I have done some searching in the forum on masks that seal at high pressures, but still could use more help. I realize that the seal working also depends on one's individual face geometry.
I running at a pressure of 17 cm H20. I recently went to my respiratory care center for trying on different masks. I tried 5 and could not get any to seal.
I had been using an oracle mask that I was able to get to work with a nose plug, but did get a lot of leaks and when I got low leaks, the AHI was too high (in the 30's).
I have been able to get a regular quattro (not fx) mask to seal but with super tight strap tension, and using a pad-a-cheek anti-leak strap as well. I have welts on my forehead, nose bridge and around the perimeter of the mask where it touches my skin. With this I have been able to get AHI's around 10 when the leakage is around 12 liters/minute. Cannot get AHI any lower, but the main issue is getting a mask to seal without punishing my face.
Any other advice on other masks would be welcome.
High pressure masks that work
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charlestek
- Posts: 55
- Joined: Mon Jul 11, 2011 3:44 pm
Re: High pressure masks that work
Sometimes the masks have to float instead of being cranked down.
An Activa floats on your face... so you might try that one.
An Activa floats on your face... so you might try that one.
Re: High pressure masks that work
My pressure is set to 18. I use the Activa Lt. nasal mask and it has been working great. It does kind of float on your face and does not need to be tight on your face. In fact, the instructions say not to make it too tight. Hope this helps.
_________________
| Mask: Mirage Activa™ LT Nasal CPAP Mask with Headgear |
| Additional Comments: Pressure @ 18. Also use SleepyHead Software |
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ThomasMcKean
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Re: High pressure masks that work
I should like to know what works as well but for me it would be a full face mask and that really limits the options!
The Honorable Thomas A. McKean, HOKC
Author, Soon Will Come the Light: A View From Inside the Autism Puzzle
http://www.thomasamckean.com http://www.gallery.thomasamckean.com
Author, Soon Will Come the Light: A View From Inside the Autism Puzzle
http://www.thomasamckean.com http://www.gallery.thomasamckean.com
Re: High pressure masks that work
Charlestek:
It would help if you went to the user control panel and checked off your particular equipment and selected 'text' for the equipment display mode.
That said, I use the Oracle mask and don't get leaks at a pressure of 14.5, some lower than you but not that much lower.
Did you use the Oracle strap that comes with the mask? Did you try both inner flap sizes?
Could you get / give us the breakdown of the type of apneas your are getting. AHI alone is not quite enough.
It would be helpful if you could post the number of OSA's, CSA's and Hypopneas you are getting.
Without those numbers, we can't tell if your problem is one of ccomplex sleep apnea or poorly treated obstructive sleep apnea.
Don't get discouraged. Finding the correct mask and getting it fitted properly is a common problem for CPAP users and you may need to look / try quite a few more. I hope you DME continues to be supportive is letting you try different masks.
A couple of suggestions: When you try masks on, be in a resting position - lying down. Your face changes shape between being erect and lying down.
If your machine supports full data, try to get the software for it so you can look at the details for each night. Sometmes, just as you are going to sleep, you get a cluster of apneas in the inbetween time from wake to sleep when your breath control center is having difficulty determining which setting to use - CO2 or O2 levels.
It would help if you went to the user control panel and checked off your particular equipment and selected 'text' for the equipment display mode.
That said, I use the Oracle mask and don't get leaks at a pressure of 14.5, some lower than you but not that much lower.
Did you use the Oracle strap that comes with the mask? Did you try both inner flap sizes?
Could you get / give us the breakdown of the type of apneas your are getting. AHI alone is not quite enough.
It would be helpful if you could post the number of OSA's, CSA's and Hypopneas you are getting.
Without those numbers, we can't tell if your problem is one of ccomplex sleep apnea or poorly treated obstructive sleep apnea.
Don't get discouraged. Finding the correct mask and getting it fitted properly is a common problem for CPAP users and you may need to look / try quite a few more. I hope you DME continues to be supportive is letting you try different masks.
A couple of suggestions: When you try masks on, be in a resting position - lying down. Your face changes shape between being erect and lying down.
If your machine supports full data, try to get the software for it so you can look at the details for each night. Sometmes, just as you are going to sleep, you get a cluster of apneas in the inbetween time from wake to sleep when your breath control center is having difficulty determining which setting to use - CO2 or O2 levels.
