How long do you trial a mask?

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gocamels
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How long do you trial a mask?

Post by gocamels » Sun Apr 14, 2019 6:30 pm

Hi, all. I'm pretty new to all this and looking for some opinions. I've only been diagnosed and on CPAP for about 2 months, and things are going okay, but I'm still looking for a mask that doesn't shoot me in the eye, make rude noises all night, or cut off blood flow to various parts of my head.

I'm still wrapping my head around all the information, but getting there slowly. Being a healthcare professional helps, but it's still a pretty good learning curve, because sleep medicine is most definitely not in my wheelhouse. But maybe that knowledge will help someone else here. If you're new to this and feeling dumb or inadequate because it's taking time to figure things out - don't feel dumb or inadequate. There's so much information available that it's not a field of study you can master in a few months.

Anyway, my employer put us on a high-deductible health plan after Affordable Care Act became law, so I'm "enjoying" the freedom to buy whatever mask I want and experiment. Fortunately, the online DME I'm using offers 30 day returns on masks, so I've only spent a small fortune instead of a large one. I'm completely embarrassed to admit how many different masks I've tried in 2 months (LOL), but right now I'm using a Dreamwisp, and it's the closest thing to a good fit for me that I've tried. I haven't dived into full face masks yet, mainly because I'm a side/stomach sleeper and a little active (although apparently not as active as before CPAP, according to my wife). The two most comfortable masks I've tried were the Sleepweaver Advance and the Airfit P10. The Sleepweaver was a dream come true for 2 nights, then started leaking into my eyes no matter what I did. The Airfit would be perfect if the headgear was about 3 inches longer so that I had some room to adjust it to fit. I can't put the clips on or it's way too tight, and adjusting the two halves of the strap makes it either too tight or leaky.

The Dreamwisp is not quite as comfortable, mainly because I'm super hot-natured, and it makes my nose sweat. :D But it doesn't leak and it doesn't have hard plastic parts to poke me in the face when I thrash around on my pillow, so this is it until I get tired of feeling like I'm being waterboarded all night. (No, it's not rain-out, best I can tell. I've played around a good bit with the humidity setting and hose temperature.)

I have downloaded both Sleepyhead and Res-whatever since I'm using a ResMed. Wasn't 100% sure I needed both, but as we say in the guitar world, why have 1 when 12 will do? Unfortunately, I don't have an SD card reader on my laptop, so I've had to order one of those. According to the clinician readout on the Airsense screen when I'm in clinician mode, I'm having <1 AHI average per night for the last 2 weeks, no central apneas at all. My mask leak is all over the place but I'm not sure if it's mouth leak (don't think so because my mouth isn't nearly as dry when I wake up now as it was pre-CPAP), true mask leak, or just aberrations because I'm pulling the mask away from my nose to wipe, scratch, etc. My overall leak numbers have been below 20l/min the last 2 nights, though.

So now to an actual question. How long do you give a mask before you decide that it's not the answer and move to the next one? I've been anywhere from a week to 2 hours. If I can't make it seal, I'm not wasting a night trying to sleep in a wind tunnel. Other than that, I've tried to give each mask a fair trial, while staying in my return window for my DME.

I'd love to hear from everyone else, though. How long do you trial a mask before you move on?

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raisedfist
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Re: How long do you trial a mask?

Post by raisedfist » Sun Apr 14, 2019 7:43 pm

I can tell if a mask is going to work rather quickly...i'd say a maximum of three (3) nights honestly. The only non full face mask I can stand is the AirFit P10 nasal pillows. The only FFM that I can wear all night is the F&P SImplus. It's pretty easy to tell when a FFM doesn't work for me, as it will either leak and/or simply hurt the bridge of my nose. I don't feel like wearing any pads or moleskin just to protect my skin.

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gocamels
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Re: How long do you trial a mask?

Post by gocamels » Sun Apr 14, 2019 8:03 pm

Speaking of pads or moleskin, that leads me to another question. Would a mask liner help absorb some of the sweat, possibly keep me from having to pull the mask up to wipe? I've ALMOST bought some a few times, but didn't want to spend the money until I had a mask I knew I could tolerate.

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Pugsy
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Re: How long do you trial a mask?

Post by Pugsy » Sun Apr 14, 2019 8:20 pm

Welcome to the forum.

I once gave up on a mask after only 90 minutes...but it was the longest 90 minutes of my entire life.
To be fair though....I was far from new to cpap therapy and masks when I happened to try the mask that holds the record for having the shortest amount of time on my face. So I had a lot of past mask experiments under my belt and had already learned a lot about myself and what I wanted and needed and what to expect from a mask. It's really hard when you don't have much experience to draw upon with other masks.
Interesting to note though...that 90 minute record was with a Respironics Wisp mask...not the one you have but the prior first model. :lol:
I got zero patience for the Wisp...in any reincarnation.

