Help with Mask Ideas

[BreathlessinSoddy]

Hi, I'm very new to all of this. Let me start there...

I was diagnosed a couple of weeks ago. My pressure setting is 11. I currently have the Mirage Quattro FFM and the Liberty Hybrid nasal pillow mask. I liked the Quattro when I first got it, but I have been getting increasing damage to my nose bridge. I purchased a PadCheek for the nose bridge, I even cut a sock up and tried to pad the clip ridge. Still getting worse. At least it doesn't hurt anymore, it has actually become numb. After talking with my Dr, they decided to send me to the DME again.

This time I came home with the Liberty combo mouth and nasal pillows. I can't use it at all. My nose holes are incredible small, the small nasal pillows are still miles to big. I feel like I can't physically pull enough air through my nose with that mask on. I think the nasal pillows are actually blocking my air flow. So the lack of adequate air through my nose makes me open my mouth to breath, which in turn causes me to cough because I'm not used to the continuous positive pressure atmospher. Hopefully you get the point.

I am a very active sleeper ( I should through that in there too). Does anyone else have a really thing nose bridge like mine? What did you do about it? I really don't want to have to go to the total face mask, but I'm afraid that might be my only option.


HELP

[Madalot]

Hi Breathless!!

I totally understand what you're going through and your frustration. I had the same situation. The only difference is I never tried a mask with nasal pillows. I tried just about every FFM and even a couple different TOTAL face masks.

What finally worked for me was using the original FFM mask (F&P 431). The first thing we did was loosen the mask so it wasn't cutting into my nose bridge so much, thus giving the area a chance to heal. We gave it a couple days and didn't worry about the leaking problem during those couple days. My DME suggested that I use an acne astringent on the area to help it heal, which it did seem to help. Plus, I use a PLASTIC bandaid across the bridge of my nose.

Now, the area is healed and I have a "routine" every night. I clean my face (I purchase pre-moistened face cleansing cloths) and clean my entire face. Then I take the acne astringent and apply it to my nose bridge. Then, I take a plastic bandaid and put it over the area. And I'm ready to go.

This is what worked for me, but I know everyone's experience is different. Maybe some of this will be helpful for you.

[LSAT]

If you like the Quattro, ask your DME to let you try the Ultra Mirage FF. It is very similar to the Quattro, but, each size come in a shallow and standard to fit different nose shapes. Many people that can't wear the Quattro are happy with the UM.

[dcarreiro]

This is pretty funny. I have the exact same experience. I currently have the Quattro and Liberty at home. Quattro is a great mask but I am having nose bridge issues. So I got the Liberty and there is no way to get a seal. I tried everything last night and never could get a seal. However, I did find something out last night. If I keep the head straps a bit loose, the quattro works better as the cushion fills up with air and makes a seal. Pretty good seal, but when I move it seems to break it a little then I have to re adjust. Guess I will keep working at it. I did not know that they had 2 different sizes for the Ultra Mirage FF. Maybe I will try that. IDK. The battle continues.

[BreathlessinSoddy]

Thanks for the ideas. I tried the band aid thing the second night I wore the Quattro. My DME suggested to try some cosmetic sponges. I'm gonna get some of those today and try them. I'm gonna call them again on Monday and see if I can try the other masks that were suggested.

[dcarreiro]

How did the Band Aid work? Please post your results as that would help me tremendously.

[JoyD.]

Hi Breathless,

"Pillows" on pillow masks can vary tremendously. The "Respironics Comfort Lite 2", for example, comes in "Extra small" as well as "Small" and seems to work for people with "slotted" nares. Other pillows like those on the Swift LT seem to work best on those with rounded nares.

Some have used the CL2 Extra Small size pillow, but "trimmed" the opening so as to allow more air through.

I have nares that are neither round nor slotted, but somewhere in between . . . and the LG size Aeiomed Headrest works best for me (even though I used the MED size in other pillow masks).

So you might want to check your local DME's and see which pillow masks come in small or extra small pillows. Some DME's allow you to take home and try a couple nights with a "demo" mask first before deciding to buy.

Joy

[Madalot]

How did the Band Aid work? Please post your results as that would help me tremendously.

I'm going to chime in here because I am using a bandaid successfully. But the ONLY one that worked was using a PLASTIC bandaid -- the others made the situation worse. I also tried cotton pads/balls, but they didn't solve it, plus made my mask leak worse.

For me -- PLASTIC bandaids solved it (as well as cleaning the area with acne astringent).

[Muse-Inc]

If the ResMed Liberty isn't working, try the RespCare Hybrid mask, come with 3 sizes of oral cushion, 3 sizes of pillows that can be adjusted to sit at 2 heights -- this is the original hybrid style mask. They fit quite differently. I was supposed to use medium pillows but can't get enough air so I use the large and get a good seal. The pillows are very different between these 2 masks.

