Difficulty finding a mask

[amacmanes]

I have used a cpap for several years with limited success. I have been very conscientious and have used it every time I sleep. Never the less I always wake up as tired as when I went to bed. I have tried at least 7 different masks the latest being the mirage quattro, AirCurve f10, fitlife mask. The problem I have is that they all leak excessively. The only solution has been to tighten them up but then they are so tight and uncomfortable I can't sleep. The RT say that the problem is the pressure is so high. The pressure is set at 20 & 14. The machine is a ResMed AirCurve 10 VAuto. With this pressure I am still experiencing AHI in the range of 50 + per hour. My machine a new Bipap Resmed machine reports the Central apnea to be an average of 25 events per hour. I am not sure what the "before treatment" reading was. The MD has scheduled another sleep study due to the central apnea. The problem also is that the leak causes so much noise I have to sleep in our spare bedroom because I keep my wife awake. (I wake myself up also), I am up adjusting the mask, etc. 5-6 times a night. So far Cpap or Bipap has not made much difference to me. Any thoughts??
Thanks in advance.

[Pugsy]

With 25 centrals an hour I am not surprised you feel like crap still.
You need to have those centrals evaluated and addressed. When is the next sleep study?

In the meantime have you ever tried some sort of mask liner to help with the leaks and watched the fitting videos for the various masks that you have tried? With many of these newer masks too tight is actually likely to cause more leaks than to fix them as the mask has to inflate to seal and too tight doesn't allow the mask to inflate.

Mask liners...you can make them out of an old Tshirt or buy ready made.

http://www.padacheek.com/PAC_Maskliners.html

[Julie]

Hi, little suggestion - most masks, including FFMs, come in S, M + L, with very few options, except for some that now come in Petite. But, not knowing your ethnic background, etc., I imagine it could be hard for some people to find the right mask when most were (I imagine) designed for a 5'9", 60 yr old Caucasian male, and only more recently have a couple called themselves "For Her" masks, never mind for Asians, Africans, etc. However, while my background may or may not have anything to do with how things fit, I used the ResMed UltraMirage FFM for many years because what fit was the small shallow size they make, and why it works for me... what aspect, I'm not sure (it certainly isn't flatter than others and neither is my nose ), though I do have a flattish nasal bridge area. In any case, what I'm saying is that you need to root out the odd stuff in unusual sizes to find ones that work for you... make a point of bugging the DME's (or just the Cpap.com website when you have time to really look at things) for maybe unconventional sizes and fit, etc.

All that being said, is it possible you just kept being given ones that were too big, and never thought to try smaller ones?

Anyhow, good luck with whatever you do.

[Elle]

Checking google images to see what's different about a caucasian face. This is a theory I have never come across.

[robysue]

The pressure is set at 20 & 14. The machine is a ResMed AirCurve 10 VAuto. With this pressure I am still experiencing AHI in the range of 50 + per hour. My machine a new Bipap Resmed machine reports the Central apnea to be an average of 25 events per hour.

Well it's no wonder you still feel so bad: Your treated AHI is still well into the severe OSA range. It's a good thing that the doc has scheduled another sleep test for you. In addition to the leaks you are experiencing, it seems that the prescribed pressures are not addressing your sleep apnea.

You also write:

I have tried at least 7 different masks the latest being the mirage quattro, AirCurve f10, fitlife mask. The problem I have is that they all leak excessively. The only solution has been to tighten them up but then they are so tight and uncomfortable I can't sleep.

Have all the masks you've tried been full face masks that cover both your mouth and nose? Or have you ever tried a nasal mask or a nasal pillows mask?

The reason I ask is this: The small nasal masks are often easier to seal, particularly at high pressures, simply because they have a much smaller footprint on your face. Smaller footprint means there are fewer places for the seal to break.

If you are not a dedicated mouth breather, it is worth trying a nasal mask instead of a full face mask.

And all the masks you explictly list use an air-filled cushion to create the seal. The air cushion must be fully inflated for the mask to seal correctly. Over tightening the headgear not only leads to an uncomfortable mask, but it also increases the chances that the mask will leak and that the leaks will be excessive leaks. In other words, you may be trapped in a viscious cycle of "tighten the straps to eliminate the leaks, which leads to more leaks, which leads to more over tightening the straps, which leads to more leaks, which ...."

At your next sleep study, you should bring your current mask with you and show the tech who is running the test exactly how you fit the mask each night. The tech may be able to help you learn how to fit the mask so that the air cushion in your mask has a chance to fully inflate.

[Sheriff Buford]

But, not knowing your ethnic background, etc.,

Dang, now my machine knows I have a native-American (really should be American-native) background! It's going to start giving me fits now!

Sheriff

[hman]

I tried two different full face mask in my first sleep study,and they leaked and were uncomfortable.When I went back for my second sleep study,I used a nasal mask.It was the Phillips Respironics Wisp mask.Once I received my BIPAP machine that is the mask I have used.It is a very quiet mask and easy to adjust and has different size pillows with it.I have low AHI with this mask.

In my sleep study I had AHI's of 70plus per hour.I have less than 4 per hour now.

I recently tried the full face mask,Fisher Paykel Simplus.It is a very comfortable mask,quiet,but a have a lot of leaks and moisture around my face.I think mask liners will solve the moisture problem,cause I have the humidifier turned down low.

I am now using the Phillips Respironics Pico mask,seals well,light and comfortable,but do not over tighten.It made the bridge of my nose sore.Also it is not a very quiet mask like the Wisp or the Simplus.

You might give one of these two nasal masks a try.I like them both.
Good luck finding a mask.