Can Data Tell If I Have a Mask Problem?

[Pugsy]

Well...at least you had more time out of large leak than in. The last hour segment...pretty darn good...nice steady almost level line...that is what we like to see.
You would need to check your mask's vent rate at your pressure to get an idea just how much of what you see betwee 2 and 3 hour segment might be excess.

Is using the ramp something you just have to do to get comfortable with your pressure?

[sylvie]

Charlie,

Here's my 2 cents. Try a Pilairo nasal pillow mask. Then get a deluxe style chinstrap from cpap.com. You don't have to wear the chinstrap tight, just enough to make your brain "remember" to keep your mouth shut. If possible, get a mouthguard, like the cheap kind from Walmart. This will "reinforce" the idea to keep your mouth shut by making you want to shut your teeth on it--in my opinion, it doesn't matter if you grind your teeth or not--this will help. I got a mouthguard from the dentist, I only wear it on the top teeth, and paid way too much for it -- I should have thought to get the one at Walmart probably. Then put the Pilairo over the chinstrap. Then get a cervical foam collar and wear that too. They come in different sizes, you just have to find the one that's right for you. You don't want one that makes your head feel like a Pez dispenser, because you want to keep your head slightly tipped down--this is to prevent your tongue from falling into your airway anymore than needs be, and also so your chin rests slightly on the collar. Your lips will probably flap unless you put a thin smear of poligrip on them, which really works for me. If possible, try to elevate the head of your bed with bricks or something else. I do this setup every night and it is the only thing that works--chinstraps alone do not do it for me. Also, the Pilairo is the ONLY mask that works for me on a consistent basis, and it is "heavenly" comfortable, as the pillows are very billowey and soft. I have used the Pilario nasal pillows for many months now and not one of them has "sprung a leak" or failed in any way--and I wash it every day in baby shampoo. For the record, I rotate 3 of them around. Hope this helps.

[5thumbs]

suggestion for when you go back to the DME today

1. I know the Quattro doesnt work, take it back
2. Please fit me with these two new masks under pressure in your office. That way I can focus on the mask that is capable of holding pressure and you could potentially save me weeks of evaluation if the mask leaks from the get go.
3. Please order a Liberty or xxyyzz brand hybrid mask. If either of these two full face masks dont work, that will be the next step. IF they do work, I also plan to get a hybrid mask once my insurance permits (of course dont say this unless it is true).

Dont mean to be pushy, but my friend, you sound exhausted and you need some relief. Squeaky wheel gets the grease.

[Char1ieJ]

suggestion for when you go back to the DME today

1. I know the Quattro doesnt work, take it back
2. Please fit me with these two new masks under pressure in your office. That way I can focus on the mask that is capable of holding pressure and you could potentially save me weeks of evaluation if the mask leaks from the get go.
3. Please order a Liberty or xxyyzz brand hybrid mask. If either of these two full face masks dont work, that will be the next step. IF they do work, I also plan to get a hybrid mask once my insurance permits (of course dont say this unless it is true).

Dont mean to be pushy, but my friend, you sound exhausted and you need some relief. Squeaky wheel gets the grease.

Excellent suggestions. The Mirage Quattro isn't going to work for me. I am sure of that now. I'm going forward with testing the ComfortGel Blue FFM presently. IF I have any trouble with fit on it, I'll have the DME order the Liberty for me as well. He normally keeps them in stock, but was out when I went over Wednesday. We're going to get this worked out. And you're right -- I am exhausted and need some relief. I plan to sleep or at least rest/relax tonight and some tomorrow. THANKS again 5thumbs!

I went and played a little volleyball last night -- hoping to get some good exercise. When I got home, for my cool down, I stretched and then sat down in my recliner. Next thing I know, it's 5:15am. So, no therapy last night. UGH! Now, I'm sucking wind and hating it.

[Char1ieJ]

So... on Friday my DME gave me two more masks to try - the Respironics ComfortGel Blue FFM and the F&P FlexFit 432.
Over the weekend, I used the ComfortGel. The leak graphs are below:





This is with no tweaking, mask liner, etc. -- other than fitting to my face and going to bed. I did sleep on my side some last night, as my back was hurting. So, that could account for some of the leak rate in the last graph. I plan to use the ComfortGel tonight, then switch to the F&P to test it for 4 nights, then make a final decision.

Learned opinions on the question - Is this mask right for me? - would be much appreciated.

[Pugsy]

Did your mask supplier just hand you these two masks and say go for it or did he/she actually sit down with you and show you how to fit it and also use a machine with pressure so you could test it out?

[archangle]

Have you checked your head for extra holes? You don't have any really large piercings, do you?

Sorry for the humor. You do seem to be one of the hardest mask fits I've ever seen.

I wish I had the answer for you. A last resort might be an oracle oral mask, but they're pretty difficult to get used to.