[BreathlessinSoddy]

I did try the band aid early on. I think that might actually be a good solution too. I think I would need to use 2 band aids. I tried only one before and my irritation and bump only moved down my nose.

I seem to be on the right track for a solution. I bought some Molefoam padding yesterday at target. The kind for shoe padding. I lined the inside nose area on the mask last night and I don't think I made my nose bridge irritation any worse last night.

I also bought the cosmetic sponges. I tried the egg shaped sponge last night in combination with the moleskin. It's too thick and causes leaks. However, I might try cutting the foam depth in half and see what happens. The egg shape is actually quite perfect for my nose. I find that the next limiting factor is the quattro vent holes however, can't block those or I'll have a whole new problem.

Thanks so much for the other mask ideas and the hybrid info. I'll definately speak to my DME about them tomorrow. I'm disappointed in the big difference between trying masks on at the DME and then putting them on at home. I try to lay back as much as I can in their office chair, but I wish more DME's would get the idea to get a cot or something for people to lay down on. I'm really hoping to alternate between the quattro and a hybrid.

[park_ridge_dave]

This is pretty funny. I have the exact same experience. I currently have the Quattro and Liberty at home. Quattro is a great mask but I am having nose bridge issues. So I got the Liberty and there is no way to get a seal. I tried everything last night and never could get a seal. However, I did find something out last night. If I keep the head straps a bit loose, the quattro works better as the cushion fills up with air and makes a seal. Pretty good seal, but when I move it seems to break it a little then I have to re adjust. Guess I will keep working at it. I did not know that they had 2 different sizes for the Ultra Mirage FF. Maybe I will try that. IDK. The battle continues.

Just a thought, I use the Quattro and what I do it set up the straps with the adjuster for the nose bridge set almost all the way "Out". I set my pressure for the full pressure (No Ramp). Then I put it on and start turning the adjuster until I get the leaks stopped.

This does two things:

1.) it gives me maximum comfort.

2.) It allows the "skirt" to expand and gives me a better seal.

3.) I am Using a CPAP Pillow and can now sleep on my side using this method.


I have only had two leaks where I woke up in the last three nights, Those were caused by me rolling over on the mask.

Bottom line. The Quattro is a very good mask (There are others, e.g. F&P 431 my DME doesn't carry it ) but it can take a little fiddling to get it right.

Good luck! and Cheers,

Dave

[BreathlessinSoddy]

I did a combo molepadding lining installation and astrigent/band aid application last night and it worked like a champ! I still slept horribly. I'm having a lot of issues with nighttime coughing. I'm starting to believe that I couldn't only breathe through my nose if my life depended on it. I have had my nose broken 3 times, so that probably has something to do with it.

One problem down, I'm not giving up!

[BrettAnd]

Strange but true....I had the same prob. with my Quattro. I even tried foam medical tape. Tape slowed the ulceration but didn't stop it. Then I tried the Respironics Fitlife. So far that works for me.

[fiberfan]

I try to lay back as much as I can in their office chair, but I wish more DME's would get the idea to get a cot or something for people to lay down on.

My DME has one but I can't mimic how I sleep at home on their cot since my back doesn't do beds. Do you think they would get the message if you brought a pillow and camping mat with you to try on a mask?

One problem down, I'm not giving up!

I love your attitude. I am sure you will find a mask that works for you.

[Janknitz]

I found some bandaids that really help--they are Johnson and Johnson "Advanced Healing Blister for fingers and toes". They are "cushioning gel pads" and just the right size for a sore nose, but a bit pricey since you either have to use a new one every night or walk around with a bandaid on your nose all day. You can find them in the bandaid aisle of any place that carries bandaids.

There are also gel comfort pads you can get from mail order CPAP supply companies. I finally got one the same day my nasal pillow mask arrived, so I haven't tried it yet, but it's there in case I get a cold or something and have to use the dreaded Quattro for a few days.

But, the bottom line is that if you have pressure and merely pad pressure, you are adding to pressure, not relieving it. (I used to work with quadriplegics and paraplegics who get pressure on bony prominences in wheelchairs and in bed, and also with people who needed braces and orthotics. The mantra was that pressure needs to be relieved, NOT padded!). So it may not be the best idea to pad in the long run--either try to adjust the mask to relieve the pressure or try a different mask.

One trick that helped me when trying to adjust the cushions on masks with air cushions like the Quattro was to make the mask loose, then only tighten straps during the "inhalation" phase of the cycle, so that the cushion was fully inflated when adjusting it. That's the best way to ensure that it is as loose as possible but not leaking. (This may seem like a no-brainer to most people, but I had to figure it out the hard way!).