Best Mask for New Bipap User

[tmtyler357]

This is my first post so go easy on me. I tried searching and didn't really find what I was looking for. I'm just looking for a full face mask that people find comfortable with a good seal. I do have facial hair, but tend to keep it shaved (when I have the energy - I'll explain in a minute). I also have severe allergies and am often congested and I get sick very easily since I'm on immunosuppressive medications.

I just had the titration study and we used a medium Mirage Quattro Full Face mask, while it sealed up nicely, it really hurt the bridge of my nose. I ignored the pain and managed to fall asleep and did very well. I slept most of the night during the study except a couple times I woke up. The one time was because the mask was leaking after the tech increased the pressure. We adjusted the mask and tightened it up. After awhile it stopped hurting while the mask was on, but as soon as it came off, the bridge of my nose was red and sore.

As for the energy part of it, I have a neuromuscular/autoimmune disease called myasthenia gravis that causes severe muscle weakness and fatigue with repeated use of the muscles. This includes all voluntary muscles including those used to breathe, chew, swallow, talk, walk, and your arms. It also leaves me tired and without energy most of the time. Little things like showering and shaving leave me exhausted. I am being treated and am doing better, but I'll never be back to "normal". This is why my doctor chose the bipap instead of starting with CPAP. I'm not strong enough to exhale against the air pressure. I'm not sure what my numbers were because I forgot to ask. (In my defense it was 5am.)

I'm not sure if I'll be able to choose a mask or not, but wanted to know what people thought might work better for me in case I do get to choose. For what it's worth, I'm quite young too, at 22yo.

Thanks in advanced! I look forward to being a part of this great community.

[popcpoo]

I developed a large sore on the bridge of my nose when I first started using a bipap machine. I placed a bandaid over it at night while using the bipap. Now, I use a small piece of moleskin on my nose. It can be purchased at Walmart, CVS, Walgreens, etc. It is self adhesive and comes in small sheets or a small roll. This des a good job of protecting my nose.

[tmtyler357]

I hadn't thought about moleskin. My grandfather used to use it on his oxygen tubing and I have used it on my eyeglasses in the past. I just looked in the mirror and my nose is swollen too. Maybe the mask was just too tight?

[Pugsy]

Welcome to the forum.

Mask preferences and success are more diverse than there are masks out there. One man's treasure can be another man's trash.
No mask should cause sores, abrasions or pain though. If that happens it's usually fitted incorrectly (often too tight) or the wrong size or simply the wrong mask for the individual.

There are mask liners that often will help with minor pressure/leak issues if the mask is otherwise working well.
There are store bought versions or you could even make your own out of an old Tshirt.
A lot of forum members really like the padacheek.com mask liners. Multi use and washable and will last months and months with common sense care.
Remzzzs makes a nice mask liner but is designed more for single use though some people are able to reuse them successfully.

You should be able to choose whatever mask you want but finding the right mask can be a challenge for anyone no matter which machine they use.
The nasal pillow masks are of course probably the simplest but they won't work if the nose is too congested.
Now if your nose sometimes works okay and sometimes not...it hurts nothing to have 2 masks available...one for the time when the nose is working well and another when the nose isn't working so well.

You might look at one of the hybrid masks...considered full face masks because the nose and mouth are both part of the circuit but the mask doesn't come up over the nasal bridge area so it totally takes pressure/sore issues on the nasal bridge area out of the equation.

The Innomed/Respcare hybrid is a good one...comes with 3 sizes of cushions and nasal pillows so that it's easy to find the right size combination.
https://www.cpap.com/productpage/RespCa ... -Mask.html

This mask is very new and just now in the pre order stage but should be available very soon. It's pretty much a hybrid but used a cradle cushion instead of nasal pillows. It's brand new and reviews on it will be coming in once more people get a chance to try it. Early reviews from the people who got to demo it ahead of time have been promising.
https://www.cpap.com/productpage/respir ... -mask.html

There's no mask out there that works for everyone though. Not even the little nasal pillow mask I used. It's just the way it is with any mask.
If you want to consider a nasal pillow mask for the times when the nose is clear you might look at the one that I use (click on the link in my profile) as it is a very popular mask. Nasal pillow masks do well with facial hair no matter how long.

Any mask out there will work with a bipap (bilevel pressure) machine no matter what the pressures.
Of course higher pressures do create additional challenges but that happens no matter what mask is used. In general the less real estate of the mask touching the skin the less leak issues a person will have. Simply less area needing to keep contact.

I use a bilevel pressure machine myself and I often see pressures over 20 cm. You can use any mask pretty much at any pressure with any machine. The only really important part is what works for you the best.
I think finding the right mask is probably the hardest part of this cpap/apap/bipap therapy. Sometimes you have to kiss a lot of frogs (masks) to find your prince though.

[tmtyler357]

Thank you so much for such a detailed response. I'm looking into all the things you suggested. I like the design of the hybrid mask, but I also have my nose pierced on the side so I'm not sure if that would interfere with the nasal pillows or not. I have to agree, it seems finding the right mask is the most important and most difficult part of this therapy and I haven't really even started yet. There are so many options though and I'm very bad at making decisions. Thanks again for the great reply!

[Pugsy]

I don't have any piercings but the nasal pillows just barely have the tiny tips of the inner cone go inside the nostril and actually never touch the inside wall of the nostrils.
They shouldn't be touching the area where the stud is inside the nostril. It shouldn't be an issue. Nasal pillows don't really go very far into the nostril. The bulk of the pillow rests on the nostril and it doesn't take much pressure at all to get and keep a good seal. The end of the nose doesn't get moved at all and in fact if it does then the straps are too tight. People often have the straps too tight thinking it has to be to stay put but it doesn't work that way.

[tmtyler357]

That sounds great actually. I think I'll consider a hybrid mask then. I'm also told the respiratory therapist at the company I'm using is very good so she might have some input as well. Something tells me this will be the first of many masks to try. I still can't believe how sore my nose is today.

I just hope the company gives me options. :/

[tmtyler357]

So that sore on my nose that was just red and swollen has now turned into something that looks like whiteheads/pimples and they're filled with what looks like white pus. I really wasn't expecting that. I would have assumed if it was an allergic reaction that it would be all over where the mask touched my face and it would have been more like a rash. Any ideas?

[ChicagoGranny]

I also have severe allergies and am often congested

Are you under the care of an ENT/Allergist?

[tmtyler357]

No I'm not. I just have my PCP and a pulmonologist (who prescribed the bipap), and then of course my neurologist. So far, I've been doing great with my allergies. I don't know if it's the prednisone or what, but I haven't been congested in awhile. I also take Allegra every day along with Singulair. I'm on 60mg of prednisone once a day so that could be what's taking care of the allergies.

[PeterPap1]

I suffer from external nose pimples quite frequently. It's embarrassing, for sure! I attribute it to the fact that my CPAP blows warm, humidified air all night, causing the skin to become oily. This oil, then, blocks pores, leading to the pimples. Don't know what to do about it. Folks call me Rudolph!

Since the first night in the Sleep Disorders Clinic in Ottawa (in the psychiatric hospital, of all places!), where they diagnosed for half the night, and provided a mask for the other half, I woke up in the morning with the feeling that the entire front of my brain was scattered all over the place. I had had a good few hours of continuous sleep, for the first time in my memory! Thank you CPAP (and to my RT daughter who spotted the apnea problem)!