Not ready to give up, these are the masks I've tried

[ozij]

Hi MrRandom,

I'm sorry you're having such a difficult time with you masks and eyes.

I notice you haven't tried any of the nasal pillows masks - e.g. Breeze, Headrest, Opus, Optilife, and I wonder why. You've only tried the combined ones. Maybe a shot at one of them will give you a chance of figuring out of the air is really coming out of your tear ducts, or blowing on your eyes from imperfect seals.

From the way you describe it, you have a very shallow nose bridge, and most masks don't fit on it, and leak into your eyes from the outside.

Resmed sells a special, shallow cushion, for its Activa nasal mask. The cushion is said to be better fitting for people of East Asian descent - maybe you should try that.

Eyes are no laughing matter - but you do have to find out for sure where the leak is coming from. I understand the lab told you that tear duct leaks are rare - and if that's your problem, nothing can be done about it.

Do you have anyone to help you set up the and check it for leaks?

What do you do about hose management? For me, masks were getting knocked out of place and until I routed the hose from above my head. Have you tried that?

Some people find that a different head pillow also makes a big difference - and there are special pap-pillows to be had.

Please go to an eye doctor again with your eye problems - dont' try tough it out - and please give a nasal pillows mask a chance.

What is your pressure, by the way?

O.

[rested gal]

MrRandom, I was going to suggest what ozij mentioned... switching to a "shallow" in the resmed Ultra Mirage FF mask. Each of the sizes (small, medium, large) also come in two different cushion "shapes." Standard and Shallow.

Several years ago a guy who had talked to a nurse who was a support person at resmed said the nurse told him she thought the "Shallow" cushion worked better for more people than the "Standard" does. I always had better success using the Shallow instead of Standard when I used an Activa and an Ultra Mirage FF.

I'd try a Small Shallow, and a Medium Shallow in the Ultra Mirage FF mask, if I were you. One of those "Shallow" cushions might do better for you than Standard. The "Shallow" cushion has a blunter inverted V at the bridge of the nose. More like an inverted U. It's also a tad wider at the nostrils, and is a bit shorter vertically from bridge of nose to under the nostrils.

The Shallow sizes fit the same plastic frame interchangably, just like the Standards do. You don't have to buy a whole new mask to switch to "Shallow."

[sleepycarol]

I agree with O that you should revisit the eye doctor and keep trying.

Have you tried the shallow seals? I have found on the Activa I need a shallow to keep it from leaking.

Yes, masks are very expensive -- but the alternatives are so much more expensive. Funerals are thousands of dollars. Hospital stays are thousands of dollars. Long term care is very expensive. The consequences of NOT using cpap is too great to be ignored.

Have you visited with the sleep doctor again? It is possible they may have a solution. There has to be others that have the same problem -- yes I read where it was rare in one of your post. Could other factors BESIDES cpap be causing the problem?

Babs has a trial going with the NAII. You could pm her and see if you could test drive it and see if there were any improvement prior to buying another mask.

How are you judging what size mask to get? Are they being fitted to your face? Have you tried having the DME fit you and actually laying down with the mask (yes, even if it is the floor) with the pillow you normally use and with the cpap at your pressure?

[MrRandom]

Well I haven't tried any of those because I absolutely need to breathe through my mouth at times. I have a lot of allergies and nasal congestion. I've been doing sinus rinses and using nasalcrom, but it's allergy season and not much works, not even sudafed.

I was pretty sure it was coming from inside, up through my tear ducts, at least in part. Because I stuck large bandaids over my eyes and even put tape over that to cover the tiny holes in the bandaids. I could still feel a small amount of air on my eyes every now and then, esp in the inner corners. And sure enough I woke up at 2 am with them dried out, inflamed, gritty, etc.

I am going back to the eye doctor, but even he was skeptical the plugs would stay in against the CPAP air. I'm also going back to the sleep doctor after my surgery. I don't really expect he's going to have any answers for me, though, tbh.

[MrRandom]

Oh, I was judging what size mask to get by using that measuring guide on cpap.com. The doctor also measured my face and head when I saw him, he was the one that recommended the quattro small, but I don't know the actual numbers he got. And just the fact that I'm small and have a small jaw.

[ozij]

If you absolutely need to mouth breathe you may want to try a Hans Rudolph mask. The have a large variety of sizes, and calipers you're supposed to use for measurement. They also sit further down on your nose.
http://www.rudolphkc.com/detail.php?pid=144

And someone has recently discovered the ZZZ mask worked when nothing else did.

O.

[JeffH]

You know, MrRandom, in pretty much every post you taking about quiting. I personally have had enough. Why don't you go ahead and quit. This forum isn't FOR quitters.

[sleepycarol]

MrRandom Posted: Sun May 04, 2008 6:19 pm Post subject:

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Well I haven't tried any of those because I absolutely need to breathe through my mouth at times. I have a lot of allergies and nasal congestion. I've been doing sinus rinses and using nasalcrom, but it's allergy season and not much works, not even sudafed.

I was pretty sure it was coming from inside, up through my tear ducts, at least in part. Because I stuck large bandaids over my eyes and even put tape over that to cover the tiny holes in the bandaids. I could still feel a small amount of air on my eyes every now and then, esp in the inner corners. And sure enough I woke up at 2 am with them dried out, inflamed, gritty, etc.

I bet you are dealing more with allergies than anything else. Until you have them under control you probably aren't going to get any relieve.

