Looking for feedback on my CPAP experiences so far

[oldyeller]

Happy New Year!

I've been on CPAP since August, and I'm pretty frustrated at this point. I haven't been able to find a full-face mask that seals AND doesn't destroy the bridge of my nose. (I have a thin, bony nose, with a bump right at the bridge.)

Started with an Resmed Ultra Mirage. Despite the forehead pads and bridge adjustments it was very hard on my nose, it It also left two sore bruises on my forehead where the pads sat.

Then tried the Resmed Mirage Liberty. More comfortable, but never could get a reliable seal at the nostrils. When it was semi-reliable, I had it strapped down so tight that the area between my upper lip and nose was swollen and sore in the morning, although it usually went away after an hour or so.

I'm now on a Fisher&Paykel HC432, which has been the most comfortable and best sealing of the bunch, but is still very hard on the bridge of my nose. (This morning, the first thing my wife said to me in the new year was "Wow, your nose looks horrible.")

My planned next step is to try the next size up on the HC432, they put me in a medium and I think a large might be better.

Where I'm looking for input from experienced CPAP users is this.....

I am at a pressure of 18, and have never gotten a good seal with any of these masks without REALLY tightening down the straps. My doctor and nurses have told me that I should not need to tighten a mask to the point that it's uncomfortable, it's just a matter of experimenting and finding the right mask. But the two people I've worked with at the DME supplier have both told me that with a pressure that high, tightening the straps really tight is going to be a fact of life. Anyone with a high pressure have any thoughts?

Also, one person at the DME told me that with a pressure that high, my doctor should have prescribed BiPAP rather than CPAP. Does that make any sense? As I understand the differences, I don't understand why it would.

Thanks for any input!

[OutaSync]

Believe me, I share your pain!!! I also have a nose with a bump at the bridge where it was broken years ago. I have found that the nose bridge protector by padacheeks to be very helpful. THat protector also covers the forehead piece:

http://www.padacheeks.com/PAC_Nosebridge.html

I hope that helps you.

Bev

[oldyeller]

Thanks for the advice, as soon as I can find my wallet I will order one of those. Am I the only one amused that it comes in all those patterns? Like the right fabric is going to make my headgear fashionable!?!? At any rate, I'm going for the pattern called "Crazy."


thanks again-
Yeller

[OutaSync]

Glad you haven't lost your sense of humor Nothing says "sexxxy" like our headgear. I went with "Paint dabble", myself.

Bev

[Wulfman]

Happy New Year!

I've been on CPAP since August, and I'm pretty frustrated at this point. I haven't been able to find a full-face mask that seals AND doesn't destroy the bridge of my nose. (I have a thin, bony nose, with a bump right at the bridge.)

Started with an Resmed Ultra Mirage. Despite the forehead pads and bridge adjustments it was very hard on my nose, it It also left two sore bruises on my forehead where the pads sat.

Then tried the Resmed Mirage Liberty. More comfortable, but never could get a reliable seal at the nostrils. When it was semi-reliable, I had it strapped down so tight that the area between my upper lip and nose was swollen and sore in the morning, although it usually went away after an hour or so.

I'm now on a Fisher&Paykel HC432, which has been the most comfortable and best sealing of the bunch, but is still very hard on the bridge of my nose. (This morning, the first thing my wife said to me in the new year was "Wow, your nose looks horrible.")

My planned next step is to try the next size up on the HC432, they put me in a medium and I think a large might be better.

Where I'm looking for input from experienced CPAP users is this.....

I am at a pressure of 18, and have never gotten a good seal with any of these masks without REALLY tightening down the straps. My doctor and nurses have told me that I should not need to tighten a mask to the point that it's uncomfortable, it's just a matter of experimenting and finding the right mask. But the two people I've worked with at the DME supplier have both told me that with a pressure that high, tightening the straps really tight is going to be a fact of life. Anyone with a high pressure have any thoughts?

Also, one person at the DME told me that with a pressure that high, my doctor should have prescribed BiPAP rather than CPAP. Does that make any sense? As I understand the differences, I don't understand why it would.

Thanks for any input!

There's NO WAY that a UMFF should hurt you if you have the right size and if it's adjusted properly. Those masks have to be worn looser in order for them to seal properly. The seal has to expand from the pressure on the inside of the mask to fit to your face. If it's too tight, it'll crush the seal and make it leak more. Quite a few "high-pressure" users use the UMFF with good success.

I started out (briefly) at a pressure of 18, but quickly found out I only needed about 10 - 12 cm.

