This is so hard

[Suetois]

I've been trying to adjust to using an APAP machine since before Thanksgiving. I've tried four masks, and the doctor lowered my max pressure once (it's currently set at 8-16). I don't have any trouble going to sleep, and I don't think I'd have any trouble staying asleep, but I haven't found a mask that doesn't either leak or hurt my face.

Currently, I'm using a nasal mask because the two FF masks I tried left a sore on the bridge of my nose if I tightened them enough to stop leaks when my pressure went up to the maximum setting in the middle of the night. Unfortunately, I'm still mouth breathing part of the time (despite the DME tech's assurance that I would rapidly learn not to do that if I tried a nasal mask), so I probably need to go back to a FF mask. Also the nasal mask is causing sores *under* my nose. Another problem is that this mask doesn't handle pressure above 15 well either. When I loosened the headgear a bit a few nights ago, everything was fine until the pressure went up and the seal blew out again. *I* was sleeping through it, but my husband prodded me awake because it sounded like a whoopee cushion, so he couldn't sleep. So I tightened the headgear again.

Last night I was determined to get through the whole night with the mask on, so when I woke up because it hurt, I just wiggled things around a bit and went back to sleep. This morning the area under my nose was so irritated that it's still stinging seven hours later. Obviously, that won't do.

At the same time, I can't just give up. You can't get away with "holding your breath" for a minute at a time while you're asleep forever. Plus, I'm exhausted every day, so something really needs to be done about the situation, and that something is CPAP therapy. I know there are many different mask styles out there and maybe there's a magic one that will work for me, but I'm becoming quite discouraged about my chance of finding it. Thanks for the opportunity to blow off a little frustration here.

[Emilia]

Have you explored a Hybrid mask? These have nasal pillows plus a mouth piece. Nothing on the bridge of the nose: https://www.cpap.com/cpap-masks/hybrid-cpap-mask.php

Many on here will also tell you that using a nasal pillow mask such as the Swift FX or Swift LT plus taping the mouth is a wonderful way to go.... Use the search to find threads on this topic.

Good luck!!

[chunkyfrog]

I hate it when they say that.
I'm convinced that they make that assumption because they make more money on nasal interfaces.
Of course, some people CAN breathe only through their noses.
A lot of us do all day long; then give the mouth a turn at night.
I found the Quattro intolerable at first, and wore the micro for several months--
Until I was able to get insurance to spring for a Swift FX;
which has worked with tape and Poligrip strips--until I got my Respironics Comfortgel full face from cpap.com
Even that nearly gave me a blister at first; but I padded my beak and don't need to now,
except maybe with a new cushion.
Our hosts do have return insurance with their masks--other styles come with multiple sizes--notably the Hybrid.
Welcome to the forum.

[xenablue]

I'm only 3-months on CPAP, but have been a huge mouth-opener - I say 'mouth-opener' because I don't so much breathe through my mouth, but the CPAP air goes up my nose and out my mouth, so even the Mirage Liberty couldn't work properly.

I started using a PapCap as a chinstrap, which helped when using the Liberty, but I also used it with my Swift FX for Her. After a week or so using the Swift, noticed I'm not waking up with desert-mouth, so starting loosening the chinstrap a little each night to the point where tonight I'm going to try the nasal pillows without and see if I've trained myself to keep my big mouth shut (hubby is doubtful LOL).

Cheers,
xena

[bayourest]

I've been on xpap for about 2 mos. There is a gel nosepad that helped me a lot when the mask started wearing on my nose.I must also recommend the padacheek liner which I think helps tremendously with FF mask comfort. I no longer need the gel nose pad now that I have the mask liner. check out padacheek.com

[bradb]

My question is, why is the nasal mask irritating your skin so much? Could this be some kind of allergy? Do you have a silicone mask--I have heard they make such a good seal that it can irritate skin (like those waterpoof bandages that have such a good seal you can get a rash after half a day).

Still, don't give up. Find a place that will let you try on more masks!

[sister]

I'm only 3-months on CPAP, but have been a huge mouth-opener - I say 'mouth-opener' because I don't so much breathe through my mouth, but the CPAP air goes up my nose and out my mouth, so even the Mirage Liberty couldn't work properly.

I started using a PapCap as a chinstrap, which helped when using the Liberty, but I also used it with my Swift FX for Her. After a week or so using the Swift, noticed I'm not waking up with desert-mouth, so starting loosening the chinstrap a little each night to the point where tonight I'm going to try the nasal pillows without and see if I've trained myself to keep my big mouth shut (hubby is doubtful LOL).

Cheers,
xena

Hi xena,
I would like to ask a question ,if I may. I too have a big problem with the air coming back out the mouth and nothing I have tried is comfortable. Is the papcap comfortable? I have many chin straps that most of them don't work,the ones that do have to be so tight that I can't sleep.

I have been trying for over 4 years and have not been able to solve the leak problem.
I had the surgery,[UPPP], so I have found it impossible to train myself to keep my mouth shut,no throat back there!
Any suggestions would be greatly appreciated!!!
Would you buy the papcap again or is it really uncomfortable?
Thanks so very much!

