best masks for higher pressures

Guest · Post by **Guest** » Fri Sep 16, 2005 8:08 am

Hi,
I was wondering what masks would be good for higher pressures, and welcome users comments.

I presently use the large ultra mirage nasal mask with a chin strap. My pressure is 14, and I am battling strap marks, leaks around the eyes and a sore nose bridge. I have tried the comfortcurve, could not get a good seal, the breeze, no leaks, but felt that could not exhale against the pressure, (have the invacare polaris with soft-ex) and felt my breaths were too short. especially the exhale. Tried the dreamseal and again too many leaks.
Any thoughts on mask recommendations or experiences would be greatly appreciated. Also, is exhaling easier with the swift than the breeze... I read that here somewhere.

Thanks, RM.

CareS · Post by **CareS** » Fri Sep 16, 2005 9:12 am

Definitely the Aptiva.

WillSucceed · Post by **WillSucceed** » Fri Sep 16, 2005 9:37 am

I don't know about much about the Polaris with Soft-Ex but, something that you have said really catches my attention.

the breeze, no leaks, but felt that could not exhale against the pressure, (have the invacare polaris with soft-ex) and felt my breaths were too short. especially the exhale.

Are you saying that you feel as though you are not able to fully exhale? If so, I strongly suspect that this is NOT an artifact of the mask, but of the Soft-Ex. Soft-Ex is the Invacare (Polaris) answer to Respironics C-FLEX and there are users that find C-FLEX to be uncomfortable. It is possible that Soft-Ex is similar to C-FLEX in design and may simply not be right for you.

With C-FLEX, the pressure decreases when the user starts to exhale. Then, just before the user has fully exhaled, the pressure increases again. For some users, this causes them to have "breath-stacking" -breaths become shorter and more rapid as the user is not able to fully exhale and, is not able to have a pause between exhalation and inhalation. In essence, the pressure increases before the user wants it to increase -the inhalation is triggered and the user ends up trying to 'catch up' to the machine.

I'm not a Dr., so please take my suggestions with a huge grain of salt. I would also suggest that you talk with your Dr./supplier/RT about this as well. Having said this, I would suggest that if you did not experience leaks with the Breeze, try using it again but, turn the Soft-Ex feature off (hopefully you can turn it off) and see how you do. My hunch is that you will find that the Breeze still seals well and, you will be able to get your full breath out, including being able to have a short pause if you wish, before you start to take in your next breath.

I know that 14 feels like alot of pressure (I was titrated at 15) but it is possible to get used to it without the Soft-Ex. You did not mention how long you have been getting treatment -some folk at higher pressures (14) find that they do better if they work up to that pressure over the course of several weeks, doing a 1cm increase weekly until they get to 14. Also, use of an auto-titrating machine (AutoPAP) can be a great alternative to a single pressure CPAP.

C-FLEX, as well as Soft-Ex can be very helpful for many users, but are not the answer for everyone. My first machine was a RemStar with C-FLEX and I hated the feeling of panting and not being able to get a full, satisfying exhale. I turned off the C-FLEX and all was well. I really think that the difficulty you mentioned with exhaling is not a mask problem, but a machine problem. The give-away on this was your comment that your breaths, especially your exhale, felt too short.

WillSucceed · Post by **WillSucceed** » Fri Sep 16, 2005 9:57 am

I just went to the Invacare site to take a look at your device. You can turn the Soft-Ex off and run the unit as a straight CPAP. Might be worth turning Soft-Ex off for a night and trying the machine.

Again, please talk with your Dr./supplier/RT about this.

RM · Post by RM » Fri Sep 16, 2005 11:11 am

Thanks for the reply.... I will definately try to turn the soft-ex off tonight.
Some differences between the nasal mask and the breeze are:
1. with the nasal mask I would get pressure in the ears with swallowing, with the breeze there is no build up of eustachian pressure.
2. I could wear both masks all night long, but with the breeze, I would sometimes have a headache, not feel rested at all... and really feel like my breaths were short. I seemed to be able to breath better with the nasal mask and feel better in the mornings, but the bridge of my nose is sore, I have marks and have leaks into my eyes. Also one of my nostrils always seems to be stuffy... should this affect the breeze?

I really wish that I could use the breeze, since it is comfortable with no leaks or face marks... but if I wake up and feel bad maybe it is not for me.
I have been on CPAP for 3mos.
I'm going to test the breeze w/o the soft-ex tonight to see if I can breath more normally... if I can't I'll stick with the nasal mask, or try to find another nasal mask that doesn't leak, is easier on my nose and face.
I'll let you know how it goes.
Thanks,
RM.

I am also in the process of try to get another machine.. auto or bipap I really don't know which would be better for me at this point.. but it sounds like the feature to ease exhalation isn't going to be benefit for me.

Fatigue Fighter · Post by **Fatigue Fighter** » Fri Sep 16, 2005 6:48 pm

I use the ResMed Mirage Swift Nasal pillows. I really like it even with pressures at 17. I use a BiPAP because I couldn't exhale at the same pressure as I inhale. I started at 12/8. That wasn't enough. So within 4 months I underwent another titration and am now at 17/13. I am really glad I started with a Bilevel system from the beginning. The odd thing with me is that it doesn't matter what the exhale pressure is, it just has to be less.