I, too, have severe allergies (according to my allergist I am a 12 on a scale of 1 to 10). I take Zyrtec daily -- year round (my allergies are year round). In the spring they get really bad -- enough to swell my eyes shut, dry them out, gritty, etc. etc. I will wake up even at night with them itchy and gritty feeling and dried out. In the spring, along with the Zyrtec -- I take Singulair (used for allergies as well), a prescribed nasal spray and prescribed eye drops in extreme cases. I am told to carry Benadryl at all times and to take it as needed if still needed. (I also have an Epi-Pen for emergencies). Get your allergies under control if they are that severe.


You have made several post and have a few other threads here and in the majority of them you are reporting adverse reactions. I agree YOUR VISION is important. So is breathing at night!!! You are still new fairly new to therapy and IT IS UP TO YOU to make it work or not!! You are in control. No matter what is suggested it is still up to you, unless you take the steps to correct the situation it will not get better.

You need to be PROACTIVE in treating both your allergies and sleep apnea. I, also, realize medical treatment is expensive. Cpap equipment is expensive, medicines are expensive, what isn't these days?

As far as your bandaid experiment unless the bandaids were airtight air still could have been leaking under the bandaging near the bridge of your nose.

[MrRandom]

Wow, I guess it's all relative. I'm sitting here thinking I barely have allergy problems at all, but that's in comparison to how it used to be. Used to be I could not move my head at all because my sinuses were so plugged they hurt, especially at night. Used to be I was stuck using a nebulizer every 4-6 hours because my lungs were so inflamed and constricted. Used to be I spent the spring and summer not doing anything because if I started moving around too much my throat would swell closed.

So a little nasal congestion that means I have to breathe through my mouth sometimes seems like nothing at all to me. You could be right that my eye problems are related to allergies. I did not sleep with the CPAP last night but my eyes still dried out. Not as badly, so the CPAP probably just aggravates an existing problem. But I'm not sure it's going to get any better than this, considering how severe it was. I have taken allergy shots for years. I have taken every antihistimine known to man, I have a HEPA filter I run in my bedroom, etc. Now I'm off all the drugs except benedryl, sudafed, and an albuterol MDI when I need it.

[sleepycarol]

I was told by my allergist that you never get cured of your allergies. Shots may lessen your reactions somewhat, but you still have the allergy. I have tried the allergy shots at two different intervals for a few years each time. Neither time lessen the severity of my reactions so I no longer get them. I always felt really bad after the shots for a couple days and was miserable.

I, too, have trouble getting the antihistimines to work me for -- the majority do nothing for me. Zyrtec is one of them that does work for me. So far my body has built up a resistance to it and I have been on it for a number of years.

Would it be worth it to see if allergy eye drops helped? I know there have been occasions when I have wanted to claw my eyes out due to the symptoms of allergies.

[blackvelvet]

Have you tried a hybrid? I had trided many of the FF masks but they leaked on to my eyes or onto my chin and I just couldn't deal with it. The other one I wanted to try was the hans roudolf (sp) but couldn't locate it localy to try. The hybrid has a bad reputation in my area with the DME's and sleep doctors but it is the only oen that didn't leak for me. My allergies are also very bad but after 3 years on shoots and taking meds they are somewhat better now my problem is mouth breathing in in compairison that is not an issue. I also use Nasacort AQ now and it has helped with the masks and I actualy do breath though my nose on occation now though not all night or even every night.

[neverbetter]

Hybrid is wonderful, but if you have had a dry mouth, it may happen a little with a Hybrid, too

You may be a great candidate for the Nasal Aire device.
Fantastic mask. get the one with all 6 prongs in the package for 5.00 more. Than you can help Babs with her cpap social work....
Seriously, she has helped numerous people with her kindness here.

[birdshell]

Note: There actually are custom masks being made in other countries.

This is custom made and available in oz however with the way the U,S dollar is at the moment it would be an expensive trip.



http://sleepapneamasks.com.au/

Click Here for a Number of Sources of Custom Masks from 1998

Customizing a nasal CPAP mask using a silicone elastomer--Aug. 2008, Journal of Prosthetic Dentistry

I recall one that was made somewhere in Africa (?) that I'd actually investigated. I could not find it with a Google search, sorry.

Sincerely,
Karen,
Who thinks custom ski boots aren't the only things that should fit properly

[Slinky]

Well, you "could" try the Respironics Simplicity simple nasal cushion. It isn't even made to fit on the bridge of the nose, but rather lower on the nose and thus less chance of leaks into the eyes.

Or you could also try the ComfortLite 2. It comes w/2 sizes of nasal pillows and 2 sizes of simple nasal cushion (which like the Simplicity fits lower than the bridge of the nose) OR it can come w/2 sizes of nasal pillows and 2 sizes of nasal seals (similar to the pillows but the seals fit AT the nasal openings w/o fitting into the nasal openings at all. Its like getting 2 different masks in 2 different sizes in one.

[birdshell]

Having used the Direct Seal on my ComfortLite 2 for a year, let me say that mine did extend into the nostrils a bit.

I should also say that the Simple Seal (which DOES require an additional elbow adapter) made my nose cold. I couldn't sleep.

Another similar design is the Breeze mask. It has an over-the-head-and-down-the-nose design, and has a nasal pillows interface as well as the DreamSeal. It would be the mask I wear today but...I am allergic to the silicone.

Sincerely,

Karen,
Who wasn't allergic back in the day