How is a full mask supposed to fit?

[michaeldwilson]

I've been on the CPAP for a little over two weeks and my progress has been slow but steady, I think. Last
night was a pretty good night with 6.5 hours of sleep and an AHI of 4.2.I have a couple of questions about
how the full mask is supposed to fit.

I know that I was wearing it too far down my face because it pinches my nose and restricts air flow, but how far up
should I wear it? On some nights, with some success, the lower part of the mask is just under my lower lip, keeping
my mouth pretty much shut. I don't know if this is proper or not. It does tend to keep my mouth and cheeks from
ballooning with air and waking me up. On the other hand, my throat closed last night and woke me up because I
couldn't breathe. So I'm not sure.

A related question, then, is should I wear the mask low enough that I can breathe through my mouth and let the
forced air make its way down my throat? I've had some success with this approach as well. But as I said, my cheeks
balloon with air and it's difficult to fall asleep with this happening.

I appreciate all the help. I'm completely new at this and groping in the dark literally and figuratively.

Thanks,

Mike

[Wulfman...]

I've been on the CPAP for a little over two weeks and my progress has been slow but steady, I think. Last
night was a pretty good night with 6.5 hours of sleep and an AHI of 4.2.I have a couple of questions about
how the full mask is supposed to fit.

I know that I was wearing it too far down my face because it pinches my nose and restricts air flow, but how far up
should I wear it? On some nights, with some success, the lower part of the mask is just under my lower lip, keeping
my mouth pretty much shut. I don't know if this is proper or not. It does tend to keep my mouth and cheeks from
ballooning with air and waking me up. On the other hand, my throat closed last night and woke me up because I
couldn't breathe. So I'm not sure.

A related question, then, is should I wear the mask low enough that I can breathe through my mouth and let the
forced air make its way down my throat? I've had some success with this approach as well. But as I said, my cheeks
balloon with air and it's difficult to fall asleep with this happening.

I appreciate all the help. I'm completely at this and groping in the dark literally and figuratively.

Thanks,

Mike

What mask is it and what size?
There are "templates" on the manufacturers' websites that you can check for the proper size.
An old sizing guide that was on the CPAP.COM website (since gone) measured a line from the middle of the eyeballs down to the middle of the chin below the lower lip. I saw a link to a mask template for one of the ResMed masks on the CPAP.COM website the other day, which uses that basic principle.

They need to be comfortable, "float" on the face, sit high enough on the nose so as not to restrict breathing and the lower edge needs to rest about midway between the lower lip and chin. Straps should not be too tight. I prefer a little more tension on the bottom straps and the top ones a little looser.

Quite often, the bed pillow is an important component in whether a mask "works" or not. A pillow too soft will allow the head to sink too far into it and push the mask out of alignment. There are quite a few bed pillows which have been designed for this therapy and some that work well with it. Mine is in my profile.


Den

.

[palerider]

I have a couple of questions about how the full mask is supposed to fit. ... I know that I was wearing it too far down my face because it pinches my nose and restricts air flow, but how far up should I wear it?

there are mask fitting templates on the web for ffm... just google for it, something like whatever your mask is and 'fitting template'. and see if you've even got the right size mask.

the resmed ones are measured between the dip in your chin below your lower lip to the dip in your nose below your brow line... I don't know how other mfgrs templates work.

[anonfan1432]

my experience is that it works best when you can breathe the best through your nose.

for me, it is a little bit high up, like right below my lower lip.
The worst part about this though is that the mask actually covers part of my eye, and sometimes i wake up with really dry eyes from air flying into it.

[palerider]

my experience is that it works best when you can breathe the best through your nose.

for me, it is a little bit high up, like right below my lower lip.
The worst part about this though is that the mask actually covers part of my eye, and sometimes i wake up with really dry eyes from air flying into it.

you know, you might have mentioned that little tidbit over in the thread where you're complaining about waking up too many times a night...

[Julie]

There are very many FF masks in diff. sizes, and you have to try out various types to find what fits you comfortably. You shouldn't have to decide consciously about where to seat it on your face based on our ideas, but where it feels most comfortable and appropriate for you, and where it seems likely to stay put (relatively) overnight without pinching anywhere or not covering part of you adequately, etc. Of course when you lie down with the machine going, you may make tiny adjustments up or down, etc. to get the 'ideal' seat, but that should be all you need. Some nights I feel the need to pull it downwards just a little bit, other nights it seems to be ok as it went on.

[chunkyfrog]

Just a note about mask sizes: sometimes there is a fair stretch between sizes;
--of those who fall between sizes, some folks can make either size work,
but others have to use a different mask entirely. Different companies, luckily,
have different size schemes, so a different brand mask may work better.
You mentioned your cheeks ballooning up--this tends to go away as your
internal muscles learn to direct the air correctly.
It's a bit like breathing through your nose while eating.

[michaeldwilson]

I want to thank everyone for their helpful suggestions! I actually went to sleep the night before last without using my CPAP. I was lying in bed and the next thing I knew the alarm went off. I've been using the CPAP for 2 1/2 weeks and missed just the one day, and I really felt the difference. Yesterday was one of those half-zombie days. I did use my CPAP last night. My numbers were usage 6.3 and AHI 6.8, not great, but I really feel so much better this morning. I guess this CPAP is now a permanent part of my life.

