Having CPAP/mask problems

[allisonandrews]

Not too pleased with CPAP. I also feel kind of like I was conned into buying the thing when I should have just rented it so that I could have returned it. But, now it is too late, and I own a Resmed S8 Elite.

(Background - AHI was 5.2 so CPAP was "Suggested" and I am to report back as to how I "feel" to determine if I should continue using it or not.)

The air from the CPAP does not bother me at all.

I don't open my mouth, so no need for chin straps, polident, or other things in a never ending quest to fix that problem.

I keep the humidifier just barely on, and so far no rainout. (I can't stand the air when turn it up past 1.5 - just too warm and it makes me feel like I am suffocating.)

I've got the Comfortgel in a size small. I think the mask may be my issue. It seems like it is either sitting too low on my lip or too high on my eyes. It also seems a bit broad for me near the bridge of my nose.

I'm looking at two options to try at the moment. Any thoughts on which one might be better?

1. Buy a new mask out of pocket - the HC406 Petite Nasal CPAP mask https://www.cpap.com/productpage.php?PNum=2020&PAID=230 for $54.

2. Buy a new cushion and flap in a size petite for the comfortgel for $32.99.

The second option is cheaper, but it still leaves me with the large headgear of the original comforgel. Any thoughts?

[allisonandrews]

Also have a quick question on the leak level. My mask choice is set at the activa (I think). When I look at my daily data, my leak rate is around .1 or .12. Where does this fit in the spectrum of leaks?

[ozij]

Setting you mask definition on "standard" instead of activa will make figuring out the leak numbers easier.

O.

[allisonandrews]

Okay - I'll try that. The DME set it the first time, but I know I can change it.

I'm also looking at the Oracle oral mask... seems interesting as my main source of problems seems to be with something on the bridge of my nose, blowing in my eyes, or too far down on my lip...

...off to do some more research!

[JWALSH2689]

Just in case you do not know how to change the setting...the following article describes how to change the "clinical settings" on the more popular machines.

http://www.cpap-supply.com/Articles.asp?ID=130

[Slinky]

Well, definitely you don't have the right size mask, it is obviously too long for you. I doubt that buying the smaller size nasal cushion for this mask would alleviate the bridge of the nose problem tho it should alleviate the too far down on your lip problem.

I don't know of any way to avoid a mask sitting on the bridge of your nose except to go to a nasal pillows style mask - or ....

a good choice might be the ComfortLite 2. It comes in a kit w/both 2 sizes of nasal pillows AND 2 sizes of a simple nasal cushion so it is almost like getting two masks for the price of one. The simple nasal cushion does not fit on the bridge of the nose, rather it sits somewhat down the nose from the bridge.

Did you ask your local DME supplier about their mask exchange policy?? They should be willing to exchange cushion sizes or even for a different mask AT NO CHARGE w/in at least the first 30 days. If they won't, they are jerks and it is your misfortune to have to do business w/them.

And, let me tell you, that Resmed S8 Elite w/EPR is one honey of a CPAP. I LOVE mine. In fact, I loved it so much I bought a very lightly used Resmed S8 AutoSet Vantage as a back up and travel xPAP or for when we think I might need a pressure change. I use my Elite as my regular nightly machine.

If you don't have insurance and are self-pay, you are not "stuck" w/this local DME supplier and in the future when you NEED to do business locally I certainly would pick another one to do business with, one that has a reasonable mask exchange policy!

[allisonandrews]

Okay.

I'm seriously thinking about trying to buy one of the Oracle Oral ones on CpapAuction. Then, in 3 months, I'll get a new mask with my insurance and I will try something else. (If I like the Oracle, I'll just go ahead and get another one to have as backup).

I'm going to try a good cleaning on my comfortgel this weekend. DME told me to use Ivory soap on it. I don't have any, so I admit - it's just gotten a wipe down so far (I think I have 35 hours on it). Yes, I know this is bad and I will try to be better in the future! Perhaps the silicone seal part has gotten oily and that is allowing it to "move" around on my face. My second night with it, I wore it 10 hours with no problems.

Seeing what some people have had to pay, I think I got a reasonable deal. (Probably not as good as going through CPAP.com though.) For everything (CPAP, humidifier, mask, etc.), my out the door total was $605.00. That was for a purchase and I had not touched my deductable yet for the year.

