Mask issues - ComfortLite 2

[Iskander]

Hey, folks, I'm nearing the end of my first week on CPAP, and although I'm fine with the pressure, and I'm beginning to feel the effects (qualitatively better already) I seem to have started like so many with some mask problems.

I have a ComfortLite2 mask, that I tried first with nasal pillows, but woke up halfway through the first night with a very sore nose, so I switched to the simple cushions that also came with it. They are much more comfortable, and I'm happy to stick with them. The problem is more with the seal, and - I think - the headgear.

I like that it carries the hose above my head - I have a lot of freedom of movement to roll from side to side, but as I do so, the seal gets broken. Likewise it gets broken when the pressure increases. This is simply a design problem, I think - the mask's point of attachment is on the forehead, so pressure will just blow it off my face. I've tried using surgical tape to pull the mask onto my nose, but it's not really working well (the tape slips off the mask). If I tighten the headgear so much that it can't move at all, I end up with great marks all over my (shaven) head all damn day, and a headache. If I have it tight enough that it basically maintains its position, the mask leaks. I might try the pillows again, with less (physical) pressure on the mask and straps and so on, but I'm sceptical.

So, before I get a new mask altogether, I wondered if anyone has had any experience using a highly porous sports bandage (or similar) to just hold the mask lightly in place? It doesn't take much: I've dozed with my hand holding it.

Finally, I've begun to be reluctant to go to bed. It's troubling me a bit. I thought I would take to therapy pretty easily, I'm quite sensible about necessary things... but lately I've been... uncomfortable... about masking up. Maybe it's just anxiety about the quality of sleep I'll get (I had a bad, bad night last night). Tell me it gets easier!

[rested gal]

I wondered if anyone has had any experience using a highly porous sports bandage (or similar) to just hold the mask lightly in place? It doesn't take much: I've dozed with my hand holding it.

I use "similar" to hold just about any mask I use in place. The "similar" that I use is a leg cut off a pair of pantyhose tights, placed over the front of just about any mask and tied up high behind the head with a "double start knot." That's a knot that stays very flat and is easy to adjust or undo.

Pictures of various ways to route one or two homemade straps to stabilize a mask are here:
http://www.tnlc.com/Lara/laura/osa/aura-strap6ways.jpg

How to tie a doublestart knot:
http://www.fieggen.com/shoelace/doublestartknot.htm

The material in pantyhose tights (not plain pantyhose) works very well as a homemade strap. Soft, stretchy, keeps its width nicely.

The homemade strap doesn't have to be tied tight at all. It works much in the same way that holding your hand up lightly to steady a mask works. Just a little "push" on the front of a mask can do wonders.

[NeedinZs]

Hi Iskander,

I am going through the same exact thing with that mask and cushion. I have the Comfortlite not the Comfortlite II. I don't know how much difference there is.
I really would like it to work, because it is comfortable, and I have the same problem as you with the nose soreness from the pillows.

It's exactly as you described, feels fine at first and then the pressure goes up and you loose the seal. I sometimes too have been able to lay my hand upon it and hold it in place. (works temporarily for a few more minutes of sleep).

I have tried to up my min. pressure a bit, since I've become more used to it, so that there wouldn't be all that much of an increase when it goes up, but that hasn't really worked well either.

I am getting ready to try a smaller size cushion. (I'm now in a medium)
I will let you know if that helps any at all. Maybe it's just too big?

And who designed the damn thing with the air escape right between the eyes? Sometimes even when I'm sealed, the escape air bounces off my pillow into my eyes.

I've been up since 3 this morning, trading out masks between the Swift pillows and cushions, so excuse my ranting. FInally got back to sleep at 6:00, then alarm goes off at 6:30.

I know it takes a while to find the right mask, so hang in there. You are doing great for your first week, believe me.

Sometimes there's a rough night, but all in all, it does get easier, and then you really appreciate those good nights and days.
(But I understand your frustration totally on those bad nights).

Did your mask come with different size cushions? I'm guessing not.
I'll let you know if going down a size makes any difference in a couple days.

Take care,

NeedinZs

[NeedinZs]

THANK YOU, RestedGal!!

I'm trying that tonight!!!! YIPPEE!!! I knew those pantyhose would get used one day!!

