problems getting seal with activa and breeze is uncomfortabl

Wistful · Post by **Wistful** » Thu Mar 08, 2007 8:06 pm

Hi,
After giving up two years ago, I am trying to get this OSA under control and use my CPAP. The trouble is that all the masks my Respiratory Therapists can show me leak around the eyes.

I am trying the Activa now, hoping that it will work. The problem is I can't seem to get a consistent seal. My best fit is with the bottom just above my lip - a little lower and the top leaks, higher and the bottom leaks. It takes me about an hour to fiddle it into place, but it is such a precarious seal that I wake up a short while later with a leak and give up. I have read the CPAPtalk FAQ, keep the bottom as loose as I can without causing leaks... Anything else I can try?

I am afraid the only option I have left after this is a nasal pillow (most like the breeze), but I hate the feeling of having something up my nose. The air pressure is so intense that it reminds me of water going up my nose.

They need to invent a mask/skin-friendly caulking!

Any ideas?
Thanks!

Pressure 9-14

Babbie · Post by **Babbie** » Thu Mar 08, 2007 9:51 pm

Wistful --good for you for giving it another go!! I've used the Activa for my primary mask for over a year. My insurance would pay for another so I got another Activa. The first couple of nights I was having horrible leaks with the new one and didn't know why. I found that the position of the forehead piece can make a huge difference! I had it in the wrong position on the new one and once I put it where I had the old one, it took care of the problem. I would try the different positions to see if that helps because it sounds like you're keeping it loose. Actually the top strap is fairly loose on mine as well - hardly feel the forehead cushion touching my head at all. I still get minor leaks sometimes but I think everyone does once in awhile. Hope this helps.
Kathy

ChainSaw · Post by **ChainSaw** » Fri Mar 09, 2007 11:01 am

I just changed from ResMed FF mask to a Fisher 431. It doesn't go up as high on my nose, so any leakage won't blow on my eyes. It also covers my chin and goes under my chin so I won't need a chin strap.
I've only had it two nights and am already singing its praises.

Snoozing Gonzo · Post by **Snoozing Gonzo** » Fri Mar 09, 2007 1:49 pm

As Babbie mentions above, the forehead piece is important even though it may only lightly or occationally touch your head. I have found that micro-adjustments of each strap while laying down work the best. The straps may not be equal from side to side because of the shape of your face, your pillow, or the way you sleep. You may find the top needs to be tighter than the bottom. The mask needs the skirting filled with air and to raise up away from your face to seal, thus the advice to keep it loose. Sealing leaks by tighting doesn't seem to be intuitive. Sometimes I find tightening the lower straps (very small increments) eliminates an leak into the eye.

The good news is once its customized for you, it pretty much stays that way.

Good luck and hang in there.

Chris

Wistful · Post by **Wistful** » Fri Mar 09, 2007 2:55 pm

Hi again,
Thanks for the advice!
I will continue to fiddle with the forehead adjustment, as you suggest, Kathy.

I approve of your Avatar Chris, we are HUGE muppet fans here and my kids think I look like Gonzo when I wear my mask I will check how tight my top strap is this evening.

I will keep micro-adjusting, thanks for the support!

Erin (Wistful)

twillson · Post by **twillson** » Fri Mar 09, 2007 3:19 pm

Wistful,

I have the same problem when using my Ultra Mirage II. The mask slides up as I sleep and I end up waking with leaks. My solution for wearing the mask was to run the hose under my arm (sleeping on side or back) so that the wight of the arm keeps a downward tension on the tubing. This sounds more difficult than it actually is but YMMV.

The other solution was to alternate with a nasal pillow interface. When I get tired of dealing with the sliding mask, I switch to my Swift and more recently my Optilife. Then if my nose gets sore or I start getting leaks I switch back for a while. I am a big believer in the idea of having several options to get you through different situations.

I suspect that you could get over the initial strangeness of a nasal pillow system pretty quickly. I found that getting the correct sizes and adjustments and getting the correct humidity settings are all important for getting it to work well. Hose management is also important. If all this is correct, what feels awkward on day 1 shouldn't bother you at all by day 10.

The big advantage of nasal pillows (and probably also nasal prongs) is that leaks don't usually effect your eyes. If the interface slides around and you get only a partial seal, you will feel it, but it won't cause any soreness or irritation.

If you have the same problem with your facial structure that I do, I don't think there will be a mask that competely overcomes your problem. I think your time and effort would be better served by trying out a nasal pillow. It may not bother you as much as you think.

