Thinning silicone?

[HollyL]

Well, assuming you might have a dud, I also found my FF cushions to feel 'tougher' when I use baby wipes maybe weekly and soap/water monthly if that (to be honest).

I had read that this may be the case, but seems odd that it's just in one small patch. I think I'm probably doing something insane in my sleep and/or it just doesn't fit properly.

[zonker]

just a shot in the dark, but would a mask liner help?

[Okie bipap]

When I used the Simplus mask, I had a hard time keeping it our of my mouth for some reason. I started running two pieces of tape, one from each side of the swivel, to down under my chin. This kept the mask out of my mouth. It looked kind of strange, but it worked for me.

[rick blaine]

Hi HollyL,

From what you say, you haven't been mistreating the masks while cleaning them. And there is another possibility. It could be that both the first and second mask they gave you came from a bad batch.

One way to find out would be to switch you to another make and model of mask. Then, if it's some kind of slipping and chewing, it would also happen with that. You should go back to the sleep-medicine department. They're used to the first three months being an adjustment period.

You mention a 'four-week trial' – What is that? A period of time with an auto-adjusting machine to find out your '90 per cent pressure'? And then issuing you long-term with a fixed pressure machine?

That is the NICE recommendation, dating from several years back. Which advice is. I think, a bit niggardly. A good many sleep-medicine departments in the UK have seen the wisdom of issuing an auto machine.

And if the SMD you go to isn't one of those, you can buy your own. (With the proviso that it's a good idea to buy the same brand as your SMD has standardised on. For data reading reasons.)

If you use the search function (top left) and type in my user-name, you'll find several detailed posts on how to do that.

[palerider]

Has the NHS gone to using knock-off cushions to save money?
I have only used OEM silicone, which is far more durable.

I've never seen anything but OEM masks and parts, I've seen knockoff and low quality hoses and filters though. I certainly don't pretend to have seen it all, though

[palerider]

Are you shaving before bed? perhaps it's being abraded by stubble? (Holly could be a man's name, before anybody hits me).

Hahaha that made me chuckle. I am a non-bearded lady and I have been extra careful to remove any make-up before bed. In fact the first week of use I was so poorly I didn't wear any anyway. I don't use any face creams or moisturiser at night. Strangely I woke up this morning with the bottom edge of the silicone actually in my mouth....! I have been known to grind my teeth in the past but my partner hasn't mentioned if he's heard me doing this.

Ok, good to know.

1) I used a bit of unscented hand sanitizer on a tissue to clean my mask cushion nightly, for years. Alcohol won't hurt the silicone, and in fact may help it by removing oils.

2) bruxism (teeth grinding) is an occasional side effect of untreated sleep apnea.

If you're getting the mask in your mouth, it might not be the right size.

What I did was wash the mask weekly in dish washing soap (unscented, unless you really like the smell) and just wipe the oils off of it every night.

That might help the cushions last longer.

[juliep]

Hi everyone,

I'm a very recent user of CPAP (13 days in) and in that time, I've already had to go back to the hospital to replace a mask cushion that had torn, and my replacement is showing signs of damage now too. I have a Simplus full face mask and the silicone directly below where my bottom lip is has gone incredibly thin (this is where it tore on the first one) - I had a chest infection and terrible cough when I began treatment so assumed I had ripped it in my sleep by coughing. I have been incredibly careful to clean the mask gently with warm water and a mild soap, in fact I read that it may not be advisable to clean it every day, so I have just wiped it down the past couple of nights but it is getting very very thin.
I've got access to a drop-in clinic which is great but I can't attend until next week, just wondering if anyone has any advice?

Thanks

Holly

I use a Simplus FFM too, and it is thin by that area. But still, mine has lasted for 2 years so far. The part of the silicon seal where it connects to the plastic part is coming off at the bottom though. But I just push it back on to the small prongs.

[HollyL]

just a shot in the dark, but would a mask liner help?

I may well consider this as an option - thank you

[HollyL]

Hi HollyL,

You mention a 'four-week trial' – What is that? A period of time with an auto-adjusting machine to find out your '90 per cent pressure'? And then issuing you long-term with a fixed pressure machine?

