New TAP PAP mask review

[park_ridge_dave]

Background

I have been on “C-PAP” therapy since March 17, 2010. I “Brux” so I wear an appliance to prevent “Bruxing”. Mouth breathing has been a problem for me so I have used a FF mask (Mirage Quattro). Although I have evolved a “system that allows me to get good sleep results (AHI < 5 most nights and feeling good @ 10-13 cm H2O) that system is not without problems.

The “Problems”

The FF mask is prone to leaks when I turn on to my side.

The mask leaves those “marks” on my face and nose.

Sometimes the mask irritates the inside of my mouth where the appliance
(anti-brux) contacts the cheek. That can be painful.

I am trying to increase my max pressure to 16 cm H2O but the FF mask leaks
too much to allow that pressure without extreme tightening of the mask straps
(remember the marks?). Comfort goes down and I get eye irritation sometimes.

Even with the FF mask I can get dry-mouth when I breath through my mouth with the mask on. Although, my new heated tube machine helps alleviate this.

Goals of the “Trial”

Utilize the mouth piece to eliminate the “extra” appliance.

Get rid of the mask lines and discomfort.

Increase the max pressure to 16 cm H2O without more leakage and tighter straps.

Get rid of the “mass” of a FF mask.

Increase comfort with a lighter mask and have more freedom to sleep on my side.

To see if I can get used to the mask without mouth breathing (I am using a chinstrap to start).


Summary of first night’s use.

I set the mask up and it took about 5 minutes total. Their web videos are very good and easy to follow. I got a very comfortable fit the very first time.

Since I am a mouth breather, I opted to use a chinstrap that I had on hand (see next paragraph for more background) and the head strap that came with the mask. The head strap was to keep the hose routed over my head so that when I rolled over in my sleep it would stay “clear”. OBTW, I use a “CozyHoze Boss” (tm) to keep the hose “tied” up on the headboard.

I have to do a little more “tweaking” on the chinstrap. I am still trying to find the TAP PAP branded chinstrap as it has the tube holder built in and looks to fit better to the mask. I even called the factory to enquire but I got a polite “brush-off” from a nice person there. I bet they are really busy and don’t have time for end-user inquiries with the new product roll-out. Too bad as I really think their chinstrap would be better. I’ll pursue that later as CPAP.com will eventually have them. It would be nice to evaluate the whole “system” at one time though.
Definitely, NOT a show-stopper!


AHI is way up 12.73. (But most “events” happened while I was still awake or awakening) but most of the night I was below 5 discounting set up etc. So I think I will be able to dial it in. I recorded 3 mouth opening events (I expected many more). I used “Sleepy Head” to record/review data.


I think it would be great if the mask had a “quick disconnect feature like that found on the Mirage Quattro. Then, I wouldn’t have to mess around trying to get the hose disconnected when I get up in the night. (This could also be helped by the better chinstrap???)

Edit

This just in, I re-read the "fine" Manual thanks to Mask Guy's help and it does have a quick disconnect feature.... you just rotate the swivel until it "pops' open. Who knew?????

Thank you Mask Guy!

Edit ends


It would be pointless to base my conclusions on just one night’s use, but, so far I am very encouraged about the mask. It doesn’t seem to leak even at the higher pressure or when I roll onto my side. Since I wear an “appliance” for “bruxing” it is much more comfortable. It weighs next to nothing and so it doesn’t bother me as much as the Quattro (which is a very comfortable FF) and NO LINES on my face. And, did I mention how quiet it is? Yes, very quiet mask and “No leak burps”!

The feeling when I wear this mask is like I have on no mask at all! (Remember, I am used to a FF mask with an “appliance”)

The pillows are very comfortable even at the higher pressures. I can see why they are popular.

For a first night, I give it 3.5 out of 5 stars! I feel that I will be using this device in future, but, only time will tell.

Bottom line, if you use an appliance as I do, you might want to try it as the factory is supporting a 30 day return option (available through cpap.com). I was really concerned (still am) about mouth breathing, but, I think it may work out well. As I get more time in using this device I’ll post more info.

Also, Pugsy, I agree with everything that you have posted. I do believe that my results are in "Lock step" with yours. I too think that this mask will probably be my number one. I just need some more full nights with it.


Cheers,

Dave

[Pugsy]

Thank you Parkridgedave for such a thoughtful review. It's good to hear from someone with prior mouth guard experience and a known mouth breather to the extent they need additional support of some kind to prevent negative impact on therapy.
I do a little mouth breathing most likely when on my back but it is usually very small amount...maybe barely touches large leak territory occasionally..I sleep through it..so I don't care about it.

