Can't find suitable mask

[Tipiford]

I would appreciate hearing from some who have gone through several masks before finding the right one. I'm on my fifth mask, and the only one that comes close--but 'no cigar' as it is causing nose pressure sores--is the ResMed Mirage Quattro. I have tried a Respironics nasal: pressure sores with leaks; ComfortGel Blue nasal: pressure sores with leaks; ResMed Mirage Quattro pressure sores or leaks (even using tape across the bridge of the nose); Innomed Hybrid FFM: this mask has 3 headband adjustments, and would leak regardless of adjustments and would bruise upper lip (no matter how 'light' the adjustment); and the ResMed Hybrid: this mask would also bruise the upper lip and the radius of the curve of the mouthpiece is too shallow and would leak around the sides (both this hybrid and Innomeds' had the leak and bruising issues). I am thinking that the only option I have left is nasal pillows, but am wary because my jaw drops after falling asleep, which has also been a problem with the FFM, but that issue has been resolved wearing a homemade chin strap; my thinking is. that perhaps, the chin strap would work with a nasal pillows system.
I now have more dollars in masks than in my machine; I feel as though I'm running out of options, unless several have made the pillow system with chin strap work.
Thanx,

Tipiford

[chunkyfrog]

Have you tried a mask liner? Pad a Cheek's mask liners may help in your case,
and be an inexpensive way of giving your current equipment a second chance.
Even a home made mask liner should give you an idea if a layer of fabric will help.
Old, clean t-shirt fabric works very nicely for a DIY gasket.
I have gone through over 20 masks; but I have a very odd face, or so I've been told.

[jilliansue]

Hi! I would definitely try the chinstrap with the nasal pillows. The nasal pillows are so much more comfortable, overall, and tend to leak less simply because there are fewer mask-to-skin contact areas to have to seal. I have not yet found a full face mask I could tolerate and that did not leak way too much. So I have always used either nasal pillows or nasal masks, and have always used a chinstrap.

If you are getting your masks from a DME, you should have a 30-day return period, but you may need to ask/insist about this.

I commend you for continuing to try. It takes most of us awhile to find what works. And even then, later on we may find other solutions that work even better. Keep at it, you are worth it.

Jill

[Pugsy]

Give the nasal pillows a try with a chin strap. You may not be mouth breathing as much as you think you are.
I usually tell people "if you can normally breathe through your nose just fine during the day without issues then go ahead and give the nasal pillows a try if they interest you".
Now if you can't breathe through your nose well and nothing you can do will open up the nasal passages to the point that you can keep your mouth shut...then unless the added humidity helps clear up the nasal passageways (and it does help a lot of people) then it may not be such a good idea.

When I first started cpap therapy I thought I was a mouth breather too because I would often wake up with dry mouth and major sore throat....come to find out it was just habit brought on by a few years of gasping for breath during an apnea event of some sort.
After a couple of months of taping (I chose that route over chin strap because the chin strap sort of annoyed me and the taping was less of an annoyance) I found that my mouth breathing seemed to greatly reduce.
Now I might sometime do a little mouth breathing (usually when I might be on my back) and the mouth drops a little but it rarely is big enough or prolonged in duration enough to really be much of a negative factor in my therapy.

You might look at the nasal pillow mask that I am using right now. It comes with free 30 day return insurance from cpap.com.
If you hate it...you can get your money back.
https://www.cpap.com/productpage/tap-pa ... roved.html

If you do elect to try a nasal pillow mask....use the software to see just how bad the leaks are that might be from mouth breathing. I know that sometimes I still have evidence of a little mouth breathing but it rarely goes into large leak territory and stays there for very long. I don't worry about little episodes of mouth breathing like 10 to 20 minutes out of 8 hours of sleep.
It all depends on just how much leak is going on from the mouth breathing and how long it is lasting.

The Circadence SleepWeaver cloth masks also come with free return insurance...these are the over the nose masks. I have never used one (always used nasal pillows) but a lot of forum members just love it.

The other nasal pillow masks...like the Swift FX and Aloha..have return insurance available but not free. Still an option though...if you hate it...at least only out the cost of the insurance.