[Wulfman...]

I've been trying to adjust to using an APAP machine since before Thanksgiving. I've tried four masks, and the doctor lowered my max pressure once (it's currently set at 8-16). I don't have any trouble going to sleep, and I don't think I'd have any trouble staying asleep, but I haven't found a mask that doesn't either leak or hurt my face.

Currently, I'm using a nasal mask because the two FF masks I tried left a sore on the bridge of my nose if I tightened them enough to stop leaks when my pressure went up to the maximum setting in the middle of the night. Unfortunately, I'm still mouth breathing part of the time (despite the DME tech's assurance that I would rapidly learn not to do that if I tried a nasal mask), so I probably need to go back to a FF mask. Also the nasal mask is causing sores *under* my nose. Another problem is that this mask doesn't handle pressure above 15 well either. When I loosened the headgear a bit a few nights ago, everything was fine until the pressure went up and the seal blew out again. *I* was sleeping through it, but my husband prodded me awake because it sounded like a whoopee cushion, so he couldn't sleep. So I tightened the headgear again.

Last night I was determined to get through the whole night with the mask on, so when I woke up because it hurt, I just wiggled things around a bit and went back to sleep. This morning the area under my nose was so irritated that it's still stinging seven hours later. Obviously, that won't do.

At the same time, I can't just give up. You can't get away with "holding your breath" for a minute at a time while you're asleep forever. Plus, I'm exhausted every day, so something really needs to be done about the situation, and that something is CPAP therapy. I know there are many different mask styles out there and maybe there's a magic one that will work for me, but I'm becoming quite discouraged about my chance of finding it. Thanks for the opportunity to blow off a little frustration here.

Some things (and questions) that jump out at me.......
Your range of pressure settings are more than likely contributing to most of your problems.
Did you have a (single) prescribed pressure?
Who came up with the pressure range you're using?
You need to solve the mouth-leaking problem.......full face mask or tape it shut.
Which full face masks have you previously used?
Are you doing nasal cleansing before bedtime?
Is your humidity setting too high? (It can contribute to nasal congestion if it is.)
Do you have the software to monitor your therapy?
Do you have any idea what your AHI, leak or any of your other numbers are?

This therapy is only "hard" if you don't take charge of it. Use some intuition, think out of the box, ask yourself "What would work for ME?", etc.


Den

[GumbyCT]

Some things (and questions) that jump out at me.......
Your range of pressure settings are more than likely contributing to most of your problems.
Did you have a (single) prescribed pressure?
Who came up with the pressure range you're using?
You need to solve the mouth-leaking problem.......full face mask or tape it shut.
Which full face masks have you previously used?
Are you doing nasal cleansing before bedtime?
Is your humidity setting too high? (It can contribute to nasal congestion if it is.)
Do you have the software to monitor your therapy?
Do you have any idea what your AHI, leak or any of your other numbers are?

This therapy is only "hard" if you don't take charge of it. Use some intuition, think out of the box, ask yourself "What would work for ME?", etc.


Den

Repeating what Den said and adding a few more.

Keep a log of what worked and what needs improvement. Start for a bed early to try new things to make the improvements.
Make notes right after waking about how the nite went. Waiting will only fade the accuracy.
The mask needs to be adjusted for your highest pressure or it will leak when the pressure increases the force on it. Take the time to do this before bed, the change will surprise you.
The less surface area the mask contacts the easier it will be to seal. Nasal pillows are the easiest to seal.

I had to learn how to breath thru my nose ,boy does that help.

Good Luck

[Janknitz]

I'll reiterate some things already said and add a few more

1. Four masks is not that many. Some of us went through as many as a dozen to find the right one. That said, if you want to keep trying with the Quattro, I have some fitting instructions in my signature below (Taming the Mirage Quattro) that may help to relive the pressure on your poor nose. Some of the following suggestions may also help.
2. You have a very broad pressure range, so when you fit your mask at 8, it's going to "blow out" by 16. It might help to narrow that range, but that requires some consultation with your doctor or a good understanding of how to set a more narrow pressure range (not for newbies). Another way to deal with this is to set your PR S1 to a steady pressure of 16 while you fit your mask, then return it to the original APAP settings. We can tell you how to do this.
3. There are many more comfortable nasal and nasal pillow masks, some people use a chin strap and or tape over their lips in order to avoid mouth breathing so that they can use these masks.
4. Make sure you learn how to read the very limited data your machine gives (average AHI and Large leak) and what those numbers mean. Consider getting Encore viewer software so you will have access to all of the data your machine produces as that will help you take charge of your therapy and work with your providers to make sure that you get the best therapy possible.

Hang in there. We've all been through this hellmoon (as opposed to a honeymoon) and it DOES get better with some focused work to knock out the annoyances one by one.

[Suetois]

Grrr. I had a nice post all ready to send that addressed the suggestions and questions from everybody, and I lost the whole thing. Grrr. So. Trying again...

