sensitivity you may think about addressing both to find your solution. Try one of the new masks and set your EPR to 3 and see if that is better or worse.

[yoshi]

Here is my story, see if anything sounds familiar:
I used to think I was a mouth breather so I got a FFM and noticed that I did not breathe through my mouth when using CPAP.

After hearing great things about the P10 I bought one out of pocket and bingo I was now a mouth breather.

Turns out for me it's not the mask, it's that I hate exhaling into pressure. If I use anything like the P10 (small and nose only) I open my mouth to avoid the pressure.

I didn't want to go back to the Simplus FFM that I started with because it was hard to seal on the bridge of my nose and irritated the outside of my nose.

Doctor suggested the Amara View and I have to admit that it is tricky to get it fitted correctly, but once I do I don't even notice it with few to no leaks.

I also used EPR of 3 on my AirSense A10 and still had some level of problem with exhaling into pressure

I now have the AirCurve VPAP BiLevel and have had zero problems with keeping the mask on all night, leaks, or a sore nose. Sometimes I do have to fiddle with the Amara View still to get it on correctly. This effort is well worth it IMHO.

Just saying that the mask alone might not be the largest issue you are having. If like me you have a mask/exhale sensitivity you may think about addressing both to find your solution. Try one of the new masks and set your EPR to 3 and see if that is better or worse.

Hi PoolQ, thanks for taking time to write. I will keep that in mind. I have EPR set at 2, I'll have to go upstairs and fidget with it to see if I can increase EPR (it was setup that way from the DME). If that is truly what's needed that will be nice; a TFM seems like it would be hard to pack and travel with. I didn't find exhalation hard when I'm awake, but perhaps it's a different story once I'm relaxed and asleep. I wouldn't mind getting a P10 out of pocket just for travel purposes and use a TFM full time if it works.

--
Update:

Last night I tried a TFM, and have never seen results like this. I had to do a double take. I had all 0's for AHI, leaks, OA, Hypopneas, RERA, etc. and my pressure was the lowest I've seen so far. Granted, my situation is by no means as extreme as some folks. My goal with CPAP is to feel decent most of the day hours. The lowest I've seen my AHI was .37. Even with AHI in the decimals in the day I was still feeling a touch foggy, but TONS better than pre-cpap.

I did wake up one time last night to take off the mask to itch around the areas that were bruised up from the F10. Seemed like the humidity (auto control/auto heat control) was irritating the injury so I rolled it to a manual of 3 for humidity and 74 for tube temp. That seemed like the ticket. I did wake with some marks around my face, if it doesn't bruise I can deal with that. I was able to change position from side to back with no leaks. So yeah, I'm going to do a happy dance and see if the marks just remain temporary. And hope that the TFM is the "one".