Once again, I struggled for at least 1/2 hour to one hour trying to get to sleep because I could not get my mask exactly right. I tried to get it to "float" on my face as suggested, but it leaked around my lower cheeks when I did. I tightened the mask little by little until it stopped leaking but it took a while to get it right. I'm going to try not to move the straps before tonight. Also, as I was dozing off, I found that I could not exhale a couple of times, and that kept me from a deep sleep. It's at struggle but it's definitely worth it. I hope it gets easier.

Once again, when my alarm went off, I really struggled to wake up. When I use my CPAP, I sleep deep and don't want to wake. It's not a bad problem to have.

Thanks gain,

Mike

[library lady]

Once again, I struggled for at least 1/2 hour to one hour trying to get to sleep because I could not get my mask exactly right. I tried to get it to "float" on my face as suggested, but it leaked around my lower cheeks when I did. I tightened the mask little by little until it stopped leaking but it took a while to get it right. I'm going to try not to move the straps before tonight.

If you are troubled by the leaking, and haven't tried them yet, you could try using mask liners to help with the leaks. I couldn't control leakage until I started using liners, and they were a game changer for me!

Facial oils can contribute to the problem by preventing a good seal, and liners will absorb the oils. If you are using any moisturizing lotions before bed, they will prevent a good seal. Always wash your face well before putting on the mask; this is something to try before trying the liners.

If you want to try liners, Karen at Pad-A-Cheek makes nice ones that many forum members use, go here: http://www.padacheek.com . There are also RemZzzs, available from many DMEs or at https://www.cpap.com, the host of our forum. I'm using RemZzzs and a version of them that I make myself from old t-shirts.

[jaycee2]

I also have a Simplus FFM as my back-up mask. According to the template I should take a Large but instead am using a Small. The bottom fits in the crease of the chin below the lower lip. The top fits on the bridge of the nose away from the eyes. I was told that the experience of the DME showed that the smaller fit avoided leaks in the eyes. Just for the heck of it I tried a M also and it leaked like crazy. I couldn't get it to settle down. The S fits well nearly all night. After about six hours it starts to leak at the bottom. I don't think a smaller size will work for everyone but it might be worth a try.

[englandsf]

I'm wondering if folks with flatter broader noses do better with the smaller sizes - I have large sharp "beak" and have to use larger sizes on those rare occasions I use my FFM - otherwise it sits on and constricts the top of my nose and turns me into a heavy mouth breather.

So far this fall I have survived in pillows despite some quite heavy allergies congestion - even having one nostril completely blocked at times.

[Julie]

I will assume that when you tried on the masks you were lying down? Because your face changes so much when you do and if you only tried them while sitting, that could be part of the problem.

[Wulfman...]

I want to thank everyone for their helpful suggestions! I actually went to sleep the night before last without using my CPAP. I was lying in bed and the next thing I knew the alarm went off. I've been using the CPAP for 2 1/2 weeks and missed just the one day, and I really felt the difference. Yesterday was one of those half-zombie days. I did use my CPAP last night. My numbers were usage 6.3 and AHI 6.8, not great, but I really feel so much better this morning. I guess this CPAP is now a permanent part of my life.

Once again, I struggled for at least 1/2 hour to one hour trying to get to sleep because I could not get my mask exactly right. I tried to get it to "float" on my face as suggested, but it leaked around my lower cheeks when I did. I tightened the mask little by little until it stopped leaking but it took a while to get it right. I'm going to try not to move the straps before tonight. Also, as I was dozing off, I found that I could not exhale a couple of times, and that kept me from a deep sleep. It's at struggle but it's definitely worth it. I hope it gets easier.

Once again, when my alarm went off, I really struggled to wake up. When I use my CPAP, I sleep deep and don't want to wake. It's not a bad problem to have.

Thanks gain,

Mike

Looking at your profile (thanks for filling it in)......your minimum pressure is probably too low to head off many events. They're going to occur without much intervention. You'd be wise to look at your pressure numbers and see what they're going up to......then move the minimum closer to that "percentage" number.

It could also be the pressure changes disturbing your sleep and you might want to consider switching to a single pressure and see how that works. APAPs are OK, but they can really mess up a person's sleep architecture.......leaving them feeling unrested. Ranges of pressures also have their downside in that mask adjustments aren't always made at the higher pressures that can be reached.......and will result in excessive leaking at some point.


Den

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[Denial Dave]

http://maskarrayed.wordpress.com/taming ... e-quattro/

this will help is setting headgear and mask placement, leaks, etc....

[michaeldwilson]

http://maskarrayed.wordpress.com/taming ... e-quattro/

this will help is setting headgear and mask placement, leaks, etc....

Thanks for this and all the other suggestions! I have been trying them all and I think it's getting slightly better most nights. I did wake up once (or twice?) last night feeling as if I couldn't breathe. I think this was after the pressure had reached the higher levels because it had plenty of time to ramp up. I'm getting better about lifting the mask from my face and taking a deep breathe of non-pressured air and then putting the mask back on. That usually takes care of it, although of course I'd rather this not happen at all.

Best,

Mike