So here are my thoughts about night two with the Tap Pap.

I did change to the Small size pillows and they worked much better..just as I expected.
I also changed over to my PR S1 50 series BiPap to test for condensation in the pillows...more on that later.

I seem to remember 3 awakenings in total. All 3 when I was on my back and in pain and the last one close to my get up time because I remember sort of half dozing watching daylight appear and thinking...I need a little more shut eye.
For me with my back and pelvic pain issues...3 awakenings remembered is considered "good".

I had zero leak issues last night in terms of the nasal pillows causing any sleep disruption. Maybe a little mouth breathing but the highest the leak ever got to was 60 L/min (remember this is total leak since that is what Respironics reports and can't be compared to ResMed leak numbers) and that was relatively short lived. My large leak territory with the PR S1 machine is 90 L/min...confirmed by a large leak flag in the past when I have used this machine and 85 L/min leak doesn't get a Large Leak flag.
My overall average total leak was 30.0 L/min per Encore which is right in line with expected vent rate. It's kind of hard to get an exact expected vent rate due to the fact that I use variable pressures so the vent rate varies too.

It was a great night. Slept very well for me. Zero issues with the mask. Just my normal pain issues unrelated to OSA or cpap.

I will address the condensation experiment in another post shortly.

It's looking like the Swift FX will be delegated to number two spot in my preferences. I simply just love the freedom this mask offers. I have always said that my preference is "less stuff on my face". The Bella Loops do a decent job but the loops still sometimes pinch my ear and that wakes me up. The traditional headgear can be worn very loose but I still know it is there. Marks on my cheeks..still occasionally happen even with Padacheek fleece covers because of just "laying on something" effect...similar to laying on a wrinkle in pillow case...it causes a line on my cheek if I do that.

It's not going to be for everyone...just like any mask....there will be lovers and haters.

[fredr500]

I can't believe there is no quick disconnect. This is almost a show-stopper for me, I really don't want to mess with taking it off in the middle of the night. I guess I could always disconnect at the back of the humidifier and walk with the hose.

Or maybe this goes on and off so quickly it's not a problem. Thoughts?

[park_ridge_dave]

Amen! Sister, can I get a witness???

Seriously, Pugsy, like I said, "we are in agreement here!" I am just hoping that this mask will be my "salvation".

I didn't even talk about the supine sleeping pains, but, I too am affected. That is one of the reasons that I have occasional "bad nights" due to "pains" in back hip etc. I am hoping that this device will let me turn more easily and, thus, avoid some "awakenings'

I haven't noticed any condensation problems (probably the heated tube???) and I sleep in a room at 62-63 degrees F. Keep in mind I am a "Newb" at the pillows so only time will tell.

I am following your experiences and I hope to contribute also. This forum was my "lifeline" 3 years ago and it is still helpful to me.

OBTW check my reply to the Sleepy head "bug" post you made in your other thread.

Cheers,

Dave

[Pugsy]

I can't believe there is no quick disconnect. This is almost a show-stopper for me, I really don't want to mess with taking it off in the middle of the night. I guess I could always disconnect at the back of the humidifier and walk with the hose.

Or maybe this goes on and off so quickly it's not a problem. Thoughts?

It's really a non issue. Just disconnect at the short hose and long hose link. It's super easy.
Just turn the machine off...breathe through your mouth or mask..reach up and disconnect at the long hose junction.
Only takes about the same amount of time as finding the quick disconnect thing.

[Pugsy]

I am hoping that this device will let me turn more easily and, thus, avoid some "awakenings'

Same here since I sort of need to go from side to side easily...just wish I could stay off my back easier said than done.. I can build a wall to keep me on my side but it's a PITA to climb the wall to get to the other side.

I haven't noticed any condensation problems (probably the heated tube???)

Yes, the heated hose really helps with keeping the air warm enough at the pillow level to deter the cooling effect which causes condensation and at the nasal pillow level it is primarily moisture in our own exhaled breath that is the culprit.

Janknitz asked me about this type of condensation with these pillows so last night I changed over to my PR S1 50 series (no heated hose with that one) and set it in Classic mode at 4. That's a lot of added moisture there...my preference.
Bedroom temp was probably 60 degrees last night. I did use a Padacheek hose cozy last night because if I didn't there would have been a lake form in the hose. Been there..done that.
With the Swift FX I would have had to use the barrel cozy or I would have had some moisture accumulate in the nasal pillow from condensation of the moisture in my own exhaled breath. I know this from past experience. Nothing like a cold spray from the vent holes or snorting water to wake a person up.

