Frustrated

[bmax1985]

I've had a CPAP machine for a little over two months now. Yes I understand that it takes time to get used to but here's the story: (Sorry for long post)
Sleep study was great. Best nights sleep I've had. The guy gave me a nasal mask and I slept all night.
- During the study my pressure ranged between 4 and 6.

I got the CPAP machine which the DME set to 6. Machine is a DeVilbiss Intellipap Standard. I was given a nasal mask though I'm unsure of the brand. Mask size was small as determined by a little plastic thing that he put over my nose. It feels like it's too small to me. My doctor wanted me to use the machine for a month before seeing him again.

At the 5 week mark I was sleeping two to three hours with the nasal mask and then I'd remove it at some point during the night. Most nights I didn't even realize that I was removing the mask. Others, I'd know that I was removing it but not keep it on (I don't think it was panic attacks. Just think I got uncomfortable).
Saw the doctor who said that I was probably still adjusting but suggested I try a full face mask. This was suggested because I was having issues with allergies and my nose was stuffed up.

DME gave me a Drive Medical 'Freedom max full face cpap mask'. It came with both medium and large cushions. He discouraged me from getting a 'premium' mask like the Mirage Quattro which is what I asked him about based on a co-workers recommendation.
I don't even get two hours wearing this mask. When I put it on, it seems more comfortable than the nasal mask but as soon as the machines 'delay' time is over, the medium cushion leaks right into my eye and wakes me up. The large cushion leaks all the time. The Medium cushion just covers the edge of my mouth so I get the feeling it's almost too small. The large cushion feels like a more appropriate size but leaks. Both cushions leak no matter how I adjust the straps. I can't find any reviews of this mask but assume it's a crappy product based on other drive medical reviews.

I've decided that I won't be returning to that DME and have a recommendation from a co-worker for another DME in the area which is on our insurance.
Now I need to know if:
1. My nasal mask is too small?
2. Is there a way to stop the leaking of the full face mask?
3. Without going to the doctor and getting a prescription for another full face mask, how can I get a better full face mask like the Mirage Quattro (or another recommendation that you can offer)?
4. Without a prescription, will the other DME even talk to me about it?

Can anyone please offer suggestions? I've been lurking the forums but don't seem to make much progress in my situation. Thanks!

[kteague]

It can be frustrating getting everything to the point where things settle in and seem to be working for us. It would be a good idea to make a call to a new DME and ask what they will require. It will in part depend on what your insurance requires of them. It may get a bit sticky on whether you are changing machines, masks or supplies. Insurance usually pays replacements on a schedule, no matter which DME you are at. Is your machine in a rental period? Just do some information gathering first so you don't get caught without what you need. Yes, the new DME will need your prescription, and likely more documentation than that. The prescribing doctor should be willing to send that to the new DME.

Masks are such an individual thing. I commented on here once about a particular mask being a piece of crap and someone came in a said that mask had been a godsend to them. Go figure. It does sound like you haven't yet found the ideal mask for you, but sometimes the simplest tweaks can turn a nightmare mask to a dream mask - if the size is right. Until the TapPap mask, I'd never used a (nasal pillows) mask that didn't require an extra strap to stabilize it and reduce leaks. I just accepted it and was glad to have masks that worked with easy fixes. If you search on your mask name there's likely been discussion before on suggested tweaks. But having the right size is first. Ideally a DME would let you try a mask on laying down with the machine running at your prescribed pressure. But from what I read on here, that service is a rarity.

Sounds like it may be a process. Hang in there. Hopefully someone who has experienced this or used your mask will see this and jump in.

[Sheriff Buford]

I've decided that I won't be returning to that DME and have a recommendation from a co-worker for another DME in the area which is on our insurance.
Now I need to know if:
1. My nasal mask is too small? I don't use nasal masks, so I can't help you here.
2. Is there a way to stop the leaking of the full face mask? Yes, normally the mask is too tight, which causes it to leak. I know it feels natural to tighten a leaky mask, but I have found myself at times tightening the mask when I should be loosening. I particularly like the Mirage Quatrro because I like the cushion therory and the cushion feeling on my face. But... the first night I used it... I tightened the mask too tight and the cushion-effect was removed. That's why it is one of the few masks that you turn the machine on before donning the mask. This allows the cushion to inflate and rest on your face better.
3. Without going to the doctor and getting a prescription for another full face mask, how can I get a better full face mask like the Mirage Quattro (or another recommendation that you can offer)? There is a "Taming the Quattrro" instructions that helped me a lot. Do a search here for it. The Quattrro is either the best mask or the worst. I have read where some folks want to drop-kick the mask into the county, and some who will swear by it. On Cpap.com, it seems to be the most popular. What does your prescription say? Make sure it says "Mask of patient's choice". Normally the prescription will last one year and the DME should allow you to pick whatever mask you want. I have settled on the Mirage Quattrro and the Fitlife Total Face mask. When I get my mask replacement, I have to tell the DME which one I want. You TELL the DME what mask YOU want. See if they will allow you to return it within 30 days for a different mask. Do this until you settle on a mask you like.
4. Without a prescription, will the other DME even talk to me about it? See above...

For whatever its worth, it seems you "mask search is "normal". It looks as if you are easing yourself out of the nasal mask. Changing from one type of mask to another is a question you control and only you can answer.

Best Wishes,

Sheriff

[LSAT]

I think the DME gave you the 'cheapest' machine and mask they could find. This increased their $$$$. If you can, get your prescription and return the machine. Change DMEs.

The Drive Medical FF Mask sells for $90....The Quattro sells for $175

[bmax1985]

Thanks for the responses. I certainly didn't think about loosening the mask for better fit. I'll dig in to this a bit tonight.

[avi123]

bmax1985, I just read the first paragraph in your post. I am taking a wild guess and saying that the pressure setting on your machine is too low for proper treatment. I went thru this myself when I started CPAP three years, and when that tech at the Sleep Study Clinic prescribed for me a pressure of 6 cm on CPAP. I immediately suspected that something was wrong b/c I did not have enough air to breathe. I changed the pressure on my S9 Elite to 10 cm and felt much better. I continued with this pressure set-up for about 3 more months until I was approved for another titration sleep study and the new prescribed therapeutic pressure came out at 13 cm on CPAP.