_________________
| Mask: Oracle HC452 Oral CPAP Mask |
| Humidifier: DreamStation Heated Humidifier |
| Additional Comments: EverFlo Q 3.0 Liters O2 PR DSX900 ASV |
Oracle 452 Lessons Learned Updated
DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
Sleepyhead and Encore Pro 2.21.
DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
Sleepyhead and Encore Pro 2.21.
-
charlestek
- Posts: 55
- Joined: Mon Jul 11, 2011 3:44 pm
Re: High pressure masks that work
JDS74,
I've had apnea since the early 90's. I have at least 5 different masks at home (2 recent- Quattro Fx, Uber large Philips full mask) besides the 5 new ones I tried recently at the respiratory care try-on center.
For the first 15 years I could not tolerate any mask, I always threw it off while asleep at night. Only in the last 3 years did I get anything to work starting with the Oracle.
I can't use a nasal only mask, I have bad allergies and have had 3 sinus surgeries.
I've tried both Oracle flap sizes and always use the strap, and it has to be strapped down extremely tightly. 14.5 is quite a bit lower, I suspect there is not a linear change in seal problems for a given pressure increase, probably a logarithmic change. I have no problem with the quattro mask at 15. That said, I cannot get the quattro to "float" at 17. You have no choice, you have to strap it down or it leaks, period.
I've tried lower strap tensions, they don't work. I'm also using an auxiliary pad-a-cheek strap. I still need to clamp the forehead tightness down and pull the straps very tightly.
The Oracle has a problem in that it always has high AHI's even when it seals. For whatever reason, a full face mask putting pressure through my nose and my mouth at the same time is the only thing that will get AHI's lower than 10. The sleep doctor wanted me to try to force myself to sleep on my side with the Oracle to see if it would lower the AHI. I have trouble doing that, and even when I do, I'm not convinced that postural difference on my side lowers the readings.
Yes I know I could fool with getting software from ebay etc, but I rely on the readout paper graphs my sleep doctor does everytime I visit the office with the cpap.
I'm an electrical engineer and a software engineer, but I don't feel right now I need to get more detailed information. Maybe I will look into it.
I've had apnea since the early 90's. I have at least 5 different masks at home (2 recent- Quattro Fx, Uber large Philips full mask) besides the 5 new ones I tried recently at the respiratory care try-on center.
For the first 15 years I could not tolerate any mask, I always threw it off while asleep at night. Only in the last 3 years did I get anything to work starting with the Oracle.
I can't use a nasal only mask, I have bad allergies and have had 3 sinus surgeries.
I've tried both Oracle flap sizes and always use the strap, and it has to be strapped down extremely tightly. 14.5 is quite a bit lower, I suspect there is not a linear change in seal problems for a given pressure increase, probably a logarithmic change. I have no problem with the quattro mask at 15. That said, I cannot get the quattro to "float" at 17. You have no choice, you have to strap it down or it leaks, period.
I've tried lower strap tensions, they don't work. I'm also using an auxiliary pad-a-cheek strap. I still need to clamp the forehead tightness down and pull the straps very tightly.
The Oracle has a problem in that it always has high AHI's even when it seals. For whatever reason, a full face mask putting pressure through my nose and my mouth at the same time is the only thing that will get AHI's lower than 10. The sleep doctor wanted me to try to force myself to sleep on my side with the Oracle to see if it would lower the AHI. I have trouble doing that, and even when I do, I'm not convinced that postural difference on my side lowers the readings.
Yes I know I could fool with getting software from ebay etc, but I rely on the readout paper graphs my sleep doctor does everytime I visit the office with the cpap.
I'm an electrical engineer and a software engineer, but I don't feel right now I need to get more detailed information. Maybe I will look into it.
Re: High pressure masks that work
No need to go to EBay for soft wear. http://www.resmed.com/int/assets/html/s ... ister.html
Any landing you walk away from is a good one; if you don't break your airplane it's excellent.
Re: High pressure masks that work
Charlestek:
Please do get the free software to be able to look at your own data. You'll find that it is very helpful to see what is going on as you explore even small changes.
The difference in pressure is exponential as you assume. The difference between 14.5 cmH2O and 17 cm H2O is just 37% though so that may not be so big.
I can only use an Oracle mask because of extreme claustrophobia so I have had to figure out how to make it work for me. I was first diagnosed 10 years ago but couldn't tolerate the masks suggested so I didn't start CPAP therapy until last November (after second sleep study and badgering by my neurologist who kept saying "You know sleep apnea will kil you!") with the Oracle mask. I had similar problems to those you are experiencing but I think I now have them under control.