I would try WillSucceed's solution first and see if that works for you. There are lots of options out there.

FF

RM · Post by RM » Sat Sep 17, 2005 5:19 am

Well last night I used my nasal mask w/o the soft-ex.... WHAT A DIFFERENCE!! I was able to exhale soooo much easier!!. I can't believe that for 3mos I have been struggling with this. I would have never thought for a minute to turn off the soft-ex.... since afterall it is supposed to help me exhale, not prevent me. I see now that when I started to exhale, the soft-ex would ramp down for maybe a second or two, then the pressure would be back up, it would not let me fully exhale. I was definately stacking my breaths. I was able to exhale much more naturally and completely w/o it.

Now since it went so well with my nasal mask (ultra mirage w/chin strap) as far as breathing, I still had eye leaks and strap marks. So tonight is the big test.... I will try to use my breeze... I'm also thinking about the swift as Firefighter says its a little easier to breath against it.

Thank you so much for your advice... it has really made a difference.

Exhaling easier in OH,
RM.

RM · Post by RM » Sat Sep 17, 2005 5:21 am

sorry Fatigue Fighter.... I know its not firefighter!!!
RM

dsm · Post by **dsm** » Sat Sep 17, 2005 7:03 am

This has been an interesting thread for me. RM's experience with masks matches mine but I am luck enough that my best mask is the Mirage Ultra f/f. It usually bails me out of trouble when other masks combiined with my 15 cms.

What I find most interesting of all though was that turning of the exhalation aid on the polaris, has made such an improvement. This was a good call by WillSucceed.

I too have turned off CFLEX but appreciated it in the first couple of weeks.

RM, I am pleased this has been a breakthrough for you. Once again cpaptalk.com (via WS insights) scores a bit win

Cheers

DSM

nodding off · Post by **nodding off** » Sun Sep 18, 2005 2:04 pm

I use both an Activa and a Breeze at pressures averaging around 14, and have no problems with either of them. Neither of my machines (ResMed Spirit, PB 420E) have expiratory relief.

Sleepless on LI · Post by **Sleepless on LI** » Sun Sep 18, 2005 5:57 pm

RM.

Doesn't WillSucceed come up with good replies? He really went out of his way this time to research your problem and solve it. I, too, when I had my CFlex on in the beginning, had the stacked breathing that WS talked about. After one night with that, it was goodbye CFlex. Can't say that I miss it, but I was set at straight 10 pressure at that time. Now on apap of 8-12, with the pressure never going over 9 anymore, I really don't need it.

Also, one suggestion if you go back to the ff mask. You can always put a little piece of Dr. Scholl's moleskin under the mask where it irritates your nose and it will pad the area so it doesn't cause you soreness and it won't cause that area of the seal to leak.

Glad you're doing better without your Soft-Ex. Isn't it nice when problems get solved and it makes such a tremenous improvement with your therapy?

Good going, WillSucceed!!!

RM · Post by RM » Sun Sep 18, 2005 8:32 pm

sleepless,
Thanks for the nice reply... I will try the moleskin tonight. I did try the breeze w/o the soft-ex, but for me the pressure was still too high to exhale against... the air seems more dispersed with the ultra mirage nasal mask that I use. I wish that I could use the breeze since it is (for me) the best fitting mask, does not leak and doesn't leave any marks on my face. But I can't get by the exhaling thing. Maybe if I had a bipap it would be better. I still would maybe like to try the swift, since I've read that it maybe easier to exhale against it than the breeze.
thank you all for listening and for your help.
RM

Sleepless on LI · Post by **Sleepless on LI** » Sun Sep 18, 2005 8:36 pm

RM,

Good luck tonight with the moleskin. I will bet you see a difference when you can exhale with the ff mask on and have no pain from the moleskin padding the sore area.

You are right that when you use a nasal pillow interface, the air seems more intense because it is being directed right into the nasal passages as opposed to a ff mask, which you described as dispersed air, which you actually have to inhale to take in. With nasal pillows, you really don't have much of a choice and you have to exhale against that same directed pressure of air streaming in. Makes sense when you think about it, though.

Let us know how you did tonight. Hope it's a better night.

Fatigue Fighter · Post by **Fatigue Fighter** » Sun Sep 18, 2005 8:47 pm

RM wrote:sorry Fatigue Fighter.... I know its not firefighter!!!
RM

You're right! I can't breathe around all the smoke and would probably faint from dizziness. A fire fighter I am not, but I am currently reading a book titled, "The Smoke Jumper" .....now those are fire fighters!

FF

RM · Post by RM » Mon Sep 19, 2005 7:34 am

hey fatigue fighter....
Speaking of fire fighters... you usually see them going into the fire with the O2 tanks etc.... I wonder which full face mask they use and more importantly does it leak???? (smile)
RM.

best masks for higher pressures

best masks for higher pressures

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