A newbie to forum with some questions

[CapeM1]

Hi there..I am new to the forum and am sure that I will be spending much time reading and learning much from what seems to be a wealth of information about many different issues associated with apnea disorders. I use a Bipap ST prescribed for my central sleep apnea. My story is long but, basically, I have a lung disease which subsequently led to my breathing more and more shallow and I slowly developed extremely high CO2 levels to the point where I went in respiratory arrest. I was, thankfully, saved, but since that day I was placed on bipap ST and was told by my docs that I am never allowed to sleep without it. They initially started me on a pressure of 24, which most therapists told me was the highest they had ever had a patient on, but it beat the alternative of having a permanent tracheotomy. That was 2 years ago, and my docs have since been able to get my pressures down to 16/5.

I was so glad to find this site because in the short time I have spent here I was surprised to see how many cpap/bipap users have card readers/software and are able to monitor their own sleep habits. I was never even told that it was possible to purchase these products. I am truly sleep apnea illiterate but I certainly hope to change that with the help of this site.

Where I could use some help is with my mask. Initially with the high pressures the mask needed to be kept so tight to keep it from leaking that I developed a large sore on the bridge of my nose. I could not use pillows because of the high pressure so I kept trying different masks. Now with my pressure down to 16 the sore has healed and it is slightly easier keeping the leaks more controlled, but I seem to have a problem of always having red streaks all along the mask outline. At first the red marks would disappear in a few hours, but now they stay there most of the day and are very embarrassing, as well as uncomfortable because they are dry. Does anyone else have this problem. I have never seen anyone else with the mask "markings" and feel like I must really be doing something wrong. I wash my mask every night and use warm water with a very gentle soap. I actually tried just using warm water for a while (to rule out a soap allergy), but i am beginning to think the plastic of the mask does not agree with me..any suggestions? (sorry for the long post).

[dilligat]

I see that you have the Quattro mask. I am told by Resmed that the cushion is supposed to act like a hovercraft. When you put it on it should meet the face and have reasonable contact but still be "floating" then as the air pressure comes on the outer layer of the cushion, i.e. the floppy bit that touches your skin rather than the firmer inner layer, inflates much like a hovercraft skirt and creates a better seal which is provided by air pressure and not a hard mechanical fix where the straps are done up tightly. This should stop or certainly minimise the red marks the mask leaves.
I use a Resmed Hybrid and found with a bit of trial and error that I get a good seal without the marks in the morning. It's a balancing act of getting the mask loose enough when deflated to meet the face all the way round and allow it to inflate whilst remaining sealed. I put it on, let the pressure build and make a minor adjustment of the straps should a leak occur. I find that leaks happen almost straight away and once stopped with a little adjustment remain sealed unlesss the mask is displaced by a pull on the pipe as I move. To solve this I then pull the mask away from my face slightly allowing the cushion to inflate evenly and release any folds oir creases and let it settle back to regain the seal without adjusting the straps again.

[bdp522]

Welcome to the forum CapeM1! You will find a lot of helpful folks here.

I have found that any time the mask touches my skin it leaves nasty marks. I use a thin coat of Milk of Magnesia where the mask touches the skin. It creates a barrier to protect the skin, but still allows a good seal. A little extra moisturizer in the morning also helps.

Brenda

[Slinky]

Whilst those red marks "might" be skin sensitivity I'd be more inclined to believe they are due to your having your mask way too tight.

Its been a while since I used my Quattro as I only use it if I'm REALLY congested and just plain can NOT get away w/using my Simplicity simple nasal cushion mask. However, I do remember that thin outer cover had a real knack for cutting the skin at the bridge of the nose - AND that there was a problem I never quite nailed down w/either how narrow the area for the nose bridge was or how "deep" the "cut" was for the bridge of the nose area, perhaps too long. But the end result was that the Quattro was THE most difficult mask for me to eliminate that cutting into the bridge of the nose. Most masks fitting the bridge of the nose can be made comfortable by starting the fit slightly lower than the bridge, then when the mask has inflated w/the air pressure lift it SLIGHTLY away from the face and slide it SLIGHTLY UP to its proper position at the bridge of the nose. This manuver turned the sharp edges of the thin cover UNDER. Its more difficult to do this w/the Quattro for some reason. Part of it being its weight tends to move down on your nose/face thereby turning those thin cover sharp edges UP again allowing them to cut into the skin. With the Quattro I DEFINITELY had to hang the hose above my head to keep it from tugging down on the Quattro contributing to turning those thin cover edges UP and cutting into my nose bridge.

Lay down, lay the Quattro on your face in position (SLIGHTLY below the bridge of the nose), turn your xPAP on, tighten the headgear so it is COMFORTABLE w/no leaks. If you experience leaks run your fingertip along the seam between cushion cover and facial skin to turn the cover edges under. If necessary tighten the headgear a LITTLE more. Try lifting the Quattro SLIGHTLY off your face, letting it refill w/air and laying it back on your face again w/o loosening the headgear. Remember start the Quattro SLIGHTLY below the bridge of the nose, then move it up JUST A SKOSH into proper position at the bridge of the nose.

And it may well be that you are going to have to use some form of thin padding such as a bandaid or BreatheRite strip across the bridge of the nose to protect it from that sharp thin cover edge.

[mdbarthe]

I've been using the Mirage Quattro for over a year now. I tried many full face masks and finally settled on the Quattro. It was the best of the bunch for me. My Respiratory Therapist warned me about the nose cut and the marks on the face. As for the nose, he told me to cushion the bridge with a bandaid until I could get by without wearing one. That was about two or three months. When I quit wearing the bandaid, I had not problems.

The mask does leave marks, however, on the bridge of my nose and the back of my neck. My face remains pretty clear from the rest of the seal. The marks on the back of my neck (from the headgear straps) stay for hours after I wake up. I also have some kind of skin reaction to the forehead pad. I have to use a non-adhesive bandage pad under the rubber/latex forehead mask pad or it looks like I received a rectangular cattle brand over night.

All this aside, the Quattro is the only mask I have ever been able to get and keep a good seal on every night. It's been a godsend for me.

[CapeM1]

Thanks for the suggestions.. I will certainly give each a try.

Slinky, thanks for the suggestion about how to position the mask on the bridge of the nose. You are right about the mask cutting into it and for that reason I use a bandage every night..(I should buy stock in the Band-Aid company!), anyway I will certainly try your suggestions.

Dilligat, it makes sense that the mask redness comes from being too tight as opposed to a skin sensitivity because it certainly seems to be worse on some days more than others..

bdp522, thanks for the suggestion about the MOM. I have never heard of that for such a purpose but what the heck, if it works I'll go for it!

mdbarth, the Quattro, even though I have problems with the redness, has seemed to be the lesser of all evils from the other masks that I have tried so I, too, will continue with the bandage on the nose and keep working to alleviate the other redness I get. The headgear also leaves marks on my forehead but thankfully my hair covers those!

Thanks to all for your help. I will try these over the next week and let you know if it works! Thanks again.