Although I sort of wish I could have rented (and possible returned) the CPAP, the people in the store were very nice. They guy setting mine up was even joking around with me that I probably knew more than he did about the CPAP with some of the stuff I said (such as knowing about EPR and what it stood for, stuff about rainout, about maintenance of the machine, etc.) They really had a laugh when he realized that he had not made it where I could change the EPR level. He put his hand over the CPAP screen and told me not to look. I told him, "You're just pushing the buttons at the same time to get into the other menu." He really wanted to know how I knew to do that!

[Pilot_Ron]

That oracle looks like it would be a great mask to have when you have a cold and can't breath through your nose. I might get one to have in case.

[Slinky]

HEY! If you walked out the door of that DME supplier's for $605 you got a DEAL! I apologize and take back my snarky comment!

That is if I am understanding you correctly that you hadn't met your deducatable yet so you paid the full shot w/your insurance kicking in nothing toward your equipment.

The equal to the Resmed S8 Elite is the Respironics M Series Pro w/C-Flex. Compare what you paid w/cpap.com's price for the Pro and all accessories.

When you go to the URL that JWalsh gave you, KEEP THIS IN MIND:

You can accidentally or intentionally alter your therapy settings thru the Clinical Menu. So the FIRST thing to do is to get a pencil and long sheet of paper and write down each option and setting that appears on the LED screen in the exact sequence you encounter them w/o making any changes. That way you KNOW exactly what your settings SHOULD be and if you then elect to change them and they don't work out for you you will know what setting(s) to go back to.

And when making changes be sure to make only ONE change at a time and stay w/that change for one full week checking the data daily and for the week BEFORE deciding to make any other ONE change. And changing masks equals making a change. One week's data before making another change! Changing Ramp or EPR applies to this ONE change for ONE WEEK at a time too.

[allisonandrews]

I didn't find it snarky at all! I don't know what kind of deal my DME worked out with my insurance company, but I was at least glad to see that the DME itemized list FOR ME was over $2200. I think my deductable is $350, so I have now met it fully. I know insurance does not pay this much, but at least they didn't try to give me a bottom of the barrel machine. In fact, this one machine is the only one this DME provides.

My pressure is set on 9. I feel it a bit at first, but when I wake up in the morning, I can't even tell that it is blowing. I don't really need the ramp feature, so I have it turned off (done so in the regular patient menu). Actually, when I tried it the first time (ramp starts out at 4), I felt like I wasn't getting enough air. I also started with my EPR on 2 as I thought the ability to go up or down would be beneficial. No problems there either. This is also changed on the regular menu. I honestly don't see my changing anything with the settings. It just gave my DME a good chuckle that I knew how to!

[Slinky]

Oh, and for cleaning your mask: just plain ole baby shampoo works great, does the job but is gentle on the materials. A vinegar water rinse and then plain water rinse finishes the job for you.

The fact that the Resmed S8 Elite is the CPAP that this DME supplier routinely provides speaks well for them. Way too many local DME suppliers try to skate by w/providing a bare-bones, compliance data only CPAP.

[sleeplessinaz]

allisonandrews--hi!! I wanted to say that I had the same MASK fitting problems that you are facing and I did switch to the Comfort Gel Petite and that solved it all ------The PETITE size doesn't leak near the eyes and it is much smaller around your nose so it does not sit low on your upper lip. I call it my "Miss Piggy" mask!! I would go for that one if I were you. The head gear is adjustable so you can make it smaller as well---happy sleeping!!
Carrie

[allisonandrews]

Thanks. Good to know in case I can't get the oracle for a reasonable price. If that is the case, I will just order the petite cushion and seal and then choose the oracle in 3 months as my next month for insurance to cover. I do agree that it will be good to have an alternate "type" of mask available if I am stuffed up.

[darthlucy]

I'm not familiar with the ComfortGel mask, so this is a question for those who might be more "in the know" on that mask. For some masks, the different parts (headgear, cushion, etc.) aren't interchageable between sizes. If Allison purchases a new cushion and flap in size petite for her size small headgear, will that work? Will she be able to mix those different sizes? Just want to save her an added expense if that option isn't feasible.

[Slinky]

Some masks have interchangeable parts between sizes, others don't and darned if I know which do and which don't. Easy enough to check tho by looking up any particular mask at cpap.com I'd venture a guess that most masks DON'T.