Smashed face syndrome, is this true???

CatherineF · Post by **CatherineF** » Thu Jun 30, 2011 5:48 am

http://www.24-7pressrelease.com/press-r ... 180027.php

Do you have any "symptoms" of this with long-term CPAP use? I think it may be caused by full-face masks especially, because pressure exterted on cheeks. I am new to CPAP therapy, my first night with full-face mask was a nightmare, I couldn't even fall asleep with something on my face, it seems to heavy. I am on 7 cm to 15cm on autoCPAP. The second night I've tried nasal pillows but I am opening my mouth even with chinstrap :/ I am too scared to try taping because I have vasmotor rhinitis, my nose is often congested and runny. This mask would be ok if not my nose and mouth opening, its light and quite comfortable. I don't know what to do, I can't sleep with full-face mask because it is heavy and I don't want a headgear effect on my face ;( Nasal pillows are not good also.

Can anyone give me any advice?? Maybe I should buy a hybrid mask (Liberty, Resmed?)

Pugsy · Post by **Pugsy** » Thu Jun 30, 2011 6:08 am

Welcome to the forum.

If I were going to just have to use a full face mask it would be the Hybrid. I can't stand any pressure across the bridge of my nose or sides of my nostrils as the pressure causes immediate congestion so even the over the nose mask won't work for me.

I chose nasal pillow type because of this problem. That problem and the fact that the neck straps associated with full face masks cause tension on my cervical spine which has its own problems.

The Hybrid comes with 3 sizes of cushions. The Liberty comes with only one size. They are similar in style but often people report that the have tried both and one will fail and one is perfect.

I am not so sure that I would buy into the smashed face thing because of pressure but I could see where the mask straps and mask placement could create problems especially if too tight. Just my personal opinion.

Otter · Post by **Otter** » Thu Jun 30, 2011 6:22 am

I'm still pretty new at this, but I have the impression that some doctors' opinions of full face masks are based on older designs. For instance, I've also read that FFMs don't work because they force the mandible back, but it doesn't feel like my QFX does that, and it doesn't show in my AHI either. OTOH, I'm not sure how much pressure it takes to move things around over time.

BlackSpinner · Post by **BlackSpinner** » Thu Jun 30, 2011 7:05 am

If your masks moves your face around you have it on much to tight. Most of them float on your face like hover-crafts, tightening them up to much makes them leak.

This is the least of your concerns right now.

CatherineF · Post by **CatherineF** » Thu Jun 30, 2011 7:20 am

I am happy that ran into this forum

Pugsy, I have problems with my cervical area too, I suspect that full-face mask can intensify those problems in the long run... How do you deal with nasal pillows leaks through the mouth?

I am using this method currently: http://www.jawpain-tmjtreatment.com/ and I know that bones in the skull, jaws etc can move with light forces, so it is possible, I don't know whether this article is about old types of mask, maybe new ones don't cause this?

To Otter: it depends where is the area of obstruction, in my case it is in the area of the soft palate, it is this what collapses, my airway are wide enough on the level of the mandible (1,02cm), when someone has narrow airway also on the mandible level, this can be a problem...

To BlackSpinner: I realize that consequences of untreated apnea far outweight some side effects, but in my case (and I suppose in many cases) it would worsen not only my look but also the apnea over time. Actually I think just like you that this risk may be minimized with new designs of masks thanks to the "floating effect"

So Well · Post by **So Well** » Thu Jun 30, 2011 7:39 am

CatherineF wrote:
I am using this method currently: http://www.jawpain-tmjtreatment.com/

"Face pulling DIY"!

That is a hoot.

Thanks for posting the link. Lots of good laughs.

CatherineF · Post by **CatherineF** » Thu Jun 30, 2011 7:44 am

So Well: why do you think it is a reason to laugh? Do you think that it doesn't work?

Pugsy · Post by **Pugsy** » Thu Jun 30, 2011 8:31 am

CatherineF wrote: Pugsy, I have problems with my cervical area too, I suspect that full-face mask can intensify those problems in the long run... How do you deal with nasal pillows leaks through the mouth?