[Denial Dave]

Spend about $15 and give padacheek liners a try.
http://www.padacheek.com

[Tipiford]

Thanks to you all for the very excellent (and speedy) responses, which give me a good starting place, and in answer to those responses, this is where I'm now headed:

Have you tried a mask liner? Pad a Cheek's mask liners may help in your case,
and be an inexpensive way of giving your current equipment a second chance.
Even a home made mask liner should give you an idea if a layer of fabric will help.
Old, clean t-shirt fabric works very nicely for a DIY gasket.

I currently am using a padded 'band aid' style of pad across the bridge of my nose--and it helps some--but I will try the cotton shirt idea and use the Mirage Quattro FFM (the most effective thus far) as a back-up, as this mask is uncomfortable, even when I have the straps at their loosest level (when the straps are as loose as I can achieve a no leak situation, the muscles in my face relax after I drift into sleep and my mouth will drop just enough to cause a leak and awaken me; but the chin strap does keep my jaw from dropping far enough to cause a leak).

Hi! I would definitely try the chinstrap with the nasal pillows. The nasal pillows are so much more comfortable, overall, and tend to leak less simply because there are fewer mask-to-skin contact areas to have to seal. I have not yet found a full face mask I could tolerate and that did not leak way too much. So I have always used either nasal pillows or nasal masks, and have always used a chinstrap.

If you are getting your masks from a DME, you should have a 30-day return period, but you may need to ask/insist about this.

I commend you for continuing to try. It takes most of us awhile to find what works. And even then, later on we may find other solutions that work even better. Keep at it, you are worth it.

Jill

I am tending toward this. I have found the pillows in the two hybrids I tried, to be comfortable and much less prone to leaking. I have had to use the chinstrap for the above mentioned reason. And, much thanks for the spiritual encouragement!

Give the nasal pillows a try with a chin strap. You may not be mouth breathing as much as you think you are.
I usually tell people "if you can normally breathe through your nose just fine during the day without issues then go ahead and give the nasal pillows a try if they interest you".
Now if you can't breathe through your nose well and nothing you can do will open up the nasal passages to the point that you can keep your mouth shut...then unless the added humidity helps clear up the nasal passageways (and it does help a lot of people) then it may not be such a good idea.

When I first started cpap therapy I thought I was a mouth breather too because I would often wake up with dry mouth and major sore throat....come to find out it was just habit brought on by a few years of gasping for breath during an apnea event of some sort.
After a couple of months of taping (I chose that route over chin strap because the chin strap sort of annoyed me and the taping was less of an annoyance) I found that my mouth breathing seemed to greatly reduce.
Now I might sometime do a little mouth breathing (usually when I might be on my back) and the mouth drops a little but it rarely is big enough or prolonged in duration enough to really be much of a negative factor in my therapy.

You might look at the nasal pillow mask that I am using right now. It comes with free 30 day return insurance from cpap.com.
If you hate it...you can get your money back.
https://www.cpap.com/productpage/tap-pa ... roved.html

If you do elect to try a nasal pillow mask....use the software to see just how bad the leaks are that might be from mouth breathing. I know that sometimes I still have evidence of a little mouth breathing but it rarely goes into large leak territory and stays there for very long. I don't worry about little episodes of mouth breathing like 10 to 20 minutes out of 8 hours of sleep.
It all depends on just how much leak is going on from the mouth breathing and how long it is lasting.

The Circadence SleepWeaver cloth masks also come with free return insurance...these are the over the nose masks. I have never used one (always used nasal pillows) but a lot of forum members just love it.

The other nasal pillow masks...like the Swift FX and Aloha..have return insurance available but not free. Still an option though...if you hate it...at least only out the cost of the insurance.

I do breathe through my nose while sleeping, I need the chin strap with whatever system I'm using to keep my jaw from dropping after falling asleep, causing leakage. The Tap Pap looks interesting, but I'm not sure that I could get accustomed to an appliance in my mouth to hold the mask in place.

Spend about $15 and give padacheek liners a try. http://www.padacheek.com

This will be a viable option for the back-up FFM I have if the tee-shirt fabric is not adequate. Thanks.

[Pugsy]

I wondered about the Tap Pap oral appliance myself because I have never ever used anything like that...no braces when younger and no mouth guards for any reason otherwise.