Hi Rick,

Thank you for a very helpful reply! I'm not sure if this is standard NHS protocol now, as I know nobody personally who has been recently diagnosed with OSA. After a home based sleep study I was called back in to the Hospital pretty quickly and told that I would be given a 'trial' machine for four weeks, after which time they would assess my data. I really don't know what to expect after the four weeks is finished, hopefully a massive drop in my AHI for one thing!!!

[HollyL]

1) I used a bit of unscented hand sanitizer on a tissue to clean my mask cushion nightly, for years. Alcohol won't hurt the silicone, and in fact may help it by removing oils.

2) bruxism (teeth grinding) is an occasional side effect of untreated sleep apnea.

If you're getting the mask in your mouth, it might not be the right size.

What I did was wash the mask weekly in dish washing soap (unscented, unless you really like the smell) and just wipe the oils off of it every night.

That might help the cushions last longer.

Thank you for your very helpful responses - much appreciated!!!

[HollyL]

When I used the Simplus mask, I had a hard time keeping it our of my mouth for some reason. I started running two pieces of tape, one from each side of the swivel, to down under my chin. This kept the mask out of my mouth. It looked kind of strange, but it worked for me.

Woke up again this morning doing exactly the same thing! Bizarrely, it created a really good seal and I almost had to 'pop' it out of my mouth.
I may well try taping, thank you for the suggestion!

[HollyL]

Thank you to everyone who responded, I managed to get out of work for an hour and have just got back from the Hospital with a medium size mask now.
I was told it was likely that the small size was the wrong fit and as my jaw was relaxing, my mouth was falling below the fit of the mask - then I was probably just chewing it in my sleep!!

When I went in the first time my AHI was 10, which I was chuffed with to be honest having started out at 97.7, but likely it was 'high' because I had a chest infection and was coughing. Today my AHI was showing as 15, so there's definitely been something up. It's also the first day in two weeks I have felt drowsy at work and like I could just take a nap.

Fingers crossed the medium mask does the trick.

[rick blaine]

Hi HollyL,

In case no one's told you, an AHI of 97 is very high, and your untreated sleep apnea is 'very severe'. That's probably why they called you in so quickly.

The four categories sleep-medicine professionals use are:

0 to 5 – normal;
5 to 15 – mild-to-moderate;
15 to 30 – moderate-to-severe; and
30 and above – severe.

Those numbers are per hour. At 97, you were having an apnea every minute.

Now, as far as the 'target for treatment' goes, most sleep-medicine departments in the UK have now moved to '5 or under'. But you will find some opinions in the medical literature of ten years ago which said that: when the untreated AHI is over 60, getting it down to 10 or under is quite an achievement.

The counter-argument to that is: since the patient is going to all the trouble to be in treatment, getting the AHI down to 5 or under isn't an unreasonable thing to aim for.

Having said that, there may still be the odd night when your score is a little high. We all get those. As long as it's only once in a while. To put it another way, the average over time is what to really pay attention to.

Your profile shows the SMD has issued you with a ResMed AirSense 10 AutoSet. You might ask if you will keep that into the foreseeable future – or whether the policy of your foundation trust hospital is use the data from the first few weeks to find the pressure you were at or under 90 per cent of the time.

And then to issue you with a fixed-pressure machine set to that pressure. It's what many SMDs used to do, and what some SMDs still do.

The reason for that policy was and is to save money. In retail price terms, the difference between an auto-adjusting machine and a fixed pressure machine is about £100. And if you're buying them a thousand at a time ....

On the other hand, sleep-medicine department after sleep-medicine department in the NHS has upped its policy to 'auto-adjusting as standard'. They've done this because they have learned from experience that the extra spend improves patient compliance and other clinical outcomes.

This much is some background info. I do hope you keep logging in. So you can get the best out of your treatment.

[palerider]

An AHI of 5 is still shite, under 2 is *much* better.

[Becca8104]

I am not sure what you have available via insurance in the UK, or what the process is for requesting a different mask, but you may need to try a different make/model of mask. Very few people get the perfect mask for them right out of the gate. Most people have to try several before they get the fit & comfort they need to be successful with therapy. I have never tried the Simplus mask, but my brother has & he didn't have the thinning cushion problem with his Simplus. Unless the silicone in the UK is different than the US models, I can't explain why you are having this issue. Good luck on finding the right mask for you.