The Hybrid will be the better of the full face masks in regards to cervical issues. The lower back strap can be brought upward a bit to get it off the base of skull upper cervical spine area. I have really bad arthritis in C spine. I had 2 vertebrae removed and replaced with donor bone along with a 4 inch long metal plate. I simply cannot stand the tension needed to hold full face masks in place that comes with full face mask straps. I tried all the FFM that my DME carried. The Hybrd would have worked OK. The Liberty did not because I couldn't get that lower strap off the base of my skull and still maintain a good seal.

So I elected to concentrate on making nasal pillow mask work. I did have some mouth breathing issues when I first started therapy. Now bear in mind that I didn't have to mouth breathe during the day. For the most part I have never had extreme nasal congestion during day or not that required mouth breathing. I think m mouth breathing at night was just a habit I had gotten into because of the OSA and my body struggling for air.

I tried chin straps with some success. They aren't all the same so just because one brand or style doesn't work, it doesn't mean another style won't work. I decided to try the mouth sealing way to see if I had better results. I did so I didn't persue a lot of chin strap options.

I tried the blue painters tape and I tried Polygrip. Both were effective. Either one is easily removed or seal can be broken quite easily with a big yawn. This stuff does not set up like cement. Try it..during the day.. see if you can breathe through your nose enough to be comfortable. If you can't you will either have to treat the nasal congestion, get a full face mask or use a chin strap and maybe just have to accept a few mouth leaks.
I don't normally advocate accepting a few leaks (you will for sure need the software to make sure leak is minimal) which might impact therapy but if they are short lived leaks with minor impact on therapy that is still a heckuva better way than no cpap at all.

After about 2 months of taping I started getting lazy about taping..watched my reports and leaks weren't bad at all.
Seems like I retrained my body to not breathe through my mouth. I just broke an old habit. Others have reported being able to stop taping. Of course others report that they still have to tape.

Regarding the dangers of taping...well the first night I tried taping we had a power outage. I woke up just fine. No stress. There is some movement of air through the vent. I used the 2 inch tape. I experimented during the day to see how easily I could open my mouth using only my mouth, and I found that the tape seal and the Polygrip seal was easily broken with minimal yawn like mouth movement. I was confident should the power fail and I didn't wake up right away that my body would/could open on its own. Regarding vomiting...last time I vomited in bed was when I drank too much tequila. Any other time the nausea wakes me up long before the puking starts.
Are there risks? Sure, but so is going without cpap or even walking across the yard.

Based on my own options with not being able to use a FFM and my daytime experiments...I was comfortable with the choice to tape or use Polygrip.. You will have to make that choice yourself.

You need to get the software reports to evaluate the extent that mouth breathing might impact therapy. Figure out what you can do to keep nasal congestion to a minimum. Then make an educated plan on how you wish to address the issues.

imsleepynomore · Post by **imsleepynomore** » Thu Jun 30, 2011 8:41 am

Just suggestion if your afraid of taping and the chin strap you tried while using nasel mask maybe purchasing that expensive new ultimate chin strap that was discussed some time back . Just search ultimate chin strap for info. I haven,t tried but others have.

Dojers · Post by **Dojers** » Thu Jun 30, 2011 9:09 am

Pugsy wrote: The Hybrid comes with 3 sizes of cushions. The Liberty comes with only one size. They are similar in style but often people report that the have tried both and one will fail and one is perfect.

Just thought I'd clarify on this one - I have the Liberty - the Liberty comes in one size for the oral interface but comes with all 3 nasal pillow sizes. At least mine did.

CatherineF · Post by **CatherineF** » Thu Jun 30, 2011 9:11 am

To imsleepynomore: Unfortunatelly I am from Europe, I have to try different solutions, maybe something will work eventaully... If not I will buy this. Thanks for advice. Btw it looks quite terrible...

To Pugsy: Thank you so much for all advices, first I am going to try Chin-up strips, along with chinstrap maybe, and if this won't work I'll try to tape my mouth. I am going to have a celon-coblation for my nasal concha to contrict it, because nasal steroids have no impact on my congestion. I don't think that my mouth breathing will cease itself over time because I have a bite problem that leads to opening my mouth.
The last thing if the above won't work is a hybrid mask... But I hope I will avoid it somehow.

I want to get rid of all those damages apnea is causing to my body and my brain... I am tired all the time and I have got a huge brain fog for the last 5 years, I don't feel alive anymore ;( For now Cpap is my only solution...