So...no condensation in the nasal pillows last night. I think the main reason is the shape of the nasal pillows with the Tap Pap. If you look at them they don't have a large reservoir of "poofiness" to collect anything...no where for water to pool and run back into the nose.
Instead there is the hard plastic shell thing where the vent holes are...it sort of has a rounded bottom down below the vent holes.
I was able to see that there were some droplets of condensation in that hard plastic shell thing but with the way the mask is worn there simply is no way for the water to run uphill and get into the nasal pillows. A person would have to nearly stand on their head to get it to run up into the nose.
So with no "puffiness" (with the nasal pillow) to allow for pooling of any condensation along with the way the hard plastic part is shaped...I can't see any moisture, that does condense, being able to get back up the road into the nostrils.

Compare the shape of the Tap Pap pillows here
https://www.cpap.com/productpage/tap-pa ... -mgmt.html

to the shape of the Swift FX here, particularly the big poofy part right at the junction where the pillow attaches to the short hose and you will see what I mean about this one has a possible reservoir or holding area where moisture can pool. Not the best of pictures.
https://www.cpap.com/productpage/resmed ... illow.html

So I had some condensation but it was in the hard shell part of the mask and I had no issues at all with it making its way back up to my nose or even giving me a cold spray out the vent holes.

[park_ridge_dave]

I can't believe there is no quick disconnect. This is almost a show-stopper for me, I really don't want to mess with taking it off in the middle of the night. I guess I could always disconnect at the back of the humidifier and walk with the hose.

Or maybe this goes on and off so quickly it's not a problem. Thoughts?

It's really a non issue. Just disconnect at the short hose and long hose link. It's super easy.
Just turn the machine off...breathe through your mouth or mask..reach up and disconnect at the long hose junction.
Only takes about the same amount of time as finding the quick disconnect thing.

Pugsy,

You must be a lot more wide awake than me when I get up Actually, you are correct, it's not a show-stopper but it would be nice. Maybe I can "cobble together" a quick disconnect?? (Also, I have the hose hooked up over my head)

Cheers,

Dave

[SleepingUgly]

I'm confused... Doesn't the short hose disconnect from the long hose in the same way the short hose of the Swift FX disconnects from the long hose?

[Pugsy]

I'm confused... Doesn't the short hose disconnect from the long hose in the same way the short hose of the Swift FX disconnects from the long hose?

Yep, exactly the same.

Any quick release thing is going to have to be at the short hose to long hose junction. I just can't imagine anything being in between that junction and the mask itself and if I am going to have to reach up there anyway...why not just pull the short hose out of the long hose?
Unless someone has it crammed in so tight it doesn't come out easy...I just tested it and it comes out real easy and quick.
For me it wouldn't matter where the hose was routed but then I am not using the optional headgear so not using that little loop to secure it to the headgear....maybe that is an issue??? Maybe someone is stuffing the short hose way into the long hose so it is difficult to pull out without added force?
Maybe someone has physical dexterity issues??? I could see that as maybe being a problem.

[park_ridge_dave]

I'm confused... Doesn't the short hose disconnect from the long hose in the same way the short hose of the Swift FX disconnects from the long hose?

Yep, exactly the same.

Any quick release thing is going to have to be at the short hose to long hose junction. I just can't imagine anything being in between that junction and the mask itself and if I am going to have to reach up there anyway...why not just pull the short hose out of the long hose?
Unless someone has it crammed in so tight it doesn't come out easy...I just tested it and it comes out real easy and quick.
For me it wouldn't matter where the hose was routed but then I am not using the optional headgear so not using that little loop to secure it to the headgear....maybe that is an issue??? Maybe someone is stuffing the short hose way into the long hose so it is difficult to pull out without added force?
Maybe someone has physical dexterity issues??? I could see that as maybe being a problem.

You don't have my severely arthritic thumbs then. It can be a bit of a struggle reaching up overhead with my arthritic shoulder too.
I'm just saying that it can be a little more difficult for us "more mature" users......

[Pugsy]

You don't have my severely arthritic thumbs then. It can be a bit of a struggle reaching up overhead with my arthritic shoulder too.
I'm just saying that it can be a little more difficult for us "more mature" users......

I bet you don't have many more years than I do under your belt. We just have the old arthritis acting up in different places.
Fortunately my hands aren't one of them. Though I did break my wrist a while back...so I know sort of what it's like to need 2 good hands and only have one.

I did happen to think of the dexterity issue though. I will see if I can come up with some thought that would make it easier to remove the short hose....don't know how it could be anywhere other than at the short hose junction though.
I don't know about you but the mouth guard requires both hands its such a good fit to get mine off.