If you liked the P10 except for the headgear...
Look at the ResMed Swift FX nasal pillow mask. It's very similar to the P10 but the headgear is fully adjustable and will accommodate your larger head better. Only down side to it, to be honest, is it doesn't have the silent venting that the P10 has. It probably doesn't vent any worse than the DreamWisp though...not as nice as the P10 but better than most of the other nasal pillow masks.
If it had diffused venting....it would be perfect for a lot of people.

Or look at the F & P Brevida...a super comfy nasal pillow with adjustable headgear AND it has an optional diffuser that you can clip on and diffuse the venting and make it silent.

When new to therapy...I wouldn't spend much time on a mask that I wasn't happy with....you should know within a couple of days if it is worth investing more time in. Make use of the mask swapping time you have available with your supplier and don't spend an inordinate amount of time on a mask that just seems to have more negatives than positives. There's nothing keeping you from maybe going back to a past experiment that was maybe the best of all you tried.
Make use of your free swapping time so that you don't have to spend your own money on these experiments.

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Okie bipap
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Re: How long do you trial a mask?

Post by Okie bipap » Sun Apr 14, 2019 8:54 pm

Some of my mask trials have lasted less than one night, and others have lasted up to a month or more. Of course, if I forget the date and let my trial go over the return date, I simply pass the mask on to someone else that wants to try it. I usually return masks I do not like within the 30 day trial period. But, other times I am just too hard headed to admit the mask isn't working for me and keep on trying until it is too late to return it. Other's have benefited from my stubornness.

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Re: How long do you trial a mask?

Post by chunkyfrog » Sun Apr 14, 2019 10:38 pm

2 minutes--at the DME's office.
I left with another P10.
Life is short.

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gocamels
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Re: How long do you trial a mask?

Post by gocamels » Mon Apr 15, 2019 7:46 pm

Last night was extremely discouraging. After having several good nights in a row with the Dreamwisp, last night it made my face so hot I laid in bed for over 30 minutes before finally yanking it off and going back to my Airfit P10. Sleep was fitful, woke up tired, to see that my AHI was up to 1.5.

I'll be able to actually see my data when I get home from work (assuming the SD card reader I ordered works), so should be able to tell whether the limited data my machine gives me directly is a good indication of how I'm sleeping or if there are some things that need fixing. What I do know is that I've traded 8+ hours per night of sleep with an AHI of 31 for around 6 hours per night with an AHI of around 1. When you take into account the number times I wake up to adjust my mask, etc., I'm not really getting any more sleep than before I started. Actually, probably less. I'm getting sleepy at work more often than I did before. Not great when you're sitting in front of a computer for 10 hours in a hospital. :D

I'm really hoping my SH data will show me something useful. I'm still on my MD's default (4-20), so chances are I can adjust my EPAP to meet my actual needs, at minimum. That and hopefully finally finding a mask that works for me will help me pay off this sleep debt and start feeling better.

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babydinosnoreless
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Re: How long do you trial a mask?

Post by babydinosnoreless » Mon Apr 15, 2019 8:00 pm

gocamels wrote:
Mon Apr 15, 2019 7:46 pm
Last night was extremely discouraging. After having several good nights in a row with the Dreamwisp, last night it made my face so hot I laid in bed for over 30 minutes before finally yanking it off and going back to my Airfit P10. Sleep was fitful, woke up tired, to see that my AHI was up to 1.5.

I'll be able to actually see my data when I get home from work (assuming the SD card reader I ordered works), so should be able to tell whether the limited data my machine gives me directly is a good indication of how I'm sleeping or if there are some things that need fixing. What I do know is that I've traded 8+ hours per night of sleep with an AHI of 31 for around 6 hours per night with an AHI of around 1. When you take into account the number times I wake up to adjust my mask, etc., I'm not really getting any more sleep than before I started. Actually, probably less. I'm getting sleepy at work more often than I did before. Not great when you're sitting in front of a computer for 10 hours in a hospital. :D

I'm really hoping my SH data will show me something useful. I'm still on my MD's default (4-20), so chances are I can adjust my EPAP to meet my actual needs, at minimum. That and hopefully finally finding a mask that works for me will help me pay off this sleep debt and start feeling better.
Do you have a heated hose? Maybe now that its warming up you might want to turn it off. I know I turned mine off last week after a similar issue. We hit 90 last week and are expected to do so again by Thursday. I've only slept like 5-6 hours a night all week its been so hot.

gocamels
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Re: How long do you trial a mask?

