New user asks for mask/headgear suggestions

[Bookbear]

I have been diagnosed with OSA and have been prescribed a CPAP (although I don't have the unit yet, still waiting for the HMO to "authorize" it). I am HIGHLY motivated, but am very new to all this; and am feeling a bit overwhelmed at all the various masks and headgear available. I have been told that I will likely have some choices made for me by the insurance company, but that it will still leave me with a (smaller) range of masks to choose from. I've also been told by the insurance people that they will not fund 'trial and error' on masks until I get the "right" one. So, I would really like some suggestions from users here as to some good choices, given the following about me:

(1) I have a fairly thick, full beard, (2) I sleep on both my left and my right sides (alternating through the night), (3) I am not generally a mouth breather, (4) I have oily skin, and am pretty sure I will have problems with breakouts on my face from pads/mask seals, (5) I take an blood pressure medication that gives me a very dry mouth, (6) I won't be able to tape my mouth shut, and (7) I often have nasal congestion at night.

Sooooo..... any suggestions with brands/types of maks/headgear/interfaces to start with? The doctor has specified a heated humidified unit, if that makes a difference in choice of mask.

Thanks to to you all for a wealth of information I have already gleaned from here.

Good sleeping! I hope to be joining you soon!

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP

[Goofproof]

I went with a FF Mask from the get go, Congestion is the pits. Their are some good threads on ff masks, If I were you I would loose the beard, some keep them and get by. I don't see how. Most people don't like a FF mask, but even if congested you can use them all the time. If you can't hold in the required pressure to keep your airway open, you aren't doing yourself any good. Jim

[Guest]

I too have a full beard and am a side to side sleeper. I find the Comfort Lite 2 is a great interface for me. For nasal congestion, I was prescribed Flonase which I use, but I think just the pressurized, humidified air keeps me pretty uncongested.

[Ritap1965]

If you can clear up your sinuses at night before going to bed, a nasal mask would be better for you. If you got the ComfortLite 2 you can get both the pillows and the cushion, and you get 2 sizes for easier fitting. That way you can switch to the cushion if the pillows bother your nostrils to much. A chin strap may be the way to go to keep our mouth shut if you end up breathing through your mouth.

I am struggeling with the full face masks. I find them uncomfortable and I don't sleep well with them. I do some mouth breathing, but I'm going to stick with a nasal interface. Out of the 2 full face masks I have, Ultra Mirage Full Face mask and Fisher & Paykel HC431, I prefer the Ultra Mirage. Less leaks and more comfortable.

Good luck with your choice.
Rita

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CPAPopedia Keywords Contained In This Post (Click For Definition): mirage, HC431

[rested gal]

If you got the ComfortFull 2 you can get both the pillows and the cushion, and you get 2 sizes for easier fitting. That way you can switch to the cushion if the pillows bother your nostrils to much.

I feel sure that was a slip...that Rita meant to type ComfortLite 2. And I agree with what she said about...what she meant to type.

Another excellent nasal pillows interface, imho, is Aeiomed's "Headrest" (formerly called the "Aura".)

[brasshopper]

I have been diagnosed with OSA and have been prescribed a CPAP (although I don't have the unit yet, still waiting for the HMO to "authorize" it). I am HIGHLY motivated, but am very new to all this; and am feeling a bit overwhelmed at all the various masks and headgear available.

Ok, I've been using a CPAP since the late 1980's. In all that time, I have had a full beard and moustache.

The mask I used to use was a Respironics standard silicone skirt in size MS (Medium Small). The key here was that the skirt touched my skin above my moustache. Also, the skirt is different than a gel type in that it comes to a "point" and that the air pressure makes the seal tighter.

When I got my CPAP, conventional wisdom was that the CPAP was equally effective whether your mouth was open or not. However, most people learned to close their mouthes because opening your mouth was uncomfortable.

My mask recently broke - I think it was about four or five years old. They no longer make that mask in that size. I had a mask that I picked up somewhere and it was a Respironics medium. It simply did not fit. I found a 10 plus year old mask that was size MS, but it was all gummy and oily, a real mess. Better than the medium which leaked around my eyes, but not much. I believe that I've had a total of about five masks over the years, and three sets of headgear. Maybe four, I forget. I wash the mask every few months whether it needs it or not. I get a blemish under the mask skirt every two-three years.

Did I mention that I have always slept with my glasses on? I never used the supplied forehead pad, I have always just rested the mask against the glasses.

I went for a sleep study recently for re-titration and they wanted me to use their mask. I explained how I slept, and the tech immediately reached for a Resmed Mirage Swift Nasal Pillow system.

I was astounded at how comfortable the nasal pillows were by comparison, how light they were, how much less they caused me facial issues, the whole nine yards. Also, well, the glasses were a lot more comfortable - and, furthermore, it was possible to take the glasses off or put them on without disturbing the mask.

Despite the fact that it was totally out of pocket, I called cpap.com and dropped the $120 for the system.

According to the tech, I had one leak which I fixed, more or less instinctively, without waking up enough to notice. She was about to head in to fix it when she noticed that I had.

I sleep on my back. With the old mask I would frequently have long leaks, and dry eyes from the air blowing out of the corners of my eyes. I told the previous titrator that I had constant leaks and could not fix them and that they should just give me a pressure that worked with the leaks.