Emilia--I haven't tried a hybrid mask yet, but I did try a nasal pillow at my DME the last time I was there. Having learned that I needed to fit this stuff at the upper pressure, I asked the tech to do that. At 16 the nasal pillows made my nose feel like it was blowing up like a balloon, so the tech suggested I should try the nasal mask I have now. My FIL uses a nasal pillow, though, and his max pressure is 23 (on bipap), so maybe I need to give the nasal pillow a longer try.

Chunkyfrog--I've been resisting the idea of buying masks without insurance coverage, but it's beginning to look like it's going to come to that. I can just see myself with a half dozen failures cluttering up my bedside table, though, and that would get pretty expensive.

Xena--I haven't tried a chin strap because I doubt it would help. I barely open my lips while I'm breathing, so I'd probably have to use tape. That would be a last resort for me, though. I'd much rather use a FF mask simply because it would be easier. I'm open to giving it a try, though.

Bradb--I don't *think* I'm allergic to silicon. I just don't have a problem with allergies. Besides, the only place I'm having a problem is on pressure points. It seems that a silicon allergy would probably show up anywhere the silicon touched.

Bayourest--I wish I still had the second FF mask I tried, because it was more comfortable than the nasal mask I have now. Unfortunately, the DME took it back when I got the nasal mask. I think that was related to what my insurance will let me have. We're retired military, so we have military insurance, and it's pretty restrictive in terms of what it will cover and who you can get it from.

Den--I think the pressure range is the problem too, but when I had my sleep study done I started to respond a little at 8 but still had a few apneas/hypopneas up to a pressure of 18. When I saw my sleep doctor (who's actually a neurologist) last month I told him about the problems I was having with the FF masks, and he reviewed my data and said we could try reducing the upper pressure to 16. I've tried the Quattro (not the FX) and the Comfort Gel blue FF masks. Both were totally successful at the lower pressures, but would lose seal around 15 so I was tightening the headgear to try to stop that--and messing up the bridge of my nose. I don't *think* nasal congestion is part of the problem, and I only have the humidifier set to 3. I'm not getting any rainout or anything and find that level very comfortable. I don't have the software to monitor things in detail myself--partly because I doubt I'd know what I was looking at. I do know the basic information I can get from the machine's screen.
Days >4: 25 of last 30
Large leak: 1%
AHI 7-day average: 4.3
Average 90% pressure 14.7
I think the numbers aren't too terrible, but I'm waking up all the time to reseal the mask. I'm spending about 9 hours in bed, but only 6 of those are therapy hours according to the machine. The other 3--scattered throughout the night--are mostly time I've been fussing with the mask trying to eliminate the air leaks that are waking me up or trying to get things adjusted so it doesn't hurt after a short while. BTW, I discovered that a comfortable fit when I'm upright is way too tight when I lie down, so lately I've been trying to adjust things during an afternoon nap (which is accounting for some of the therapy time). Oddly enough, I don't have leak problems while I'm napping, but I've also noticed that the pressure when I'm napping seldom goes above 11. I only seem to hit the high pressure levels when I'm deeply asleep--which makes sense because that's when I always snore the heaviest.

GumbyCT--I'm going to take your advice and start a log of what I've tried and how it worked. If nothing else, it will give me information to share with my sleep doctor when I see him again at the end of the month.

Janknitz--I know from reading here that many people go through a lot of different masks/techniques before they find something that works well for them and that four masks isn't all that many, but it feels like I've been trying and trying and trying night after night--so I'm frustrated. I'm not ready to give up, though. I did originally fit the nasal mask at the DME at the upper pressure, but that was sitting up. For some reason, when I lie down the fit changes and it's too tight to be comfortable--but if I loosen it I get air leaks. LOL about the "hellmoon" comment. It really does feel about that bad. I naively thought that I'd just get a CPAP machine, and once I could go to sleep with it, I'd quit snoring and feeling so tired all the time. I guess I should count my blessings in that at least I do find it easy to get to sleep. I see a lot of people really struggling with that very first step.

Thanks for all the advice guys. I really appreciate all of it.

Sue

[BlackSpinner]

It is probably not an allergy per see but that your skin doesn't like not being able to "breathe" or is reacting to your own secretions which can't go anywhere under the mask. I find that mask liners make all the difference.

[jmelby]

Your comment that you have irritation under your nose from your mask makes me wonder if you may need a larger size? It's not just the mask type that makes a difference, but also proper sizing.

[Muse-Inc]

...haven't tried a hybrid mask yet...maybe I need to give the nasal pillow a longer try

The Hybrid is a FFM, it comes with 3 sizes of oral cushions and 3 sizes of pillows that can sit at 2 heights. Quite a few of us here wear it from lowish to high pressures. Do not confuse it with the ResMed Liberty, also a hybrid-style mask.

Most of us also use one of these suggestions to help anchor the pillows: viewtopic.php?t=14422&highlight=

[Snore1957]

Hello
Currently using one of the Hybrid Masks. The others made me feel clastrophobic. Initially had some soreness. My lower teeth hurt then the bridge of my nose , but I figured out how to adjust it so that it doesn't hurt or leak. Finally last night slept the whole night and kept the mask on all night. I ve had my machine since new years eve. Last week I would wake up and the mask was in bed beside me. That was a downer but this week I think I may have turned the corner. Good luck. Hang in there.