Got my AHI below 2; Now I need a new mask

[SleepySandy]

My AHI has been pretty decent since starting CPAP. So, I haven't been focusing on it too much - I have other issues.

This week, I performed an experiment on a particular CPAP setting . My AHI dropped quite a bit. For the past 4 days it's been: 1.9; 1.4; 1.0; 1.3

Unfortunately, these numbers have come at a cost. My nose is paying the price.

I have a UMFF mask. I tighten it just enough to stop the eye leaks and it doesn't feel like a lot of pressure. When I wake up in the morning, there's a very deep dent and painful dent across my nose. It stays red and hurts all day.

I have tried to add moleskin to the mask - it wouldn't stay in place. I put moleskin on my nose fuzzy side down and secured it with a blister BandAid, which is also cushy. Still dented. Each day it's getting more and more painful. I'm afraid the skin is going to wear out and split open.

I don't see a way to make this mask work without destroying my nose. So, I'm looking for a new mask. It has to be a full face mask. I've already tried the ComfortFull 2, which doesn't work.

I'm wondering about the FlexiFit 432 - the foam cushion appeals to me and my sore nose. Unfortunately, I haven't seen one of these in person and I can't find a decent picture of the cushion.

I'm also wondering about the Hybrid, but it's an unlikely option. My nostrils don't tolerate nasal pillows well. If the Hybrid pillows are smaller than the small Swift or the small CL2, it *might* work. If not, I can't do the Hybrid.

I am also searching posts for feedback on full face masks.

Any recommendations, even if they involve surgery on my UMFF will be appreciated.

[cflame1]

Sandy,
What was your problem with the swift pillows? Do you remember? That may give somebody an idea if you could handle the hybrid.

[SleepySandy]

My nares are slotted. One is narrow. The other is very narrow.

The Swift made my nostrils hurt like crazy while I was using it and then all day after using it. I did try lotions, but nothing worked. It was a stretching thing, I think.

My Swift is a small. My CL2 is also a small. I had the same problem with the CL2, but I don't think it was quite as bad.

If it helps, the XS NasalAire II actually fit my nostrils.

[Snoredog]

If you are having problems with the UMFF and controlling pressure across the nose bridge and leaks, the 431 or 431 won't be much better, they have NO foreghead support so you have even less control than the UMFF.

I wonder if you have the correct size? If it is too large it can be why it is difficult to control the area over the nose.

[SleepySandy]

My UMFF is a small.

[Snoredog]

My UMFF is a small.

most females have difficulty sizing a Full Face mask, that is because even with the small size it is too large.

I wish I could tell you the Soyala small might work for you, but I've had the same problem with the full face version (nasal version is fine).

[Snooter]

My AHI has been pretty decent since starting CPAP. So, I haven't been focusing on it too much - I have other issues.

This week, I performed an experiment on a particular CPAP setting . My AHI dropped quite a bit. For the past 4 days it's been: 1.9; 1.4; 1.0; 1.3

Unfortunately, these numbers have come at a cost. My nose is paying the price.

I would think that if your AHI is below 5 you are doing great. 5 and below is considered normal. If you are feeling fine (with the exception of your nose) then just accept that 1.9 or 1.4 is just a number.


BTW my AHI is around 4. My focus is in being more comfortable, since I have a read mark on the bridge of my nose also.

[SleepySandy]

I wish I could tell you the Soyala small might work for you, but I've had the same problem with the full face version (nasal version is fine).

Thanks, Snoredog. I wish you could, too.

I would think that if your AHI is below 5 you are doing great. 5 and below is considered normal. If you are feeling fine (with the exception of your nose) then just accept that 1.9 or 1.4 is just a number

I actually wasn't focusing on my AHI at all. I check it, yes, but the higher numbers (3-4) weren't concerning me.

But, I haven't been feeling better - that's a long and complicated saga. I decided to make a change to see if it would help my fatigue level.

My focus is also comfort because my AHI isn't going to stay this low if I can't use my CPAP, which is where I'm headed at this point.

[Wulfman]

My UMFF is a small.

Which cushion do you have.....shallow or standard?
Is the forehead piece in the full, upright position?

The things that affect the UMFF fit are size, cushion type, tension, and positioning (including forehead adjustments).

The text below is from CPAP.COM's site concerning the UMFF sizing when ordering. I've highlighted the part that describes the difference between the shallow and standard cushion types.

To my way of thinking, if the UMFF is sized and adjusted properly, it should absolutely NOT cause any soreness, marks or excessive leaking (at least not at pressures below 17).

Best wishes,

Den



**This cushion is for full face masks only. It will not work with any nasal mask. It will work only with that sized Full Face Resmed Mask.**

Either the Small Shallow or Small Standard cushions can be used on the original Small Mirage Full Face Mask, the Small Shallow or Small Standard Series 2 Mirage Full Face Masks, and the Small Shallow or Small Standard Ultra Mirage Full Face Mask.