I have learned to sleep on my back. I frequently have nasal congestion. Usually, I open my mouth for a minute when I am first going to sleep and I allow the airflow to dry things out. Once there is a good dry airflow (usually under 30 seconds), I close my mouth. The tech told me that it is their habit to use a chinstrap with the nasal pillows and I told her that I did not think I would need it. I was right, years of practice have me habitually sleeping with my mouth closed (I will mouth breathe during a power failure).

Once I go to sleep, the pressure usually stops new congestion.

By the way, I am still using my original CPAP. The biggest problem with it is building a head of steam in it before I go to sleep. Maybe I'll get a new one soon, one that runs on electricity . One problem with replacing it is that my original study was a home study and, now that I am covered by Medicare, they won't take it for diagnosis. Despite the fact that I have used a CPAP every day for the last 20 years, a compliance which one sleep specialist called record breaking, I have to have a new diagnostic study which meets Medicare's requirements.

[apneaicinisrael]

Hi, and WELCOME!

Your high motivation will be your greatest asset here! Add a pinch of humor and a splash of patience and you'll do just fine. I am a devoted pillow user, and I surely don't have a beard, so I can't tell you what to do with that. But think about the pillow systems. I find them so light and easy that sometimes at night I reach up to touch my pillows just to make sure they are still there! THere are four good systems, as per my take on it: Swift; Breeze; Comfort Lite 2; and Aura Headrest. The Swift has it's outlet hose from one of the sides which may or may not matter to a side sleeper. With all of them try to route the hose up and over your head and fasten it to the headboard or wall above your head. Read through the forum for lots of info on each system. Post more questions as they come up. If you decide on what you want and your insurance doesn't offer it, see how much it will cost out of pocket from cpap.com. The prices there are really reasonable.

Good luck,
Keep posting!

AII

[reval]

I think every new CPAP-user should at least consider (or try, if that is possible) the Mirage Activa mask. It is a nasal mask and it seals VERY well, even if you have a beard. Many people, including me, like it very much.

The use of a CPAP seems to have resolved my frequent nasal congestions during the night that I had in the past, others seemed the have experienced that effect as well.

[twillson]

I agree with breasshopper and others that you should try a nasal pillow interface before deciding on a full face mask. I have had both the oily skin problem and the dreaded congestion problem. I have only had one night were the combination of pillow and decongestant didn't work, and only a few nights where the decongestant was even necessary.

By reputation, full face masks seem to be much more cumbersome and more problematic than pillows. I think it makes more sense as a last option than a first option.

I would describe my sleeping patter as you did (mostly on side but switching from side to side) contrary to expectations I have been very happy with the ResMed Swift as long as I keep my face slightly higher than parallel to the bed, which feels both comforable and natural to me. This also ensures that the exhaust doesn't bother my better half. I'm sure that the ComforLite 2, Headrest (Aura) or Breeze would also work for you. Go to a good DME and try them all![/b]

[CPAPjerryCPAP]

I had a full beard also, and constant nasal congestion. My doctor said go with a FF mask, so I got the ComfortFull 2, man I struggled. I first trimmed my beard to Miami Vice stubble, better, but still the feeling of the "alien on my face thing" prevented me from sleeping.

I discovered this board and after some searching around decided to order the Activa Mirage. I have not looked back, my beard is not as full as it used to be but people know it's a beard and not forgetfullness; and as far as nasal congestion, I do my ritual of blowing, rinsing and stripping (see thread on breathe-rite strips) and with the heated humidifier on 4 I haven't had a problem.

Just keep the Activa loose and sleep brother, sleep.

Sleep well.

Jerry

[Tumbleweed]

My vote is for the Swift. I've had beard and mustache since way before I started on XPAP and have had no problems, even when I did use a regular mask. You may also consider the NasalAire2 if you are on straight CPAP. That one is great for us side-sleepers too. The only thing about the Swift is trying to sleep on the side that the short hose is on...... I know many have written about the discomfort of that hose, and yet, I seem to sleep right on the dang thing with no problems. AND, that is with a very firm pillow which I prefer!

[Bookbear]

A big THANK YOU toall who responded....lots of good suggestions and I am feeling a bit less overwhelmed by all this now. This is a great group and a great resource. I am slowly working my way through previous threads and getting a lot of background info there as well. I feel that I won't be in "lamb to the slaughter" mode when I visit with the DME! Again, thanks!

[Gidgie]

Hi, Bookbear. Welcome to the club! This is a really great bunch of folks, and sooner or later you'll meet a whole lot of them.......Reading your posts and the replies about beards and such, gives me an itch to contribute my 2cents worth.......Gidgie is female.....but Gidgie also has a beard.....a neat little chin-fringe that fits quite nicely in the chin cup of my F&P 431 FF mask.....and no, I can't shave my chin or use hair removers......relates to my environmental disorder......once seen it's a sight not easily forgotten......but folks around where I live are so used to it no one realy notices........So yeah....try & keep the beard if you can......

[Ritap1965]

Rested Gal, thanks for the correction. You are absolutely right, I meant ComfortLite 2. I have edited the post so I don't confuse anybody.

[woozle]

Hi there! I am glad you have found this site! I received my cpap machine on wednesday. My DME had to go back and change my machine 3 different times as I was WELL prepared when I first met with him due to the info obtained on this site! This will be my 3rd night on the machine and things are actually going well. I was given a chin strap, even though in my study I didn't open my mouth when using the nasal pillow. The first night I did not use the chin strap, and I kept opening my mouth and waking up. So last night I used the chin strap and slept 8 hours. I also am a side sleeper and the nasal pillow works well for that. The heated humidifier seems to help with any stuffy nose as well. Good luck!!