Pugsy · Post by **Pugsy** » Thu Jun 30, 2011 9:16 am

Dojers wrote: Just thought I'd clarify on this one - I have the Liberty - the Liberty comes in one size for the oral interface but comes with all 3 nasal pillow sizes. At least mine did.

Yes, both the Hybrid and Liberty come with the 3 sizes of the nasal pillow part of the mask.

The cushion or oral interface for the Liberty requires a sizing estimate on the part of the user to select a size.
The Hybrid comes with 3 sizes automatically so sizing error is avoided plus the unused sizes can often be swapped with other Hybrid users that also have unneeded cushions. Saves money. Of course same thing holds true for the nasal pillows.

Pugsy · Post by **Pugsy** » Thu Jun 30, 2011 9:20 am

CatherineF wrote:first I am going to try Chin-up strips, along with chinstrap maybe, and if this won't work I'll try to tape my mouth. I am going to have a celon-coblation for my nasal concha to contrict it, because nasal steroids have no impact on my congestion. I don't think that my mouth breathing will cease itself over time because I have a bite problem that leads to opening my mouth.
The last thing if the above won't work is a hybrid mask... But I hope I will avoid it somehow.

That's a good plan to start with.

Do you know about the software? You will need it to evaluate the leak or mouth breathing issue.

nanwilson · Post by **nanwilson** » Thu Jun 30, 2011 9:22 am

Why would the Hybid be your last choice? Many of us here on the forum use one of the two available. I mouth breath too and I have tried other full face masks but find the respcare/innomed hybrid the best. I can wear my glasses to read in bed and have no forhead piece or anything across my nose. Go to cpap.com and read up on ALL of the masks available, I'm sure there is one that you would be interested in. They may even ship to you in Europe...just ask, I live in Canada and they ship to me. If they don't ship to you try and find a supplier in Europe that will. It takes some legwork and time, but you may find what you want in your own area.

Dojers · Post by **Dojers** » Thu Jun 30, 2011 9:29 am

Pugsy wrote:
Dojers wrote: Just thought I'd clarify on this one - I have the Liberty - the Liberty comes in one size for the oral interface but comes with all 3 nasal pillow sizes. At least mine did.
Yes, both the Hybrid and Liberty come with the 3 sizes of the nasal pillow part of the mask.

The cushion or oral interface for the Liberty requires a sizing estimate on the part of the user to select a size.
The Hybrid comes with 3 sizes automatically so sizing error is avoided plus the unused sizes can often be swapped with other Hybrid users that also have unneeded cushions. Saves money. Of course same thing holds true for the nasal pillows.

Yup - true that. The thing I like about the Liberty being in a single oral size is I had a heck of a time with the oral interface coming off while I slept. I'm a restless sleeper even with having my c-pap now and I'd wake up all of a sudden with weird air noises and realize the mask had come free of the frame. Plus I had a heck of a time with the nasal pillows too. But like you said previously (I think) a person usually says one fits better than the other and it doesn't matter which side of the coin you're on.

I have cervical problems as well and have had fusions done in 2 of my discs using my own hip bone (OUCH!!!!) and have the 4" titanium plate as well. But I've been fortunate in that the straps sit right on my neck so I don't have that pain problem with it. Thank goodness! Cervical problems are bad enough without added pressure!

I agree with everything said here in regards to the "smashed face syndrome". I think if you have that it is most probable (but not necessarily so) that your mask is too tight or maybe it has something to do with the way you sleep. *shrug* But I don't think it's as big a problem with the hybrid styles (Hybrid and Liberty are the only 2 I know of) due to the way they fit. YMMV (Gee, I wonder if I would have gotten SFS having to wear the gear I used to wear *looks at profile pic* - that's bloody scary!! )

Smashed face syndrome, is this true???

Smashed face syndrome, is this true???

Re: Smashed face syndrome, is this true???

Re: Smashed face syndrome, is this true???

Re: Smashed face syndrome, is this true???

Re: Smashed face syndrome, is this true???

Re: Smashed face syndrome, is this true???

Re: Smashed face syndrome, is this true???

Re: Smashed face syndrome, is this true???

Re: Smashed face syndrome, is this true???

Re: Smashed face syndrome, is this true???

Re: Smashed face syndrome, is this true???

Re: Smashed face syndrome, is this true???

Re: Smashed face syndrome, is this true???

Re: Smashed face syndrome, is this true???

Re: Smashed face syndrome, is this true???