[parsnip]

I used the TAP PAP last night for the first time. My thoughts:

I was suprised at how tight the mouthpiece is on my teeth. A little too tight I think, my teeth were slightly sore this morning. I may try to reform it to be a little looser. For those who haven't tried it, it isn't soft like a sports mouth guard, it is hard plastic when cooled. It takes some work to get it out of my mouth. I also have very crooked teeth which may contribute to that issue.

I had zero leak issues last night. Haven't looked at the data, but I am confident it should be reasonable.

I agree that the pillows run small, I use a medium on the Swift FX but was using the large on this one.

I don't know if this works for everyone, or how long it would last this way but, the swivel end of the hose pops apart pretty easily on mine and goes together easily too. That seems like it would work as a quick disconnect. YMMV

This is the first mask that I have found that allows me to sleep easily on both sides. The mask simply doesn't move at all.

My one issue is that I need to figure out a new hose management strategy. The hose was getting caught when I rolled over. Still didn't cause leaks but the pull back bothered me at night.

For reference, I use a Resmed S9 with APAP set to 10-15.

[Mask guy]

I can't believe there is no quick disconnect. This is almost a show-stopper for me, I really don't want to mess with taking it off in the middle of the night. I guess I could always disconnect at the back of the humidifier and walk with the hose.

Or maybe this goes on and off so quickly it's not a problem. Thoughts?

Hi, the swivel/ball joint between the CPAP hose and the smaller mask tube is designed to seperate, to act as a quick disconnect. To seperate it simply bend the swivel/ball joint beyond its maximum range and it will seperate. (not not pull it straight out).

When you want to connect it, do this in reverse - connect one side at an angle and rotate it back into position.

[Mask guy]

I used the TAP PAP last night for the first time. My thoughts:

I was suprised at how tight the mouthpiece is on my teeth. A little too tight I think, my teeth were slightly sore this morning. I may try to reform it to be a little looser. For those who haven't tried it, it isn't soft like a sports mouth guard, it is hard plastic when cooled. It takes some work to get it out of my mouth. I also have very crooked teeth which may contribute to that issue.

I had zero leak issues last night. Haven't looked at the data, but I am confident it should be reasonable.

I agree that the pillows run small, I use a medium on the Swift FX but was using the large on this one.

I don't know if this works for everyone, or how long it would last this way but, the swivel end of the hose pops apart pretty easily on mine and goes together easily too. That seems like it would work as a quick disconnect. YMMV

This is the first mask that I have found that allows me to sleep easily on both sides. The mask simply doesn't move at all.

My one issue is that I need to figure out a new hose management strategy. The hose was getting caught when I rolled over. Still didn't cause leaks but the pull back bothered me at night.

For reference, I use a Resmed S9 with APAP set to 10-15.

If you find it is bit too tight you can run it under a hot water tap and place it in your mouth before you go to bed. (leave it in your mouth all night, do not remove it after 4 minutes). That way it will cool and set to the shape of your teeth over night. It should be fine after that.

If your teeth are not straight you may also want to try moving it in your mouth a bit, after 1-2 minutes of the standard fiting process, that will make it a bit looser.

[Pugsy]

FWIW...I just now tried removing short hose from long hose with one hand.
I tried both the swivel connector trick that MaskGuy suggested as well as traditional removal at the short hose/ long hose junction. I managed it just fine with one hand and minimal effort but I can see how someone with arthritic shoulders would have trouble reaching overhead and someone with less than ideal flexibility in fingers and thumbs could have a problem.
Popping the swivel hose thingy probably was the easiest...just a little crimp and it pops off easily. Very little force needed. I was originally a bit leery of doing that just in case I broke something but the force needed is very minimal.

I still don't know about how to manage for those people with problematic shoulder joints.
Maybe the solution would be not quite so tight of a fit on that mouth guard to make it easier to pop off.
Though I have discovered that I can now do it (removal of mouth guard) with one hand where yesterday it took both hands...so maybe practice will help somewhat. Putting it back in place...still a bit of work but again maybe not quite so much "good fit" would help. I am thinking it doesn't have to fit like skin tight to hold the nasal pillows in place.

I rarely have to get up in the middle of the night so this is pretty much a none issue for me but I do understand that others aren't so lucky. This all goes back to what I have always said...there is no "perfect" mask out there that is going to be "perfect" for the whole cpap world. We all have different needs and different preferences and different things that will make or break a mask in so much as what will work for each of us.
We each have to make our own compromises and decide what makes or breaks the deal.