What I found is that using the strap, tightened down increased my AHI substantially and you may be experiencing the same thing. My theory is that tightening the strap has a tendency to pull my jar back and increases the rate of OSA's for me. So I don't use the strap at all. At your increased pressure it may be necessary to use the strap but only experiments will be able to tell that.
The second thing is that the distance adjustment between the inner and outer flaps is very sensitive. I started out with it quite tight to fight leaks but found that over time, that a looser fit gave better results. My assumption is that the leak rate is entirely controlled by the inner flap and the outer one controls positioning. Getting the separation just right for you will require a few nights of trial and error. Too tight, and it doesn't get better, too loose, and the leaks get worse.
Third, I found that using a hose support device that keeps the hose vertical in the night with only just a little slack greatly improves the leak rate for the Oracle. That lets me sleep on my back or side without any pull on the mask. If the hose is pulling on the mask, the leak rate can get very high and tightening things doesn't help.
Finally, a recent discovery, is that the Oracle mask is really sensitive to hygiene. The mask needs to be thoroughly cleaned each day inside and out. Washing my face just before bedtime helps with leaks. The mask seems to stay put to lateral movement if everything is squeaky clean. I've come to the conclusion that the inner flap is only good for about 90 days and then I need a new one no matter how careful I am. Of course, my insurance company only reimburses every 180 days so I have to pick up the difference.
Some of these same issues may apply to the other masks you are trying. Skin oils seem to interfere with the maintenance of a proper seal so carefully cleaning the areas of other masks where they touch your skin and carefully cleaning your face in the contact areas may help them as well. I think, and this is only my speculation, that skin lotion is probably a bad idea at night.
Hang in there. If there is anything I can do to help, please don't hesitate to ask.
Please do get the free software to be able to look at your own data. You'll find that it is very helpful to see what is going on as you explore even small changes.
The difference in pressure is exponential as you assume. The difference between 14.5 cmH2O and 17 cm H2O is just 37% though so that may not be so big.
I can only use an Oracle mask because of extreme claustrophobia so I have had to figure out how to make it work for me. I was first diagnosed 10 years ago but couldn't tolerate the masks suggested so I didn't start CPAP therapy until last November (after second sleep study and badgering by my neurologist who kept saying "You know sleep apnea will kil you!") with the Oracle mask. I had similar problems to those you are experiencing but I think I now have them under control.
What I found is that using the strap, tightened down increased my AHI substantially and you may be experiencing the same thing. My theory is that tightening the strap has a tendency to pull my jar back and increases the rate of OSA's for me. So I don't use the strap at all. At your increased pressure it may be necessary to use the strap but only experiments will be able to tell that.
The second thing is that the distance adjustment between the inner and outer flaps is very sensitive. I started out with it quite tight to fight leaks but found that over time, that a looser fit gave better results. My assumption is that the leak rate is entirely controlled by the inner flap and the outer one controls positioning. Getting the separation just right for you will require a few nights of trial and error. Too tight, and it doesn't get better, too loose, and the leaks get worse.
Third, I found that using a hose support device that keeps the hose vertical in the night with only just a little slack greatly improves the leak rate for the Oracle. That lets me sleep on my back or side without any pull on the mask. If the hose is pulling on the mask, the leak rate can get very high and tightening things doesn't help.
Finally, a recent discovery, is that the Oracle mask is really sensitive to hygiene. The mask needs to be thoroughly cleaned each day inside and out. Washing my face just before bedtime helps with leaks. The mask seems to stay put to lateral movement if everything is squeaky clean. I've come to the conclusion that the inner flap is only good for about 90 days and then I need a new one no matter how careful I am. Of course, my insurance company only reimburses every 180 days so I have to pick up the difference.
Some of these same issues may apply to the other masks you are trying. Skin oils seem to interfere with the maintenance of a proper seal so carefully cleaning the areas of other masks where they touch your skin and carefully cleaning your face in the contact areas may help them as well. I think, and this is only my speculation, that skin lotion is probably a bad idea at night.
Hang in there. If there is anything I can do to help, please don't hesitate to ask.
_________________
| Mask: Oracle HC452 Oral CPAP Mask |
| Humidifier: DreamStation Heated Humidifier |
| Additional Comments: EverFlo Q 3.0 Liters O2 PR DSX900 ASV |
Oracle 452 Lessons Learned Updated
DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
Sleepyhead and Encore Pro 2.21.
DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
Sleepyhead and Encore Pro 2.21.
