Leaks around bridge of nose with BiPAP inspiratory pressure

[martoon]

Quick background: I'm 52, male, not overweight, and have OSA due to a narrow palette and my tongue effectively being too big for the back of my mouth/throat. I've been using a dental device for about 14 years, but it's not effective enough anymore, and I'm trying CPAP. Untreated, I have an AHI of 37. It's lowered a little with the dental device (I don't know the specific AHI), but not by much, and I'm barely able to function during the day.

A few months ago I got a CPAP device and struggled for a while getting a good enough mask fit. I tried a few different types of masks, and the AirFit F10 eventually worked okay for me. But they found that when the pressure is high enough to reduce the obstructive apnea events, I have central apnea events.

I had another sleep titration study with a BiPAP, and they said they found a setting that worked for me. So they prescribed a BiPAP (an AirCurve 10).

With the higher inspiratory pressure of the BiPAP, I get major leakage around the bridge of my nose with the AirFit F10. If I lie very carefully, I can find a couple head positions that don't leak, but as soon as I start to fall asleep and my head turns, I get major leaks. It's usually when I turn my head to the side. I've tried sleeping with my head on the edge of the pillow, so the mask is off the edge, but even having the pillow pressed against the side of my face changes the shape of my face to where I get massive leaks blowing into my eyes.

I've tried the mask looser, tighter, and everything in between. It seems the only way I can keep it from leaking is to tighten to where it's painful, and this makes my face, hands, and feet go numb.

Of the different full-face masks I tried (with the CPAP, before the BiPAP), the seal over the bridge of my nose was always the most difficult. It seems they don't make a mask that really fits the shape of my nose. I tried the DreamWear full face mask, because it covers the mouth while using a nasal pillow, but my nostrils are long and narrow, and it was difficult to get a good seal there. With the rigid mouth piece, turning my head at all (even if I didn't really press the mouth piece into the pillow) would make the nostril pillows leak.

Thanks in advance for any suggestions!

[LSAT]

Go to padacheek.com and get a mask cushion for your mask.

[raisedfist]

I agree. I also recommend purchasing the Simplus mask when it goes on sale...it performs like a champ.

[Zomby Woof]

I've tried the mask looser, tighter, and everything in between. It seems the only way I can keep it from leaking is to tighten to where it's painful, and this makes my face, hands, and feet go numb.

Of the different full-face masks I tried (with the CPAP, before the BiPAP), the seal over the bridge of my nose was always the most difficult. It seems they don't make a mask that really fits the shape of my nose.

Brother-man, I feel your pain!

Our CPAP paths have numerous similarities: complex sleep apnea, AirCurve 10, F10 bridge leaks and massive headaches from mask headgear.

Without giving my complete cpap therapy history, I suggest that full-face masks are at a disadvantage for bipap users, particularly so if you have a high pressure prescription. Mine originally was 12cwp 25cwp 8 pressure support, and, the bipap function caused the F10 to dance up and down on my face like a demented spider. This cannot be helpful for maintaining a mask seal.

The short of it is this: I overrode the erroneous comments of my DME (nasal pillows can't handle high pressure) and tried the RESMED P10 Nasal Pillow mask. It handled the high pressure prescription perfectly, greatly reduced mask leaks, and with its tiny sphagetti straps eliminated headgear headaches.

Consider a trial of the P10. Our forum sponsor CPAP.com makes it easy with their 30-day return policy.

Best of luck!


BTW, you should go to your User Profile and enter your equipment and prescription deets so we all know the context of your comments.

[Kroldor]

I've tried the mask looser, tighter, and everything in between. It seems the only way I can keep it from leaking is to tighten to where it's painful, and this makes my face, hands, and feet go numb.

Of the different full-face masks I tried (with the CPAP, before the BiPAP), the seal over the bridge of my nose was always the most difficult. It seems they don't make a mask that really fits the shape of my nose.

Brother-man, I feel your pain!

Our CPAP paths have numerous similarities: complex sleep apnea, AirCurve 10, F10 bridge leaks and massive headaches from mask headgear.

Without giving my complete cpap therapy history, I suggest that full-face masks are at a disadvantage for bipap users, particularly so if you have a high pressure prescription. Mine originally was 12cwp 25cwp 8 pressure support, and, the bipap function caused the F10 to dance up and down on my face like a demented spider. This cannot be helpful for maintaining a mask seal.

The short of it is this: I overrode the erroneous comments of my DME (nasal pillows can't handle high pressure) and tried the RESMED P10 Nasal Pillow mask. It handled the high pressure prescription perfectly, greatly reduced mask leaks, and with its tiny sphagetti straps eliminated headgear headaches.

Consider a trial of the P10. Our forum sponsor CPAP.com makes it easy with their 30-day return policy.

Best of luck!


BTW, you should go to your User Profile and enter your equipment and prescription deets so we all know the context of your comments.

My DME said the same thing when I was picking up my bilevel machine. However, they agreed to let me go home with nasal pillows anyway. I have the Dreamwear gel pillows and they have been excellent for me.

[ajack]

I second going to a FFM if you can't get a nasal mask to suit. Go back to your provider and talk with them about mask fit initially. There are also youtube videos and over on apneaboard they have articles on it. Have you used the mask fit function that blows high pressure, to help fit the mask?

[martoon]

Thank you, everyone, for the replies!

I'll look into the mask cushion, and ask my doctor and DME provider about the Simplus mask.

I've tried nasal pillows in the past, but never had good luck with them. I'm a mouth breather, and I don't get good airflow through my nose. I also have a hard time getting a nasal pillow that fits the shape of my nostrils. I may give the nasal pillow another shot, though (with a chin strap).

I filled in my equipment info in my profile, but I have an AirCurve 10 ST, and that isn't an option in the profile settings (it just has S and VAuto, so I went with S).

[Julie]

Go to Cpap.com and find the mask... with pix, reviews, everything.

[zonker]

I've tried nasal pillows in the past, but never had good luck with them. I'm a mouth breather, and I don't get good airflow through my nose. I also have a hard time getting a nasal pillow that fits the shape of my nostrils. I may give the nasal pillow another shot, though (with a chin strap).

you might want to give nasal pillows another try and use a firm foam collar and this method-

viewtopic/p1089718/viewtopic.php?f=1&t= ... s#p1086296

i've been using jay's suggestion for a number of years with very good results.

good luck!