It did feel a bit weird at first. I joked about putting a girdle on my teeth. Now it is something I don't even notice after 5 or 10 seconds. There's a couple of threads about it now on the front page of the forum. One of them is the original thread that I started when I first got the mask and tried it...so my thoughts along with others as they also tried it.
The newest thread today is about the new improved mouth guard.

I think I have an Opus 360 that was donated by someone a while back that you could try to see if you liked it.
https://www.cpap.com/productpage/fisher ... -Mask.html
Not sure on the sizes of the nasal pillows. You don't have to wear it routed over the forehead if you don't want to.
It was donated by a forum member who tried it and didn't care for it. So it has been used a little but not abused and still in good enough shape that you could at least try it to see if it is even possible for you to use it and keep mouth closed with the use of a chin strap. Just send me a private message if you want to try it and I will go check to see what nasal pillow sizes I have.
It was donated...so free. I don't know the history on it as to pets or smoking household.
All I ask is maybe reimbursement for postage and that won't be much...around $5 probably and if you like it..keep it and if you don't then either send it back to me so someone else could try it or go ahead and offer it to someone else.
I hate to see good usable masks go to waste when someone might be in need.

I don't think I have any other nasal pillows masks...I did have quite a supply of the Swift FX nasal pillow mask parts (enough to build a mask) but they were all given away when I made the official change to the Tap Pap as my primary mask.
Mostly the other masks that have been donated are over the nose masks...or just the plastic parts and headgear but minus the cushions.

[avi123]

I have tried about 20 different masks and none was really comfortable. I am not talking about achieving a zero AHI or a zero leak which I do achieve it now with my present mask, but could not with full face masks. I need to try mouth guards which I would wear instead of my removable dentures, and they would seal the mouth leaks from air coming during exhalation which it does by forcing my glottis to open, and puffing the air out like from a cigarette smoke puffs? Has any one found a dentist to take impressions and cast such night guards for less than $200? I could then get rid of chinstraps, which are annoying.

[hyperlexis]

I would appreciate hearing from some who have gone through several masks before finding the right one. I'm on my fifth mask, and the only one that comes close--but 'no cigar' as it is causing nose pressure sores--is the ResMed Mirage Quattro. I have tried a Respironics nasal: pressure sores with leaks; ComfortGel Blue nasal: pressure sores with leaks; ResMed Mirage Quattro pressure sores or leaks (even using tape across the bridge of the nose); Innomed Hybrid FFM: this mask has 3 headband adjustments, and would leak regardless of adjustments and would bruise upper lip (no matter how 'light' the adjustment); and the ResMed Hybrid: this mask would also bruise the upper lip and the radius of the curve of the mouthpiece is too shallow and would leak around the sides (both this hybrid and Innomeds' had the leak and bruising issues). I am thinking that the only option I have left is nasal pillows, but am wary because my jaw drops after falling asleep, which has also been a problem with the FFM, but that issue has been resolved wearing a homemade chin strap; my thinking is. that perhaps, the chin strap would work with a nasal pillows system.
I now have more dollars in masks than in my machine; I feel as though I'm running out of options, unless several have made the pillow system with chin strap work.
Thanx,

Tipiford

Honestly, the Quattro is one of the best FFs on the market, especially for jaw drop, and is very adjustable. You should find the post about 'taming the Quattro.'

The nose sore indicates perhaps you have the top part positioned too low, adjusted too tightly, or perhaps the cushion you have is just too small. The Quattro has a cut out at the nose bridge to prevent pressure sores. The mask must be sized and positioned properly or pressure sores can result.

Going to nasal pillows will cost you more money and may end up causing you even more problems.