Post by gocamels » Mon Apr 15, 2019 9:40 pm

Okay, so I have some data, finally. Here are my last 3 nights: 2 with the Dreamwisp, then last night with the P10. Looks like I might need to bump my EPAP to 8. Am I reading that correctly?

I've played with hose temp some. I'll definitely keep playing until I find the sweet spot. Thanks for all the suggestions so far.
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Re: How long do you trial a mask?

Post by zoocrewphoto » Tue Apr 16, 2019 2:45 am

I was lucky that my sleep tech chose the perfect mask for me and fitted it perfectly. I slept over 5 hours straight without any leaks.

So, I got the same mask when I picked up my machine. I had horrible leaks and sometimes, I wanted to throw it across the room. Had I not had a good night at the sleep study, I would have given up quickly. But I knew the mask was the right one. I got some improvements with help here. I also learned that I cuold get smaller headgear. Not sure if the lab used smaller headgear or not. But that was the key to making my mask fit at home. Now, I rarely have leaks. Sometimes due to drool, sometimes when the cushion is getting older.

Sometimes, you can have the right mask and just need to master fitting and placing it. Other times, it is totally the wrong mask. (I did try a hybrid mask several nights, never got past 2 hours with it). I also like the Oracle mask. For me, it needs some altering, and I have not completely mastered that.

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Sheriff Buford
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Re: How long do you trial a mask?

Post by Sheriff Buford » Tue Apr 16, 2019 3:48 am

Till you are ready to drop kick that sucker into the next county!!

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Thumper68
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Re: How long do you trial a mask?

Post by Thumper68 » Tue Apr 16, 2019 6:54 am

Gocamels,
I agree that you need to raise your minimum pressure (what you called EPAP). We only us EPAP and IPAP terminology on bilevel machines. We use minimum and maximum pressure on APAP machines. 8 would be a good start, but you may end up at 10. 4 to 8 may be an uncomfortable jump for you. If so you can work up to it over the course of a few days or weeks. Whatever suits you best.

It doesn't look like you are using EPR (exhale pressure relief). You may want to add some in as you go up with the minimum pressure.

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gocamels
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Re: How long do you trial a mask?

Post by gocamels » Tue Apr 16, 2019 9:11 am

Thumper68 wrote:
Tue Apr 16, 2019 6:54 am
Gocamels,
I agree that you need to raise your minimum pressure (what you called EPAP). We only us EPAP and IPAP terminology on bilevel machines. We use minimum and maximum pressure on APAP machines. 8 would be a good start, but you may end up at 10. 4 to 8 may be an uncomfortable jump for you. If so you can work up to it over the course of a few days or weeks. Whatever suits you best.

It doesn't look like you are using EPR (exhale pressure relief). You may want to add some in as you go up with the minimum pressure.
Right. I called it EPAP because that's how SH has it labeled. I tried an EPR of 2 on ramp only Saturday, then switched it to full time on Sunday. Maybe coincidentally, my AHI went from 0.28 to 1.6 with that switch. It was also >1 last night. The only other variable was a switch from nasal mask to pillows both nights.

Thanks for the advice on settings, though. I'm still contemplating the pressure increase.

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Pugsy
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Re: How long do you trial a mask?

Post by Pugsy » Tue Apr 16, 2019 9:31 am

When any sort of exhale relief is used essentially a bilevel situation is created and it doesn't matter if the machine is a fixed cpap machine or apap machine. EPAP and IPAP gets created because of the exhale relief and PS or pressure support situation gets created and it's fine to refer use the words EPAP and IPAP on cpap/apap machines.

When no exhale pressure relief (or PS if you want to call it that) is used at all...then epap will equal ipap and only one pressure line is shown.

It hurts nothing to use those terms. Most of us know what it means no matter which kind of machine or what settings are being used.

SleepyHead uses the terms because that's essentially what it is when any exhale relief is used.
There just isn't any provision in SH to call it anything else when no exhale relief is used.

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Re: How long do you trial a mask?

Post by Janknitz » Tue Apr 16, 2019 2:13 pm

If you are OK with the Dreamwisp except it's too hot, you should be fine with the Dreamwear--it just sits under your nose instead of covering part of your nose so it may not feel as hot. Be sure to use the little covers on the arms of the mask, they aren't as hot as the silicone against your face. And I often blow a fan right into my face--I even have a tiny travel fan for my "personal summers". It helps.

Alternately, you could try the Wisp mask--Padacheek makes a liner so there's no silicone against your face at all. The fabric she uses stays nice and cool.

Unfortunately, I don't think a liner will work for the Dreamwisp or Dreamwear masks.
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