New & need another mask... I think? Help?

[abby123]

Hi All , I'm into this cpap thing 3 weeks now. I am not getting great sleep because of my mask leaking... I'm allowed to get another mask within first 30 days (doing that tomorrow).

Here are my problems & questions:

Problems
A) Current mask is leaking in various places, I have a thin face, bony nose, the leaks dry out my eyes or make sounds. I need to tighten it down so it doesn't leak... then wake up with a big red mark and nose pain. I tried bandaids and boomerang cushion (no good). I am not able to wear the mask loosely to create it's own seal, it will move and leak. It has no support on forehead, just kind of floats around nose with cushions. I've tried two sizes of the cushions that came with the mask, both leak somewhat.
B) Air vent wakes me up at times, if a blanket is anywhere near it, it wakes me up.... My mask seems to blow a lot of air out compared to an Eson I tried at sleep lab... maybe I just need to live with this.
C) I use a chin strap, but it doesnt always stay in place. My mouth is occasionally bone dry and I get chipmunk cheeks or air blowing out my mouth... again waking me up. I was taking the mask off, but now am "training" myself to seal off my mouth with tongue... works about 75% of time.
D) My machine happily tells me that I have NO leaks, even when test it by creating a leak that is obvious! It only gives me a leak (frown face) if it is a huge leak.

Questions
1) Do I need a FFM?

2) Do you need to use a chin strap with a FFM? If your mouth opens up, doesn't that cause leaks? does your mouth get dry with a FFM??

3) Should I try nasal pillows?

4) Would a nasal mask with a forehead support solve some of my problems? (fyi - I tried an F&P Eson nasal mask in sleep lab, but it also hurt my nose- tech said I was sleeping on my face though (I never do that) - maybe cuz I was on Ambien which I never take).

5) How many masks does it take on average to get this right? just curious.

6) When I visit my ENT doc with the data chip thing, will he be able to tell if I have small or medium size mask leaks? My machine sure isn't telling me.

If you can help, I really appreciate it!! Even if it is with just one answer. THANK YOU!!!!

[Julie]

Get a FF mask but get it fitted properly (in your measured size... not via an online template sizer), and be lying down when you try it and turn your head a few times (bring a pillow with you) and jiggle the mask up and down to get the best seal possible. And get some Pad-a-Cheek liners because they can make all the difference to the seal too.

[Hawthorne]

Sounds like you are training yourself to not breathe through your mouth by putting your tongue behind the front teeth. I did that. I did finally get it to do that all the time. I would doing it during the day when I was sitting. That helped. I hope you don't need to get a FF mask. Some do well with them though. I could never wear one. I use Biotene if my mouth gets dry, even during the night. Your mouth will likely get dry with a FF mask too because your mouth is open. It's just that your therapy is not escaping.

A nasal mask with a forehead brace MIGHT help. They can hurt your nose as well. I use nasal pillow masks and, because I have trained myself to keep my mouth closed so that I don't mouth breathe, I finds them really good.

Everyone varies as to how many masks they try to get the right one - maybe 4 or 5.

I guess I'll post this now and others can chime in with other experiences. I've been using cpap for 12+ years so have some experience.

Hang in there!

I don't know if your ENT doctor will be of help with the mask situation. It is all trial and error to get it right.

[abby123]

Thanks Hawthorne and Julie!

Well, an interesting development.... I just learned that my DME gave me the WRONG mask! I was prescribed a "Resmed Mirage FX nono standard Swift" but was given a "Philips Respironics Wisp Nasal mask". My DME substituted it, and never told me it was a different mask than the one I had in sleep lab (the one that seemed to work). And they never fitted me with it! I was given a sealed package and I didn't notice until now... I confirmed with my doctor's office that it is not as prescribed.

So... I'm a bit upset and frustrated, but may have figured part of this out. I was trying so hard to make the "wrong" mask work. I am going to get the correct prescibed mask tomorrow, but then I'm stuck with it for 6 months if it doesn't work because I am only allowed one mask exchange within first 30 days! urggh...

I just want to get some sleep!

I still appreciate any help on my original questions, because I need to learn all I can. thanks!

[Hawthorne]

I am in Canada so can't do this as easily as those of you in the US but I do with masks that are not Resmed or Philips Respironics (they do not allow online sellers to ship to individuals in Canada anymore). You can buy masks from cpap.com and get them at a lower price. Return insurance is offered as well.

This has given me the opportunity to try many masks over the years with not a lot of expense. You might want to try that. Since you are training yourself to keep your mouth closed, you could try a nasal pillows mask that way. They usually come with 3 sizes of nasal pillows so you can fit yourself easily.

Good luck with the Mirage FX Swift.