[John from Brookston]

I would appreciate hearing from some who have gone through several masks before finding the right one. I'm on my fifth mask, and the only one that comes close--but 'no cigar' as it is causing nose pressure sores--is the ResMed Mirage Quattro. I have tried a Respironics nasal: pressure sores with leaks; ComfortGel Blue nasal: pressure sores with leaks; ResMed Mirage Quattro pressure sores or leaks (even using tape across the bridge of the nose); Innomed Hybrid FFM: this mask has 3 headband adjustments, and would leak regardless of adjustments and would bruise upper lip (no matter how 'light' the adjustment); and the ResMed Hybrid: this mask would also bruise the upper lip and the radius of the curve of the mouthpiece is too shallow and would leak around the sides (both this hybrid and Innomeds' had the leak and bruising issues). I am thinking that the only option I have left is nasal pillows, but am wary because my jaw drops after falling asleep, which has also been a problem with the FFM, but that issue has been resolved wearing a homemade chin strap; my thinking is. that perhaps, the chin strap would work with a nasal pillows system.
I now have more dollars in masks than in my machine; I feel as though I'm running out of options, unless several have made the pillow system with chin strap work.
Thanx,

Tipiford

I worked with the Quattro until I "tamed" it. I found that I was wearing it too low on my face (after first being sold one too big for my face), the lower seal goes in the hollow between your chin and lower lip, the forehead straps are barely snug, and I crank the top of the mask away from my face until it starts to puff, then crank it back 3/4 a turn to seal. When it's properly set, only that thin silicone flap touches the bridge of your nose. If you have greasy skin like I do, you'll need more than the Sunday afternoon wash with mild soap. I wash my cushion 3-4 times a week.
Even though I tamed the mask, I have trouble taming myself to it, I have psychological issues and claustrophobia with it.

I tried a Swift FX pillow mask and now I'm a True Believer. Every night I have used it has been wonderful and I'm getting 5-7 hours of uninterrupted sleep with it. More leakage than with the Quattro, but nothing in large leak territory and my mouth doesn't open that much. I do not use a chin strap or tape my mouth shut (claustrophobia again)

Good luck, I'm sure you will find a mask that works great for you.

[ughwhatname]

I would appreciate hearing from some who have gone through several masks before finding the right one. I'm on my fifth mask, and the only one that comes close--but 'no cigar' as it is causing nose pressure sores--is the ResMed Mirage Quattro. I have tried a Respironics nasal: pressure sores with leaks; ComfortGel Blue nasal: pressure sores with leaks; ResMed Mirage Quattro pressure sores or leaks (even using tape across the bridge of the nose); Innomed Hybrid FFM: this mask has 3 headband adjustments, and would leak regardless of adjustments and would bruise upper lip (no matter how 'light' the adjustment); and the ResMed Hybrid: this mask would also bruise the upper lip and the radius of the curve of the mouthpiece is too shallow and would leak around the sides (both this hybrid and Innomeds' had the leak and bruising issues). I am thinking that the only option I have left is nasal pillows, but am wary because my jaw drops after falling asleep, which has also been a problem with the FFM, but that issue has been resolved wearing a homemade chin strap; my thinking is. that perhaps, the chin strap would work with a nasal pillows system.
I now have more dollars in masks than in my machine; I feel as though I'm running out of options, unless several have made the pillow system with chin strap work.
Thanx,

Tipiford

I use the Tap Pap, and there have been plenty of times that my mouth is open (more than for the mouthpiece), but I can keep my tongue glued to the roof of my mouth, so I don't have leaks. If you can learn to do the same, then you may be successful with nasal pillows. Or maybe the tongue trick plus a chinstrap.

[sawinglogz]

I second what Pugsy said above. I'm starting to consider nasal pillows despite hating them in my initial titration. (Exhaling against the pressure was hardest of the 3 masks and made my ears pop. Now that I'm on ASV, that shouldn't be a problem.)

I concluded I was a mouth breather because we tried a nasal mask, but my nose stopped up and I needed to mouth breathe to get enough air. But lately I've noticed that my nose breathes better with a hybrid than with the Quattro FX. So I'm wondering whether nasal pillows (+ chinstrap) would work for me...

That'll be my next experiment, after settling on which mask to have insurance cover during this initial 30-day period.

[avi123]

Regular Quattro? I tried this mask twice:



Even if find one that fits the contour of my face, those grimaces with my facial muscles that I do while asleep cause leaks from the peripheral seal.

About the new Quattro AIR, I don't know. It seems to me that either Resmed designers are idiots or they think that we, the customers, are stupid. Why there are no snaps on the headgear straps like the regular Quattro has?