Den

[Driver59]

I had the same problem with the HC432. With the chin flap in place it pulled the mask down on the bridge of my nose.
Think I might try removing the chin flap. Other than that I thought it was a pretty good mask. For the Liberty try tying
the nasal pillows together. As is suggested elsewhere in this forum, I found that a pair of ladies knee highs tied around the head and across the pillows keeps them in place. Actually you don't even have to have them around your head, I wrap one end
around one side of the top strap then across the pillows to the other side of the top strap. Works pretty well for me, but my max pressure is only 12.5. Also I found that hose management was very helpful. With the hose suspended from above, there is less chance of the hose pulling on the mask creating a leak. Lots of good information in this forum, hope you find the right combination.
Don

[birdshell]

I would like to propose trying the Liberty again. I had problems with the nasal pillows sealing properly, but solved them as shown below from another thread:

I had success with my Liberty mask (also made by ResMed) in tying a simple regular, real pantyhose leg around the bottom of the nasal pillows. That helped the sealing and shifting problem with that mask, so it may help with yours.

Here is a more involved discussion of the Liberty fix: Liberty Mask Slippage Fix

There are other fixes collected (and awarded) by Rested Gal. Check them out here: Lab Rat Awards for Various Mask Fixes

Karen,
Who still misses her Liberty

Another thought: What size were your nasal pillows with the Liberty? Did you get all three sizes, or did the DME provider decide that you only needed one? OFTEN, we find that the next size up will give a better seal...but maybe that isn't true for all of us!

Best wishes,
Karen

[GumbyCT]

Echoing what Den said & adding you can also try the Rested Gal homemade straps to help keep the mask from lifting OFF your face w/o making the mask way too tight. Any FFM is definitely harder to seal bc it covers much more surface area.

For that reason you should try any mask which avoids the bump you mention that gives you trouble. The Breeze and Headrest come to mind. It was much easier for me to seal just the nostrils than my whole face.
http://www.aeiomed.com/products/headrest.php
The Movie - http://www.aeiomed.com/video_product_in ... adrest.php

Use some http://www.Lansinoh.com to help seal around the nares.

Yes, I use nasal pillows at 18cm sometimes it bumps up to 20/21. The nose does just what it is designed to do - regulate. It only lets in what you need - I was surprised how much more comfy (and effective) it was.

I am at a pressure of 18, and have never gotten a good seal with any of these masks without REALLY tightening down the straps. My doctor and nurses have told me that I should not need to tighten a mask to the point that it's uncomfortable, it's just a matter of experimenting and finding the right mask. But the two people I've worked with at the DME supplier have both told me that with a pressure that high, tightening the straps really tight is going to be a fact of life. Anyone with a high pressure have any thoughts?

Also, one person at the DME told me that with a pressure that high, my doctor should have prescribed BiPAP rather than CPAP. Does that make any sense? As I understand the differences, I don't understand why it would.

Thanks for any input!

A BiPap WILL definitely help bc it reduces the pressure when exhaling rather than increasing it. If you can't get your doc to script one - ask for a loaner for a month or so to check out the results. You do have the software, right?

Good Luck,
GumbyCT
ps. like birdshell said - size can make a diff

[oldyeller]

Thanks everyone for your replies... it's much appreciated. Based on your input I've ordered the padacheeks nose bridge protector, I'll see if that helps with the HC432. I'm also going to get the larger size seals/padding for my HC432... based on driver59's comments I'm even more sure I need the larger size. And while waiting for those items to arrive, I'm going to revisit the Liberty and try a couple of the suggestions for making it seal better.

Some follow up on other questions and points made....

- I did get all three sizes of nasal pillows with my Liberty, and experimented with all 3. I had best luck with medium.

- I wish I could go with a nasal pillow only solution like the Breeze or Headrest , unfortunately I do not breathe well through my nose so have to go full-face.

- I do not have the software... a quick Google and it looks like the software and reader for the S8 series would be more than I have in my budget at the moment. Anyone know of cheap places to get it?


thanks again-
Yeller

[GumbyCT]

I had the same problem with the HC432. With the chin flap in place it pulled the mask down on the bridge of my nose.
Think I might try removing the chin flap.

Having used both the FP 431 & 432 before I should point out that to fit properly the chin should be placed into the chin cup first. The mask should then be gently leaned in towards the face, keeping the chin in place.

Mine came with a little brochure explaining how to properly wear this mask.

The 432 requires the next larger size (compared to the 431) bc of the foam taking up space inside the mask.
The 431 comes with S,M, & L sizes where the 432 does NOT.

HTH,
GumbyCT