Either the Medium Shallow or Medium Standard cushion can be used as a replacement on the original Medium Mirage Full Face Mask, the Medium Shallow and Medium Standard Series 2 Mirage Full Face Masks, or the Medium Shallow and Medium Standard Ultra Mirage Full Face Mask.

Either the Large Shallow or Large Standard cushion can be used as a replacement on the original Large Mirage Full Face Mask, the Large Standard or Shallow Series 2 Mirage Full Face Masks, or the Large Standard or Shallow Ultra Mirage Full Face Mask.

Shallow denotes a smaller cutout in the top of the cushion for the bridge of the nose. People with significant bridges should choose the Standard instead of the Shallow. This cushion is for full face masks only.

Remember that a small cushion fits on small masks, medium on medium masks, and large on large masks. Each frame has a specific size so mixing cushions will not work as it does on Resmed nasal masks.

[sleepinginseattle]

You're not using your mask correctly. If you've tightened it so that it leaves sores or marks it's too tight and will not work as designed. It is designed so that the seal inflates to create a soft yet tight seal. Your experience with marks and soreness around the bridge of the nose indicates that the seal is not inflated there.

Loosen the straps to restore the seal. If it is impossible to control leaking (in other words it leaks all the time) consider changing the sizing. If the sizing doesn't fix the problem, maybe you need to go to a different mask.

I wouldn't tolerate an uncomfortable mask for long. It isn't as though my therapy is going to end any time soon.

As Snooter wrote, an AHI of less than 5 is considered normal sleep. You're still in good shape with 3's and 4's.

[SleepySandy]

I had no idea there were standard and shallow cushions.

Mine is the standard. I have a narrow bridge, but a relatively deep nose. When I did the cpap.com online sizing tool, one of the recommendations was the Vista Deep if that helps.

So, I could try to switch to a shallow to accommodate my narrow bridge, but the tip of my nose might hit the front of the mask.

[Wulfman]

Sandy,

I have my forehead piece in the full, upright position which puts the mask back as close to the face as possible. (especially at the upper part of the nose)

I also have the top straps very loose and most of the tension is on the bottom straps.

It takes a bit of experimenting and adjusting to get the "just right" tension and fit, but there should be no soreness from this mask. It needs to be loose enough for the seal to expand with the air to get a good seal.

Because of improper adjustments and sizing, I think this mask gets a lot of bad PR. For those of us who have mastered the adjustments, it's "Heaven".

I've always used the "Standard" cushions in my masks, but the "Shallow" may be what you need.

Best wishes,

Den

[Wulfman]

I had no idea there were standard and shallow cushions.

Mine is the standard. I have a narrow bridge, but a relatively deep nose. When I did the cpap.com online sizing tool, one of the recommendations was the Vista Deep if that helps.

So, I could try to switch to a shallow to accommodate my narrow bridge, but the tip of my nose might hit the front of the mask.

Here's the link:

https://www.cpap.com/productpage/resmed ... irage.html

Switching cushions is definitely cheaper than buying a whole new mask.

Den

[SleepySandy]

Thanks, Den.

I've been using this mask for almost 3 weeks. I tend to have to readjust it every night - switching the angle of the forehead piece and/or tightening the bottom straps. I sometimes think my face size changes on a daily basis .

I do have the top straps reasonably loose and I never have to adjust them. The forehead piece doesn't give me a headache, which is a good measure for me.

It seems I've done something wrong for about the last 5 days. I'll work with it tonight and tomorrow to see if I can make it better. I'll remind myself I need to keep the seal inflated. My inclination is to have it squashed against my face - it feels more secure. I do think I would be more comfortable with a more solid cushion like the FlexiFit 432. However, I'm not going to change. Based on the recommendations here and the fact that I've reminded myself that I DID have it working, I'm going to try again.

I will call my DME on Monday to see if they have a small shallow cushion in stock. Since I'm having trouble with the the mask, they might give it to me. I've been really fortunate regarding my DME and my mask issues. Even if I have to pay for it, it's not the worst thing in the world.

[mecocosm]

My nares are slotted. One is narrow. The other is very narrow.

The Swift made my nostrils hurt like crazy while I was using it and then all day after using it. I did try lotions, but nothing worked. It was a stretching thing, I think.

My Swift is a small. My CL2 is also a small. I had the same problem with the CL2, but I don't think it was quite as bad.

If it helps, the XS NasalAire II actually fit my nostrils.

One thing you may not have realized is that the Hybrid pillows can be separated by cutting the thin bar connecting the pillows. By doing that, you can use different size pillows for each nostril and that might be the solution to your problem.

You can't do this on the Swift because the pillows are integrated with the reservoir.