I wouldn't try to steer you to a particular brand or style, but you should look into the many reviews on this site and others that describe the relative advantages of the Swift, Breeze, Aura, Optilife, etc. Get with your DME and try them out. If it makes the difference between compliance and non-compliance, it is DEFINITELY worth the effort. Just don't expect perfection. All masks leak sometimes. The priority should be to find one that doesn't bother you when it does leak.

Wistful · Post by **Wistful** » Fri Mar 09, 2007 3:37 pm

I am afraid that if I can't get this working that you are right, a nasal pillow it is. Just didn't want to go there, I find it so uncomfortable, when the respiratory therapist tried the breeze on me, I felt like she might as well have stuck her fingers up my nose.... But if suck-it-up I must, suck-it-up I will.
Thanks!
Erin (wistful)

rested gal · Post by **rested gal** » Sat Mar 10, 2007 1:06 am

Erin, if the Activa the DME gave you has a "Standard" cushion, ask to try the "Shallow." The Shallow is a bit shorter from the top of the cushion (at bridge of nose) to the bottom (under the nostrils.)

You won't need an entire new Activa to try the Shallow. The Shallow cushion can be used in the same plastic outer frame you have now. Just take the Standard cushion out and put the Shallow cushion in.

Wistful · Post by **Wistful** » Sat Mar 10, 2007 6:32 am

I'm sorry if I didn't mention this, I do have the shallow cushion. It's still big on me. Oh well
I have been reading the thread on mask sealant and am interested in trying that... It may be just what I need. My Flexi-Fit is a nice size and fit, it just always leaks into my eye, with a sealant....
Could be just what I need.

Moogy · Post by **Moogy** » Sat Mar 10, 2007 10:51 pm

When I tried the shallow Activa, I got a leak around the eyes/top of the nose. I switched back to my standard, and the leak was gone.

The very top of the opening is narrower on the standard, even tho the overall opening is larger. I have a very narrow nose bridge, and this explains the leaks, I think.

When using the shallow, I tried tape and moleskin with some success.

Also, have you tried the infamous panty-hose fix? An extra stretchy strap around the area that leaks will sometimes fix the problem.

Moogy

blarg · Post by **blarg** » Sat Mar 10, 2007 11:33 pm

Wistful wrote:I am afraid that if I can't get this working that you are right, a nasal pillow it is. Just didn't want to go there, I find it so uncomfortable, when the respiratory therapist tried the breeze on me, I felt like she might as well have stuck her fingers up my nose.... But if suck-it-up I must, suck-it-up I will.

I find the pillows on the breeze to be the stiffest out of any nasal pillows mask I have. Try a Twilight NP (or if you must, Swift) and you might be pleasantly surprised. They're much softer.

Julie · Post by **Julie** » Sun Mar 11, 2007 3:49 am

Wistful - take a look at the recent thread on glue to seal masks - it's not regular 'glue', but excellent stuff that removes very easily and painlessly, has been around for decades (for other uses entirely) and is affordable. Apparently in the U.S. it's called Tincture of Benzoin (sometimes a bit hard to find as it is 'old'), but in Canada is called Friar's Balsam and you just put a tiny bit on the mask edges that aren't sealing well, let it dry for half an hour, then use the mask. It's sold (usually) in small bottles in the pharmacy's first aid section, not as glue(!) but as a liquid. They used to use it a lot as inhaled steam for congestion with colds.

_________________

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Wistful · Post by **Wistful** » Sun Mar 11, 2007 8:03 am

you guys are awesome!

Blarg, I am comforted to hear that the breeze pillows are indeed stiff, I thought it might just be me when so many people on this forum like it so much. I tried the respironics one and didn't like it much either, but it didn't feel like as much of an intrusion. How do you deal with so much air pressure going right up your nose? Is it something you just got used to? It take about two minutes before my ears start popping!

Moogy,
Funny you should mention the seal glue - I have been reading through that thread and have ordered benzoin from my pharmacy, and am getting my mom to pick up some mask seal (she winters in Florida) and mail it to me. That could be the answer I need!!!

I will talk to my RT about the standard cushion.

I am glad to know what the panty hose was for, I've heard people mention it but didn't know exactly how it was used.

Thanks so much,
Wistful

problems getting seal with activa and breeze is uncomfortabl

problems getting seal with activa and breeze is uncomfortabl

Activa adjustments

Mask Leaks