[Janknitz]

I hope you do well with the new mask, but I'm always leery about prescriptions that specify the mask, simply because you need a mask that works for you, no matter what. So try the Nano, and hopefully it will work well for you, but if it doesn't, don't be afraid to ask for ANOTHER mask and keep working on it until you find the right mask for you.

A better prescription for a mask, IMHO, would be "mask of patient's choice" and the DME should give you options and a proper fit.

[sawinglogz]

I am going to get the correct prescibed mask tomorrow, but then I'm stuck with it for 6 months if it doesn't work because I am only allowed one mask exchange within first 30 days! urggh...

Refuse to consider this the one mask exchange, since they provided you with the wrong thing. That's their mistake, not yours. They might try to say you've had your one exchange, but don't let them. If you have to, threaten to talk with your insurance carrier about how the DME failed to fulfill the prescription (which means they inappropriately billed your carrier).

If you're able to keep your old mask during the "exchange" (which some DMEs let you do since they can't reuse them anyway), then after you get the right one, before the 30 days are up, you should "exchange" for another mask so that you can try it when you like. Also, some DMEs will let you do more than one mask exchange.

I too couldn't stand the air in my eyes (and my sinuses congest when there's pressure on the bridge of my nose), so I went for nasal pillows, but I also mouth-breathe, so I ended up with a hybrid. It's a bit leaky around the mouth, but it works for the most part, and I don't get air in my eyes!

To answer your questions/problems:

A) Based on what you've described, it sounds like you've got your mask cranked down way too tight. You shouldn't be getting red marks from it. The outer silicone pillow is very soft, and if you crank it down too hard, you get to the inner, more rigid layer, which can't conform to your face as easily, which both hurts and leaks more.

B) Different masks have air vents in different places that blow in different directions. I do find that I sometimes need to push my pillow down when it gets near the air vent, since that gets loud. But that's probably a good thing, since you don't want a blocked vent! If you don't have anything in front of the vent, it should be essentially silent.

C) I used the PR chinstrap for a while, and I didn't have any problems with it moving out of place. The mouth leaks are what did me in with nasal pillows, so I've been using hybrid for a while. Note that with FFM and hybrid, you can still get chipmunk cheeks if your pressure is high enough.

1) FFMs are helpful to have on hand when you have a cold that stops up your nose. If you're a hard-core mouth breather, you'll need FFM or hybrid. If you have one exchange left, you might try FFM over nasal pillows, since nasal pillows are cheaper if you have to buy the mask out-of-pocket.

2) About mouth opening and FFM, yes, it can cause leaks, but if you tuck your chin, your jaw isn't going to drop too far, and minor changes generally aren't enough to cause major leaks. I don't use a chinstrap with my hybrid now.

3) I would certainly look at nasal pillows or hybrid given a "thin bony nose". They were worlds better for me.

4) I don't know about forehead support, I've never tried it.

5) I tried a total of 4, one on my own dime, and stuck with the second of the 4. (FFM, hybrid, nasal pillows [all within the 30-day period], then the non-resmed Hybrid, which turned out not to fit me as well.)

6) If he knows what your machine considers a "large" leak, yes. But I think you can also check that on your machine (others with ResMeds will have to weigh in here), but also using SleepyHead (free).

[abby123]

Hawthorne, thanks for the info. I'm new and didn't realize you can buy online, try out and exchange... good to know!

Janknitz, thanks, my Rx actually does say "Resmed Mirage Fx nano swift or per patient preference". But I know my doctor didn't mean "per DME preference"! lol.

sawinglogz, thanks for all the great info! I just spoke with DME and told them it was their error and to put a note on my account that the first mask was not patient preference. They know I'm not happy...

Thanks everyone! I'm looking forward to figuring this out.

[sawinglogz]

Good luck! Also check out this article for mask fitting. It's for a full-face mask, but it explains the looser-is-better thing very well.

(Bizarrely, most lab techs crank the things way too tight. You think they'd know how these things work...)

[sawinglogz]

I'm new and didn't realize you can buy online, try out and exchange...

Online you can't exactly "exchange". You can get return insurance (which is free for some masks and expensive for others), which lets you return it for a refund.

With your DME, the mask manufacturers will replace for free any mask that's rejected by the patient in their first 30 days of treatment. So other than filling out the manufacturer paperwork, the logistics of inventory management, and having someone hand you an additional mask (from any manufacturer, same or different), it doesn't cost your DME anything to provide you another mask. Also, since they can't re-use a used mask, they don't have to take back your old one. (The manufacturer doesn't want it back.)

Thus, some DMEs will let you keep your "rejected" masks (some won't), and some DMEs don't care how many exchanges you do (some do). I was very lucky with my DME, since they took the long view of having a lifetime customer for the additional extra initial work of sending me another mask or two.

[Hawthorne]

Just wanted to add that cpap.com hosts this forum and they have lots of machines, masks, mask parts and other accessories for cpap machines. It's worth checking them out for the future.