[Char1ieJ]

Did your mask supplier just hand you these two masks and say go for it or did he/she actually sit down with you and show you how to fit it and also use a machine with pressure so you could test it out?

Basically, we talked about the problems with the Mirage Quattro leaks. Then, I suggested the ComfortGel Blue as an option. He ended up just giving me a medium (w/o fitting) in the ComfortGel and the F&P 432 in medium.

Have you checked your head for extra holes? You don't have any really large piercings, do you?
Sorry for the humor. You do seem to be one of the hardest mask fits I've ever seen.
I wish I had the answer for you. A last resort might be an oracle oral mask, but they're pretty difficult to get used to.

Haha! I've been told, at times, I had my head in a hole. Maybe it was the other way around.
No piercings at all.
Maybe I'm doing something horribly wrong with fitting the masks. They seem to leak in the same spots -- the soft flesh below my eyes, just lateral to the nose (below the boney portion) and the bottom "corners" of my mouth/chin. I don't feel as much air leaking with the ComfortGel as I did with the MQ, but I did feel some last night, especially sleeping on my side.

If it helps, here's where both masks leak...

[Denial Dave]

CJ..

Something to consider.... I wear a medium Quattro FFM, but needed a Large size Comfortgel Blue mask..... check your fitting again.

Dave

[archangle]

Sorry if I said this before to you, but I don't feel like looking back through all 5 pages of posts.

When you fit the mask, try to relax your face and make it leak, then readjust. I found I tended to tense up into the mask to stop leaks when I put it on. Then when I fell asleep, my muscles would relax and leaks would start.

[Char1ieJ]

CJ..
Something to consider.... I wear a medium Quattro FFM, but needed a Large size Comfortgel Blue mask..... check your fitting again.
Dave

Ah... since he didn't fit me with the mask, that might be the issue. During the titration study, the sleep lab gave me a size large ComfortGel Blue, too. Hmmm...

... When you fit the mask, try to relax your face and make it leak, then readjust. I found I tended to tense up into the mask to stop leaks when I put it on. Then when I fell asleep, my muscles would relax and leaks would start.

I'll definitely try that. I think I'm relaxing, but will make special note of how I'm fitting. I know I'm kinda tense because this situation is starting to really wear on me. I'm totally good with using xPAP, wearing a mask, dealing with the hose, cleaning everything, etc. The ONLY problem I have with it is the masks leaking. If I can't get one of these three to fit, I am going to make a concerted effort to figure out how to keep my lips from "blowing out" -- and just go with the Swift FX. Up to 12cm, it has given me the best leak graph so far.

[LSAT]

Re the Quattro....Try this....When you put the mask on, place it about 1/4" lower on your nose. This is wider and may stop the leak. Also...you will be wearing it slightly lower on your chin which is wider. Don't pull it lower while you have it on..place it lower as you put it on. Once it is on...gently pull the lower part of the mask away from your face to allow the cushion to fill with air. I have been wearing it this way for over 3 years without problems.

When I was originally measured, I was given a large. There were too many leaks and I exchanged it for the medium. Be sure you have the right size to start with.

[Char1ieJ]

Re the Quattro....Try this....When you put the mask on, place it about 1/4" lower on your nose. This is wider and may stop the leak. Also...you will be wearing it slightly lower on your chin which is wider. Don't pull it lower while you have it on..place it lower as you put it on. Once it is on...gently pull the lower part of the mask away from your face to allow the cushion to fill with air. I have been wearing it this way for over 3 years without problems.

When I was originally measured, I was given a large. There were too many leaks and I exchanged it for the medium. Be sure you have the right size to start with.

I'll try that on the Quattro early next week. Tonight, I'm switching over to the F&P FlexFit 432, for a few days of testing. BUT, I think we are definitely getting somewhere with the Respironics ComfortGel Blue FFM. Check out this leak graph from last night. The difference? I added a Pad-a-Cheek mask liner and slightly tightened the lower straps. It's not perfect, but going from HOURS in Large Leak to a few minutes is positively a good sign. OTOH, I don't get the much higher AHI, though.

[Char1ieJ]

Hey, we might be on to something. Since I had a so-called good night with the ComfortGel Blue FFM and the Pad-a-Cheek mask liner, I decided to hang on to it a couple more days before switching to test the F&P 432. Here are the last two nights leak graphs. Along with the night before, that's three nights without a huge Large Leak graph.

Let me know what you think... Should I stick with the ComfortGel and keep tweaking or go on to the F&P for testing?

[5thumbs]

You saw improvement with the Confort Gel over the Quattro on the 1st night. You have the F&P in hand so maybe try it over the weekend and see if there is same/better/worse results. It should not take long to make that determination since it looks like the Comfort Gel had such a "quick" improvement. Then return everything you are not using and know that you made the best decision you could have. Looks like you have cracked the situation!