Regardless, the basic physics stays that the longer the linear length of a seal, the higher the leak from it. Nasal pillows have the shortest seal length. Next, come the traditional nasal masks, etc.

[Tipiford]

I worked with the Quattro until I "tamed" it. I found that I was wearing it too low on my face (after first being sold one too big for my face), the lower seal goes in the hollow between your chin and lower lip, the forehead straps are barely snug, and I crank the top of the mask away from my face until it starts to puff, then crank it back 3/4 a turn to seal. When it's properly set, only that thin silicone flap touches the bridge of your nose. If you have greasy skin like I do, you'll need more than the Sunday afternoon wash with mild soap. I wash my cushion 3-4 times a week.
Even though I tamed the mask, I have trouble taming myself to it, I have psychological issues and claustrophobia with it.

I tried a Swift FX pillow mask and now I'm a True Believer. Every night I have used it has been wonderful and I'm getting 5-7 hours of uninterrupted sleep with it. More leakage than with the Quattro, but nothing in large leak territory and my mouth doesn't open that much. I do not use a chin strap or tape my mouth shut (claustrophobia again)

Good luck, I'm sure you will find a mask that works great for you.

The Quattro (that I can't seem to tame) does fit in the hollow or crease under my lower lip, and I've learned to position it high on my nose, and using a padded shim where the upper part of the cushion rests on it (the nose), but after my jaw starts to drop, the leaks, no matter how minor will awaken me, and I still end-up with the nose sores. (The adjustment knob, for me, needs to be turned 3 clicks in from the full out position, which is the nominal angle to fit to my face.)

I use the Tap Pap, and there have been plenty of times that my mouth is open (more than for the mouthpiece), but I can keep my tongue glued to the roof of my mouth, so I don't have leaks. If you can learn to do the same, then you may be successful with nasal pillows. Or maybe the tongue trick plus a chinstrap.

The Tap Pap seems very successful to several people on this forum, but I am hesitant to give it a try for the moment--of course, I have not ruled it out. The tongue trick, I don't think I could learn, if I could do that, I could also keep my jaw in place.

I second what Pugsy said above. I'm starting to consider nasal pillows despite hating them in my initial titration. (Exhaling against the pressure was hardest of the 3 masks and made my ears pop. Now that I'm on ASV, that shouldn't be a problem.)

I concluded I was a mouth breather because we tried a nasal mask, but my nose stopped up and I needed to mouth breathe to get enough air. But lately I've noticed that my nose breathes better with a hybrid than with the Quattro FX. So I'm wondering whether nasal pillows (+ chinstrap) would work for me...

That'll be my next experiment, after settling on which mask to have insurance cover during this initial 30-day period.

I too, thought the hybrid would be the way to go, but both brands, Innomed's and ReMed's are not angled properly for my face, or should I say, my face is not angled for their hybrids. I guess my face is sharper angled than the average. If one of these manufacturers would have an adjustable angling device, where you could change the radial curve around your face, they could fit many more people with the hybrid (or nasal or FFM as well).

Regular Quattro? I tried this mask twice:



Even if find one that fits the contour of my face, those grimaces with my facial muscles that I do while asleep cause leaks from the peripheral seal.

About the new Quattro AIR, I don't know. It seems to me that either Resmed designers are idiots or they think that we, the customers, are stupid. Why there are no snaps on the headgear straps like the regular Quattro has?



Regardless, the basic physics stays that the longer the linear length of a seal, the higher the leak from it. Nasal pillows have the shortest seal length. Next, come the traditional nasal masks, etc.

Indeed, there needs to be more selection among manufactures (there are plenty of masks out there, but too few options on the mask that would 'otherwise' fit.


Thank you all for the many excellent tips, suggestions and ideas. This has helped me immensely in my search for the 'nearly' perfect mask.

Tipiford

[xenablue]

Initially I had a problem with my mouth falling open during sleep, but it's so worth using a chinstrap to have the freedom of nasal pillows. I don't like ANYTHING covering my face - not even bedclothes, so getting used to a mask was a biggie for me.

It took me 18 months to wean myself off the chinstrap, so if you try the nasal pillows with chinstrap, don't be impatient. It's been a year now, but every once in a while I'll wake up with desert-mouth, but it's rare.

Cheers,
xena