Re: High pressure masks that work
Have you tried the Quattro FX? It's what I use and my pressures go as high as 18 and it does pretty well.
Thinking of quitting CPAP?
No problem, here's the first thing to do when you quit:
Advanced funeral planning. When you give up CPAP, you'll probably need it.
No problem, here's the first thing to do when you quit:
Advanced funeral planning. When you give up CPAP, you'll probably need it.
Re: High pressure masks that work
Software is easy part.
Card reader is hard part.
https://www.cpap.com/productpage/resmed ... -cpap.html
I have seen some on Ebay.
There is also a way to make your own card reader.. discussed here often in the past using ACR 38 card reader (a special kind) and some modifications for guiding the smart card. Pictures and instructions here at the forum if you search.
I think I remember seeing where forum member Jay Aitchsee seemed to have some knowledge along these lines.
I never paid much attention. Not my machine brand and way too much work to suit me.
Card reader is hard part.
https://www.cpap.com/productpage/resmed ... -cpap.html
I have seen some on Ebay.
There is also a way to make your own card reader.. discussed here often in the past using ACR 38 card reader (a special kind) and some modifications for guiding the smart card. Pictures and instructions here at the forum if you search.
I think I remember seeing where forum member Jay Aitchsee seemed to have some knowledge along these lines.
I never paid much attention. Not my machine brand and way too much work to suit me.
_________________
| Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
| Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/ |
I may have to RISE but I refuse to SHINE.
-
4J84JRA
Re: High pressure masks that work
Ameriken,
Yeah, I've tried two different sizes of Quattro Fx, it just doesn't seal with my face.
Yeah, I've tried two different sizes of Quattro Fx, it just doesn't seal with my face.
-
charlestek
- Posts: 55
- Joined: Mon Jul 11, 2011 3:44 pm
Re: High pressure masks that work
Pugsy,
I will look at ebay for the card reader. However, I got the sleep doctor to prescribe a bipap, but he needs to write a letter of medical necessity, and I've been waiting a month for him to do that.
The other issue after that is trying to convince the respiratory care company to give me a ResMed Vpap, because I think it is one of the best Bipaps, and it has good telemetry.
So if I get that machine it would not make sense for me to buy a card reader for the ResMed S8 that I have unless it works on the ResMed Vpap.
I will look at ebay for the card reader. However, I got the sleep doctor to prescribe a bipap, but he needs to write a letter of medical necessity, and I've been waiting a month for him to do that.
The other issue after that is trying to convince the respiratory care company to give me a ResMed Vpap, because I think it is one of the best Bipaps, and it has good telemetry.
So if I get that machine it would not make sense for me to buy a card reader for the ResMed S8 that I have unless it works on the ResMed Vpap.
Re: High pressure masks that work
Obviously.. Especially at the prices. You have waited this long. You do have data on the LED screen so it's not like you are completely blind. It is pretty good data too.charlestek wrote: So if I get that machine it would not make sense for me to buy a card reader for the ResMed S8 that I have unless it works on the ResMed Vpap.
The new S9 machines use the SD card, if you get one of those then it will be easy to use the software.
_________________
| Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
| Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/ |
I may have to RISE but I refuse to SHINE.
-
thunderhand
- Posts: 19
- Joined: Sun Feb 13, 2011 8:22 am
Re: High pressure masks that work
Do you need to use this card reader ??
https://www.cpap.com/productpage/generi ... ml?src=atg
i have one similar, but not this one.
https://www.cpap.com/productpage/generi ... ml?src=atg
i have one similar, but not this one.
_________________
| Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control |
| Additional Comments: CMS 50E pulse oximeter |
Re: High pressure masks that work
The S8 machines require this card reader...https://www.cpap.com/productpage/resmed ... -cpap.html around $100 when it can be found and then from Israel or China seller.thunderhand wrote:Do you need to use this card reader ??
https://www.cpap.com/productpage/generic ... ml?src=atg
i have one similar, but not this one.
The S9 machines use the little SD card and if the computer has a SD slot then no card reader is needed.
If no SD slot then a card reader like you show link to is used in one of the computer's USB ports. Those don't cost much at all. Generic is fine.
For the OP in this thread he has an S8 machine but it trying to get a S9 machine so no sense in spending the $ for the pricey card reader as it isn't needed with S9 machines. The S8 machines do have considerable data available on the LED screen.. just not as detailed (no graphs) as the software shows.
_________________
| Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
| Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/ |
I may have to RISE but I refuse to SHINE.