You're the best,
Gail

[BadBreath]

A ball cap or visor makes for stable and comfortable headgear that consistently maintains a seal with all of the CL2 interfaces (or original CL for that matter). Simple to create with no damage to the mask. Check it out:

viewtopic.php?t=21772

[tillymarigold]

I started with a CL2 and had the same problems. I second restedgal's suggestion.

If you're not handy [heh] with knots, you could try just tying the knot at your forehead; after all, you don't sleep face 100% down (even if you sleep on your side/stomach) so a knot right in the middle of the forehead shouldn't cause problems.

BTW as far as the nose soreness, try not tightening the mask so much. But it does take a few days for the nose to adjust to having something inside it.

[linda b]

I've been using the CL2 with simple cushion for almost a year and a half, and, like so many others, had the same problem of leaks. I used Rested Gal's pantyhose fix for quite awhile, then made my own covered elastic strap that attached with velcro at the back of the neck on the headgear. This also helped with the problem of the straps riding up at back.

Just about the time I was posting to see if anyone had "deconstructed" the CL2, BadBreath posted with pictures and information about his ball cap and visor versions of headgear for the CL2. I made one following his instructions on the visor version. I didn't like the swivel on top of the head flopping around, so I made a stretchy velcro strap with a loop to hold it loosely in place. This goes from the visor just above the ear, over the top of the head and to the other ear. I've been wearing this for several weeks now and really do like it. Oh -- I also cut the visor down some because I am exclusively a side sleeper.

The other thing I've noticed about the simple cushion is that you really do need to change it out for a new one after about 3 weeks.

[Iskander]

Thanks for all the great suggestions, everyone.

The night I posted, I decided to try the nasal pillows again - the design of the CL2's headgear looks better suited to the pillows than the simple cushion, and I hadn't had any seal problems... so it was just the nostril pain. I reasoned that if I woke up and couldn't take the pain, I would switch back to the cushion for the rest of the night. In fact, I slept so well I didn't need to, and the soreness in the morning was gone within about 30 minutes.

So, last night, I tried again with the nasal pillows, and again had a great night. This morning I woke up because I was so used to the mask that I tried to roll over the wrong way (left side -> front down -> right side) and pushed the mask off my face with my pillow. My nose is a bit sore, still, and I'm going to look into finding something to help with that, but I'm sleeping much better, and not being woken by leaks and noise.

My card reader just arrived from Hong Kong, so I'll soon be able to look at empirical data as well as my subjective sense, which rocks. (If only I can get the freaking Encore software to install. Doh.)

I guess the moral is: if at first you don't succeed, try again before switching! I'm glad I still have the surgical tape, though, and will get some pantyhose tights as backup.

Thanks again, for the suggestions and support. This is a great resource.

[kteague]

I have used extra straps to stabilize my masks and prevent leaks on every pillows mask (always careful to not block the vent holes). Using the tights legs right now.

My first mask was the Swift, that I quickly gave up on (maybe too quickly). Felt it wasn't conducive to my side sleeping without leaks and made my nose sore if I got it tight enugh to not leak.

The CL2 pillows did well for me and the headgear was not bad, especially when I added a Padacheek for the forehead piece - it helped stabilize it. But when summer came, it all just felt like too much in the heat, and the metal band on the nosepiece kept popping loose and aggravating me in the middle of the night.

For me the Breeze had the least leaks once I upped the pillow size. Actually, the small didn't leak, but they went way up in my nose. Just didn't care for the headgear, so I deconstructed it. Much more comfy but seemed to roll so I didn't quite master it.

Now using TwilightNP (Aura) and it too is deconstructed. The way the framework that remains is designed, it is perfect for anchoring the unit so it does not roll. Even so, I still use the extra strap under the nose. I really like the comfort of it and it has fewer leaks with the large nosepiece. Probably spring a leak a couple times a night.

Besides the legs of pantyhose tights, I have used sport sweatbands and women's headbands, and when the right strength or tension, they work well. Takes some experimenting. Right now I am trying to rig 3 headbands that will connect strategically to hold the framework of my deconstructed TwilightNP, support the nasal pillows, and support my chin. When I accomplish that I'll post a picture.

Sometimes our solution will be a compilation of other people's experiences. The key is to pursue improvement until we are satisfied. Good thing I don't have much money - I'd take that concept too far.

Kathy